HomeMy WebLinkAbout1983-09-16 - City Commission Workshop Meeting MinutesMAIL REPLY TO:
P.O. BOX 25010
TAMARAC, FLORIDA 33320
5811 NOR`rHWEST 88TH AVENUE TAMARAC, FLORIDA 33321
TELEPHONE (305) 722-5900
NOTICE OF WORKSHOP MEETING
CITY COUNCIL
TAMARAC, FLORIDA
September 15, 1983
Please be advised that a City Council Workshop Meeting has been
scheduled for Friday, September 16, 1983 at 1:00 P.M. in the
Council Chambers of City Hall, 5811 NW 88 Avenue, Tamarac, Florida.
The purpose of this Workshop Meeting is to discuss the proposed
Ambulance Service Project,
The public is invited to attend.
Carol A. Evans
Assistant City Clerk
"An Equal Opportunity Employer"
CITY OF TAMARAC, FLORIDA
CITY COUNCIL WORKSHOP MEETING
PROPOSED AMBULANCE SERVICE PROJECT
FRIDAY, SEPTEMBER 16, 1983
Tape CALL TO ORDER: Mayor Falck called the meeting to order on
1 Friday, September 16, 1983 at 3:00 P.M. in Council Chambers.
ROLL CALL: PRESENT: Mayor Walter W. Falck
Councilman Philip B. Kravitz
Councilman David E. Krantz
Councilman Jack Stelzer
ALSO PRESENT:
ABSENT AND EXCUSED:
Laura Z. Stuurmans, City Manager
Jon Henning, City Attorney
Bernard Simon, Fire Chief
Ray Briant, Assistant Fire Chief
Roslyn Brauner, Secretary
Vice Mayor Helen Massaro
MEDITATION AND PLEDGE OF ALLEGIANCE: Mayor Falck called for a
Moment of Silent Meditation followed by the Pledge of Allegiance.
A notice of the meeting was read into the record by Mayor Falck
and he said the purpose of this session is to discuss a proposed
ambulance service in the City of Tamarac.
City Manager Laura Stuurmans stated that during the past four or
five years, many discussions were held concerning the possibility
of the City adopting an ambulance service and many types of
services were reviewed.
Mrs. Stuurmans explained that at the present time, the County
operates an emergency ambulance service through the City's Fire
Department, whereby in most instances the Tamarac Fire Department
is the first responder and the fire truck provides a basic life
support system, after which the County takes over to provide
advanced medical support and authorizes transportation of the victim
by a private ambulance service to the closest medical facility.
The City Manager said that what is now being proposed is a municipal
type emergency ambulance service, under which the Tamarac Fire
Department will continue to be the first responder and provide basic
life support,and the County's Emergency Medical Service will also
be present to provide advanced life support and to authorize the
City to provide ambulance transportation to the closest appropriate
medical facility, once the victim has been stabilized.
C/M Stelzer commented that he has heard a permit is required
before the City can purchase an ambulance and he asked whether a
permit has been obtained.
City Manager Stuurmans said an application would be necessary
before ambulance service could be provided to the residents of
the City, but t-he City is presentiv_.in preliminary stages and
a permit could be applied for at a later date.
Fire Chief Bernard Simon stated that a report was prepared by the
Fire Department and was distributed to Council. He said that the
first step of the present system is adequately carried out by the
Fire Department but the second step, which is the
rapid transportation of the victim to the closest medical
-1- 9/16/83
facility,is lacking at times. He further explained this statement
is verified by the Broward County Report of Emergency Ambulance
Service Violations, which indicates that for Ambulance zone 2, for
the period January 1983 to July 1983 involving 3,898 emergency calls,
the total violations were 289. Chief Simon referred to a chart
showing that these violations occurred in five categories; Responses
in ten to fifteen minutes, sixteen to nineteen minutes, over twenty
minutes, equipment and personnel. The Fire Chief said situations
such as those should be non-existent if ambulance service is provided
by the City's Fire Department.
Fire Chief Simon stated that he is not criticizing private industry
as he realizes that problems occur because a five city zone is
involved and two of those cities are larger than Tamarac.
Chief Simon stated that the subject of experience was mentioned by some
of the City residents and the Report indicates that many of the City's
firemen have experience working on ambulances; and in fact the City
now has two new employees who were previously employed for a few years
with the Randle Eastern Ambulance Service, the private company servicing
the Miami area.
Chief Simon said a letter was received from the International Association
of Firemen, which completely endorses this program as being very pro-
gressive and the International Association of Fire Chiefs concurs
with the endorsement.
Referring to a chart, Fire Chief Simon explained since 1975, the Tamarac
Fire Department has provided basic life support service to the
residents of the City. This support is provided by responding to
emergency rescue calls in the City of Tamarac. He pointed out that
the Tamarac Fire Department has a good track record and they feel
500 people are alive today because of the service provided. The
Fire Department has grown and advanced with the City through the
years and in the last six months, the Fire Department has reached
the point where service can be provided without going into large
manpower and he feels the ratio per thousand residents is economical
and sufficient.
The Fire Chief stated that if there is a fire and the vehicle is
needed, under the projected plan, it could be broken away; and the
other six cities who operate under a similar system do have times
when a vehicle is not available. Chief Simon said that pagers would
be needed to notify the personnel required if the personnel is used
at a fire and the ambulance is not being used; and all that would be
needed would be to replace the personnel. The City Fire Department
has used a system of recall many times. There are negotiations in
the contract for that purpose, and though it does cost money, it
is an economical procedure.
Fire Chief Simon said the stage has been reached now whereby this
service can be offered to the residents of Tamarac. A four year
documentation study made by Fire Central Dispatch who monitor the
Fire Department's response time, shows that in 5,500 calls through
the 911 system, there was a response time of under three and a
half minutes. He pointed out that 80% of the City is within a
response time of three and a half minutes, although there are
certain areas that would require more time. The Fire Chief explained
that of the 5,500 calls through the 911 system, 75% were calls for
sickness, accidents, etc.
Chief Simon stated that the goal of the Fire Department is to
provide the residents of Tamarac with an ambulance service that
would benefit the citizens and prove to be a more cost effective
system to enable the Fire Department to assist the Broward County
EMS Division to save lives and expedite critically ill patients
to appropriate medical. facilities. The primary objective of the
Fire Department is to save lives.
-.2- 9/16/83
/rb
Mr. Ray Munitz asked whether the $75.00 fee shown in the proposal
is included in the expense portion of the present budget of
$55,000.00 in revenue relating to this item.
City Manager Stuurmans explained that $55,000.00 has been budgeted
in revenue as anticipated receipts predicated upon a $75.00 fee.
Mr. Munitz inquired about the expenditure portion shown in the
Report and the City Manager replied that a portion of the expen-
ditures remains in the General Fund, $70,000.00 of which was
transferred to the Federal Revenue Sharing budget for the procurement
of the capital for the ambulances.
Mr. Munitz questioned the net amount of expenses in the budget
which is directly related to this particular service and Mrs.
Stuurmans said it would be an approximate amount of $30,000.00.
Assistant Fire Chief Ray Briant explained that the Fire Department
took as a guideline for the proposal being presented at this time,
one thousand responses by the Fire Department using a fire truck
under the present system.
City Manager Stuurmans referred to a chart and explained that the
figures in the left hand column represent costs to the City at
the present time; and the figures in the right hand column show
what the costs would be under the proposed system.
Assistant Fire Chief Briant stated that under the present system,
the estimated cost of disposable medical equipment such as oxygen
carried in first aid kits is $4.45 per call. Fuel costs for the
fire truck taking an eight -mile average call at 3.2 miles per
gallon is $2.86 per call. The tires on a fire truck are replaced
at a cost of $1,200.00 for a complete set, which amounts to $1.20
per call and the cost of vehicle replacement over a two and a half
year period for 25,000 medical responses amounts to $40.00 per call.
Therefore, the total amount of each call respondin4 with a fire
truck is $48.51.
The Assistant Fire Chief explained that if Council adopts the
proposal being presented today, the cost of the medical equipment
that is carried on an ambulance would be $6.38. The small increase
represents the additional equipment and supplies required to trans-
port a victim to the hospital. The fuel cost would be $1.92 per
call for an average call of ten miles. Replacement cost of tires
for an ambulance is $50.00 each which is the State contract price
to the City, bringing the average call to $.30. The cost of
replacing the vehicle over a two and a half year period at a
price of $40,000.00 amounts to $16.00 per call. Therefore, the
total price per call would be $24.60 when using an ambulance
which is owned and operated by the City, as opposed to $48.51 per
call for operating under the present system of using a fire truck.
Assistant Chief Briant stated this year through August, the City has
responded to 1,.031 calls with a fire truck. Therefore, using
1,000 calls as a guideline, the total cost to the City is $48,510.00.
1f the 1,000 calls were responded to using an ambulance, the cost
to the City would be $24,670.00.
The Assistant Fire Chief further stated that 85% of the residents
of Tamarac are covered by Medicare. Therefore, at a transport
fee of $75.00, the cost factor to the City would be plus $50,330.00.
-3- 9/16/83
/rb
Assistant Chief Briant further reported the Fire Department has made
contact with an agency who could handle the collections for
the City at a fee of 5%, which would amount to $2,500.16 for
1,000 calls, thereby making the total return to the City of
$47,814.00 as opposed to the minus amount of $48.,510.00
if fire apparatus is used.
Mr. Ray Munitz said if he understands the figures presented
correctly, the overall savings to the City would be close to
$100,000..00 if the proposed ambulance service were adopted.
Mayor Falck said that to clarify the figures presented, he would
state that Assistant Fire Chief Briant is attempting to compare
the cost to the City of using the present facilities as opposed
to using the facilities proposed today. He explained that the
cost to the City would be one-half the amount of the present
service if the proposed service were adopted.
Assistant Chief Briant referred to the portion of the Report
which relates to violations, which covers Zone 5. He said
that for clarification, he would state that last night the
Fire Department of the City of Tamarac responded to three
emergency medical calls. Two of those were at 1:00 A.M.rone of which
involved an 83 year old man. The Broward County Emergency
Medical Service filed a late charge against the ambulance
company that is presently handling the City of Tamarac. There
was a 17 minute delay in responding to the calls. At 6:00 P.M.
a late charge was filed against the provider for a21 minute
delay in responding to a call for a 71 year old man. Mr. Briant
said he feels this would not occur if the Proposed service were
adopted.
Fire Chief Simon said one of the Councilmen told him some of the
residents were under the impression that they did not pay for
the use of a private ambulance; and they now feel that if a
City ambulance was used, the City would charge them $75.00.
He said that under the present system, the residents are charged
more than $100.00 for the average call. He pointed out that
C/M Krantz went over some of the bills and is aware of the situation.
Chief Simon explained that the private ambulances are the van type,
which are State and County approved. If the City of Tamarac adopts
the use of its own ambulance service, a modular type.vehicle.which
would be approved by the State and County would be requested as the
modular type is a fire rescue ambulance and has approximately
sixty feet of additional storage as well as a lower center of gravity,
and fire protection clothing can be carried on the ambulance in
addition to a mask that would be required for a fire. This could
not be done if a van type ambulance were used.
Chief Simon stated that the City of Pembroke Parks runs an ambulance
service using a van type vehicle, and when a firefighter enters the
ambulance he is an E.M.T. only because his clothing that would be
needed for a fire is not on the ambulance.
Response time varies, as explained by Chief Simon, and the City
of Tamarac's response time is an average of 3.417 minutes for a total
of 5,463 runs and the Fire Department Central Office
can verify that figure. Chief Simon said that some of those calls
were Code 1 calls, which are park scares and things of that type.
As for personnel, Chief Simon said the cost would be the same.
The City has Safe Driver Certification,which is
necessaryfand the City has maintained physical agility since the
onset of the Fire Department. Private industry is not equipped with
emergency connected clothing on their ambulances. There could be
situations where this would be necessary. The City of Tamarac con-
forms with all regulations of OSHA. The City utilizes a ten-year
background check on all employees through fingerprints.
-4- 9/16/83
/rb
Chief Simon said with regard to turnover of personnel, the private
ambulance services are a little high in turnover, but the City
of Tamarac's turnover is nil. He said he is not aware of the
in-service training policy of private ambulance services but the City
requires a minimum of.144 hours of training, which would include
fire suppression work. About half of the City's program of
training would involve handling of patients.
Chief Simon said since the City is a non-profit organization,
it does not have to maintain a profit, as do
private ambulance services. He stated that
the basic operations of a City owned and operated ambulance service
aresomewhat similar to those of a privately owned corporation. However,
the owner of a private business is 100% responsible for salaries of
attendants. Under the present proposal, the City has offered a 4%
incentive to firefighters working on the ambulance. Therefore, 4%
of the'attendants' salaries would come out of the fee charged and
96% of the salary is paid as a firefighter, which is an ongoing
expense to the City. Chief Simon said equipment and
maintenance costs are a little lower for the City than for a
private service. In addition, the City is tax exempt on fuel whereas
the private company must pay the taxes for fuel. The private company
must pay 100% of the cost for office, vehicle and equipment
storage whereas the City would have no additional costs for
these.
The Fire Chief said that he has attempted to itemize the monthly
expenses relating to the proposed operation. The City's insurance
premiums will rise slightly because there will be more vehicles on
the road.. The cost per vehicle would reflect an increase of $1,000.00
which would include malpractice, liability and the City's portion of
underwriting its own collision insurance.
The collection rates in the City of Tamarac are very high, as reported
by Chief Simon which means that the City pays those fees, and he does
not doubt this is a problem.
C/M Stelzer asked what the insurance for malpractice covers.
City Manager Stuurmans said this is an umbrella policy for general
medical malpractice and will cover not only what the City has been
performing but also any subsequent problems that would occur and
the City would be involved in as a transporting agency. She said
when transportation is involved, thereis also an E.M.T. technician
present in the vehicle. Chief Simon said a Broward County E.M.S.
person would be in the vehicle, which would make the ambulance
an advanced life support system as the E.M.S. person would bring with him
his drugs and his certification.
City Manager Stuurmans said that Chief Simon has been discussing
the protocols which would come before the City Council and be
embraced in the terms of a City Ordinance similar to the City's
Water and Sewer Ordinance which sets administrative guidelines for
the operation of the service; and the City would draw upon the
experience of the other cities, national records and what may be
recommended as a companion to Broward County E.M.S.
-5- 9/16/83
/rb
Mr. Ray Munitz asked whether the malpractice aspect could present
a problem.
Mayor Falck stated that he thinks the amount Chief Simon quoted is
a little on the high side as he recalls that the figure in the budget
for next year on collision alone is $6,000.00 for the entire City;
and he feels this amount would be adequate to cover the malpractice
portion also. The Mayor said he has not reviewed this in detail;. but
offhand he would say he is comfortable about it.
Assistant Fire Chief Briant said the cost factor was presented to
Council for the proposed ambulance service; and he would like to
state at this time that his main concern is the patient in the
City of Tamarac,- as well as the continuing care and motivation of the Fire
Department to perform this service.
C/M Stelzer asked whether the City firefighters/paramedics could run an
ambulance service while maintaining the same level of fire protection
with only one additional staff member.
Fire Chief Simon said that paramedics are not under discussion and
what is referred to are E.M.T. personnel, and that is a different
situation. The City's paramedics are County E.M.S. personnel.
He said that at the present time, the one additional man is put on for
a work week that was reduced through contract negotiations of the
Citv Council. Chief Simon said that Tamarac's population has
increased and he feels we are low on the ratio but it is adequate.
He said the Fire Department is averaging five to six runs a day at the
present time, and 75% of those runs are not rescue runs. He said the
City has two good mutual aid contracts as far as fires are concerned
and a third one is payable to Fort Lauderdale, as well as one to
North Lauderdale.
Chief Simon said the City has a communication system and there should
be backup from the provider in the zone,and that provider would be a
private ambulance service. Within 25 to 40 minutes, the City could have
people on the scene to remove the vehicle if iiecessary, and the mutual
aid contract would not be abused.
Citv_ Manager Stuurmans said it is the opinion of Chief Simon,, who
has been the Fire Chief since the inception of the Department in 1975,that
th e Department can be a Fire Department and a Fire Rescue Unit at the
same time.
Chief Simon said he feels the proposed program should be a one year
trial program with changes being made at the end of the one year
period for whatever improvement is necessary.
C/M Krantz asked whether the Fire Department has sufficient personnel
to conduct this program.on a 24 hour per day basis without problems;
and the Fire Chief said it does.
C/M Stelzer said it is proposed that the City ambulance would transport
victims to the nearest hospital only; and he is wondering whether
the City could be sued for determining 'the . care facility to which
a patient should be transported.
City Manager Stuurmans said the City does. not make that determination
as Broward County Emergency Medical Service says patients are to be
transported to the nearest medical facility. Mrs. Stuurmans says she
is referring to life threatening emergencies.
C/M Stelzer asked whether the projected startup costs would involve
what could be a high insurance rate hike to the City; and C/M Krantz
said this subject was discussed previously by Mayor Falck.
-6- 9/16/83
/rh
C/M Stelzer questioned whether the residents of Tamarac would be
double charged by having to pay a user fee for service that was
started with their tax dollars. He mentioned that with the federal
funding of the ambulances, the startup fee of tax dollars will be
very low as the income would offset the cost.
City Manager.Stuurmans replied that this is correct; and it is
her intention after the first year of experience, to have an
accounting of the function all during the course of the fiscal
year and then move it next year after what she feels will be a
successful program, into a separate accounting, similar to an
enterprise operation.
C/M Stelzer said if the fee were reduced from $75.00 to a lesser
amount, the City would not benefit. Only the insurance companies
and Medicare would benefit from the lower fee and that would be
a double taxation. Mayor Falck said that is correct.
C/M Kravitz said he feels the presentation made today is quite clear
and he thinks it was very well done. However, there are certain
things which are still unclear and he has some questions which he
hopes can be answered either today or some time in the near future.
C/M Kravitz said that first ly,he thinks the idea of the City having
its own ambulance service is an excellent one. However-,
the present proposal is not based upon a feasibility study.
Fire Chief Simon said he would have to receive approval from the
elected officials of the City before he could go into greater detail
as relates to the proposal.
C/M Kravitz said there are questions in his mind about the startup
fund, which is approximately $90,000.00 or $100,000.00, as shown in
the budget. In addition, a Letter of Necessity from the County
would be required. He said he has taken it upon himself to check
with other cities, and ..this week he received a Report and Plan
from the City. of Ramapo,. New York�in Rockland County, which is a
city approximately the same size as Tamarac. C/M Kravitz said this
Report and Plan can be inspected by any interested parties. Ramapo
has just instituted the same type of service that the City of Tamarac
is considering. C/M Kravitz said he
is mainly concerned with the two largest items in the City's budget,
which are Police and Fire. He said he would like to obtain a feasi-
bility study to determine whether the proposed service can be offered
to the citizens of Tamarac in the same way police and fire protection
are offered.
C/M Kravitz stated that he is satisfied with the insurance aspect and in
general.is satisfied with Chief Simon's presentation, but he does
not feel it.has gone far enough. He said since a�workshop is being
conducted today, nothing will be held up. He said he would recommend
to Council that an actual feasibility study be done on this project
after which Council can see how it compares to the.presentation
made today.
C/M Kravitz said he does have Plans and Reports of other cities
which bring out many facets that should be considered and these are
available for inspection by Council or the public. The Reports show
that these cities have experienced some problems and he would like
this taken up in the feasibility study.
C/M Krantz said Ramapo can be referred to, but there are six cities
right here in Broward County that could supply the City of Tamarac
with additional information. He said he would like to stress that
the City would not be making a commitment for a five or ten vear
period, as this would be a pilot program to find out if
it works. If certain adjustments could be made at the end of the
one year period in favor of the program, it would be an excellent idea.
-7- 9/16/83
/rb
City Manager Stuurmans said she would like to stress that at
present, the City is spending $45,000.00 to do a portion of
the overall function and the residents of the City are paying
an additional amount of money to a private ambulance service
to complete that function.
Mayor Falck said he he would suggest to Chief Simon that he
inspect the Report referred to by C/M Kravitz as it might
contain something he would want to respond to before Council
must take final action on this one way or the other, which
will be on Monday, September 26, 1983.
City Manager Stuurmans said that would relate to the General Fund
portion of the project. The Federal Revenue Sharing portion falls
after that date.
Chief Simon said if he could be supplied with specific questions,
he will address them and Mayor Falck suggested that he refer to
the Ramapo Report.
Mayor Falck stated that Council must make a determination before
tiie implementation of the General Fund budget on September 26th
even though the Revenue Sharing portion falls after that date.
Iie feels Council must be apprised of what the situation actually is
to decide next -Monday whether tney are interested in the
program;and if they are interested, whatever must be done could
be included in the budget. He feels a determination must be made
by next Monday, the 26th.
The City Manager said she concurs with that point
but that the costs are in two
separate areas and one will receive final action prior to the
subsequent one.
C/M Stelzer said in addition to the feasibility study, perhaps
Council can obtain some information from the neighboring six
cities as relates to their problems or suggestions. Fire Chief
Simon said he will accomplish that.
Tape Mr. Sonny Gentile, resident, stated that four years ago he was in
2 need of medical attention, at which time the
first question he was asked by the ambulance driver was, "How are
you going to pay for this - Visa, American Express or check"?
He said at that time if he had $1,000.00 he probably would have
given it to him. He said at that time he was charged $85.00 for a
run from 82nd Street to University Hospital plus $15.00 for oxygen
he was not given and he does not recall the amount he was charged
for mileage. Mr. Gentile said he feels at this point if a survey
was taken in the City and half of the people who required medical
service were questioned, they will say that the first question
asked by the ambulance driver concerned the method of_payment and
not now the patient was feeling.
Mayor Falck asked Mr. Gentile what the distance was from his home
to the hospital; and Mr. Gentile said it was about three miles.
C/M Stelzer stated that he collapsed at the twelfth hole at the
Sabal Palm Golf Course and the ambulance took him from there, which is
the very end of Tamarac in Woodlands, about a half mile to the
hospital at Oakland Park, and he was charged $95.00.
Mr. Ray Munitz asked C/M Kravitz whether the Study he referred to
from Ramapo, contained any items that were not covered today
by Chief Simon in his presentation. as he is wondering
whether there is something which was not addressed.
-8- 9/16/83
/rb
C/M Kravitz said he is not concerned with replacement costs or
other costs. His main concern is the service to the residents
of Tamarac. He said the feasibility study that was prepared by
the City of Ramapo brought out costs as well as the proper methods
to use, and he would like to find out how the City would be affected
by these methods so that the proper determination can be made as to
the acceptance of the proposal.
Mr. Ralph Stoltz, resident, asked where the ambulances would be
stationed; and City Manager Stuurmans replied that one ambulance
would be stationed at each fire house and the one closest to his
house is located at 47th Terrace & Commercial Boulevard, which is
Station #2. Mr. Stoltz asked if Sections #1 and #2 of Tamarac
are a big distance from Station #2. Chief Simon explained that
the distance is three and a half miles from the door of Fire
Station #2 to the farthest point which is the northeast corner of
the original section of Tamarac.
Mr. Stoltz asked Chief Simon whether he has checked the fire hydrants
in that section to determine whether there is a suffici'Lnt water
supply and the Fire Chief said he has.
Mr. Stoltz asked whether the proposed ambulance would replace the
fire engine that is now being used. Chief Simon stated that a fire
truck would not respond to a call and an ambulance would respond
instead. Mr. Stoltz said he has noticed that when an ambulance is
called,a fire truck is sent out and he would like to know where that
fire truck is coming from and Chief Simon said it comes from Fire
Station #2.
Mr. John Dunne, resident, asked why there is a need for both an
ambulance service and a paramedic and he is wondering whether they
can be combined. Chief Simon explained that the proposed system
would be a three-part system, under which the City provides basic
life support, the County provides advanced life support, and the
third part is the transportation. Ile further stated that basic life
support is provided within six minutes and advanced life support is
provided in up to ten minutes.
Mr. Bernie Simms asked how he would reach the Fire Department in
the event of an emergency and the City Manager said the Fire
Department would be reached by calling 911.
Mr. Simms said that with regard to qualified E.M.S. personnel,
he had a situation a short time ago when his mother-in-law fell in
one of the apartments at the Bermuda Club and he called the E.M.S.
Upon examination, it was found not to be a life -threatening situation
and he was told to take his mother-in-law to the hospital in his
own car to avoid the charge for an ambulance. Mr. Simms asked
whether this would be the procedure under the proposed service.
Chief Simon said the City would follow the instructions given
by the advanced life support unit. Mr. Simms asked whether a person
would be taken to the hospital simply because an ambulance is called
and Chief Simon explained that the proposed service would be pro-
vided for emergencies only.
A representative of the Community Ambulance Service, a private
ambulance service, said he is a State certified paramedic and has
operated as such for the past twelve years. He said he has
experience in the type of service that is being discussed today and
regarding the statement made concerning a request for money on
an emergency call, he would state that it is forbidden by the State,
the County and his company to request payment on emergency calls;
but when a situation is not an emergency, a private company is
permitted to request payment. He said that the six cities who
are currently operating an ambulance service and providing basic
life support, advanced life support and transportation, use
personnel who are assigned to that service only and have no other
duties.
-9- 9/16/83
/rb
Chief Simon said there are not six cities involved as Pembroke
Park does not provide advanced life support and he would like to
clarify the statements made by saying that all positions in
the cities referred to are dual positions; and in every municipal
Fire Department, the rank is Paramedic Firefighter.
The Community Ambulance Service representative said the point he
would like to make is that there is no city,other than the small
city of Pembroke Parkin which the Fire Department provides
ambulance service as at those cities there is no blending and mixing
of positions. He pointed out that if Tamarac would recognize those
positions as separate and apart, an amount of $20,000.00 should
be budgeted for each of twelve employees and that totals $240,000.00
per year. He stated that his company presented the City of Tamarac
with a proposal about a year ago whereby they would offer the
complete services of eleven ambulances in addition to one advanced
life support paramedic unit and a handicapped wheelchair service
for emergency and non -emergency work, at a cost of $100,000.00
Per year. He said that in addition, his comna.ny
would also provide services to and from hospitals, doctors' offices,
nursing homes, etc. and since 80% of the residents of Tamarac are
over 65 years of age, services would be required for such situations.
Mr. Ray Munitz asked what the charges are when a resident uses a
private ambulance service and the representative of the private
company said the rates are set by the County Commission.
Mayor Falck said he cannot understand the Countv imposing rates
upon private industry and actually,it is the private comoanv
that requests the rates from the County; an application is made
and rates are either approved or disapproved. The representative
of the Community Ambulance Service said this is correct, but that
he knows of two occasions when the County offered to raise the
rates rather than subsidize a private operation.
C/M Stelzer stated that the Tamarac Fire Department does not intend
to provide private ambulance service and the service that is proposed
would apply to emergency situations only, whereby a private ambulance
would be called for non -emergency situations.
The representative of Community Ambulance Service said the amount charge
to provide service by his company is based upon insurance revenue and
subsidy. He said t-here are also people who travel through the City
that might require service and they too would be charged by
the City when an ambulance is provided. The City Manager said
a user fee would be charged in such situations.
The co-owner of the Community Ambulance Service stated that he is
a State certified paramedic and was employed by fire services for
a number of years and wasalso the President of the Broward County
Paramedic System. He mentioned that he went to school with Assistant
Fire Chief Ray Briant. He said he was employed by the City of
Lauderhill at a time when that city experienced two major fires
and he responded to both. In addition, he was with the Broward
County Paramedic System at the time a major fire occurred and
responded to that,too,and was accredited with taking a police officer
out of the burning building. He said he was also present when
an aircraft was set down in Tamarac. He said he is wondering
what the City of Tamarac would do if a major catastrophe occurred
while operating the two ambulances. He stated it was mentioned
here today that the program under discussion was endorsed by the
International Association of Firefighters; but Chief Simon did
not mention that this organization across the nation advocates that
a dual position is not beneficial to the public. He pointed out that
there is also a burnout factor involved in a system such as this one
as the personnel is constantly dealing with life and death situations.
-10.- 9/16/83
/rb
He said the proposal submitted by his company to the City of
Tamarac would require no out of pocket expense to the residents
of the City. There is no private company in Broward who is re-
quired to submit a certified year-end audit and none of them are
making money on emergency services provided.Those services are
supported by the non -emergency services. He mentioned that on any
given day his company has five or six vehicles operating in Zone_ 2
of Tamarac and it is an established fact that the cost of providing
ambulance service is approximately $150,000.00 per unit per year
which would result in a cost to the City of Tamarac of $300,000.00
for the two vehicles proposed, in addition to the requirement of
a backup vehicle for $50,000.00. He said the Community Ambulance
Service would provide the City with multiple services for an
amount of $100,000.00 per year and there is County documentation
that a private ambulance will transport a patient to any facility
as long as a paramedic accompanies the patient. If a paramedic is
not present, the company can refuse to provide transportation to
a patient's chosen facility if it is felt that the distance is
excessive or for other operational reasons. In addition, he
mentioned that Fire Chief Simon is advocating the transportation
of a victim to. the nearest appropriate medical facility, but
the residents are not told that only 10% of all calls require
advanced life support and all others are classified as routine
and that his company charges only $60.00 for a routine call and
$75.00 for an emergency run. Fie said also that there are many
incidents which require the use of two or three vehicles to trans-
port victims of automobile accidents to a hospital.
C/M Kravitz said he has reviewed Chief Simon's presentation and
does not feel that anything is being hidden from Council or that Chief
Simon is not providing all the information of which he has knowledge.
However, he is wondering whether a feasibility study would provide
answers to the questions raised by members of the private service.
The representative of the private company said it would and if
a feasibility study is prepared, he will be supportive.
Mayor Falck said it was mentioned here today that emergency runs are
not profitable to a private business and he is wondering whether the
profitable runs would be enhanced when eliminating the emergency runs.
The private service representative said his company would make
money if the City operates its own ambulance service, but the
dependency the City would place upon, his company and the County
E.M.S. would be monumental because the City will not be able to
provide services with two ambulances.
Mrs. Florence Bochenek, resident, said if the City -owned ambulance
would respond to a call and the patient refused transportation
to the nearest hospital, a private ambulance service would be
called; and she added that a resident does have that right.
City Manager Laura Stuurmans explained that while the present
proposal calls for two ambulances, provisions are made for additional
backup; and the City is presently negotiating with a representative
of the City of Sunrise who is present today, in connection with
a mutual aid contract proposal. However, the City would be calling upon
the Community Ambulance Service for non -emergency transportation if
a patient refused to go to the nearest medical facility.
Mrs. Stuurmans stated that with reference to the County document
mentioned here today which states that a private ambulance
could refuse to transport a patient, she is wondering what happens
in those instances; and the private service representative replied
that his company never refuses to transport a patient anywhere.
The City Manager said all of this is part of the protocols of the
City --of Tamarac which will be created as the City adopts its own
system.
-11- 9/16/83
/rb
Assistant Fire Chief Briant said he would like to clarify a few
of the statements made here today. He said the Fire Department
of Tamarac responds in unison with the County E.M.S. and if
instructions are given by the County personnel to transport a
patient to a particular facility, the patient will be trans-
ported to that facility. He said the E.M.S. personnel are
associated with the International Association of Firefighters.
Assistant Chief Briant said last night the Community Ambulance
Service received three calls from Tamarac which were not simultaneous,
but were one hour apart; and two of the three responses were late by
17 and 21 minutes. One of the residents called for routine service
and after waiting a full hour, called 911 and the Fire Department
and E.M.S. responded. He said situations of this nature should be
considered if the City decides to contract for private services.
Mr. Bernie Simms said he is wondering why both services would
respond, and Asst. Chief Briant explained that one service provides
basic life support and the other advanced life support; and that
the Broward County E.M.S. does not provide transportation.
Mayor Falck said he feels the discussion today brought out many
points that have been a concern to everyone and he hopes when
Council meets on September 26th, a determination can be made on
this matter.
Mr. Ray Munitz asked whether it is the conclusion of this Workshop
that a feasibility study be implemented; and Mayor Falck explained
that action cannot be taken today since this is a Workshop only.
City Manager Stuurmans mentioned that Dr. Martins of the Broward
County Medical Services is present today and she thanked him for
his time.
THE MEETING WAS ADJOURNED AT 4:30 P.M.
4ASISTANT CIT CLERK
This public document was promulgated at a cost of $88.74 or
$ 2.46 per copy to inform the general public and public
officers and employees about recent opinions and considerations
by the Council of the City of Tamarac.
-12- 9/16/83
/rb