Loading...
HomeMy WebLinkAbout1986-10-29 - City Commission Workshop Meeting MinutesMAIL REPLY TO P.O. BOX 25010 TAMARAC, FLORIDA 33320 5811 NORTHWEST 88TH AVENUE TAMARAC, FLORIDA 33321 TELEPHONE (305) 722.5900 October 24, 1986 NOTICE OF WORKSHOP MEETING CITY COUNCIL TAMARAC, FLORIDA There has been a City Council Workshop Meeting scheduled . for Wednesday, October 29, 1986, at 10:00 A.M. in the Council Chambers of City Hall, 5811 NW 88 Avenue, for discussion regarding Ambulance Service. The public is invited to attend. CEB/prh 0 Carol E. Barbuto Assistant City Clerk AN EQUAL OPPORTUNITY EMPLOYER POLICY OF NONDISCRIMINATION ON THE BASIS OF HANDICAPPED STATUS CITY OF TAMARAC, FLORIDA CITY COUNCIL WORKSHOP MEETING - AMBULANCE SERVICE October 29, 1986 CALL TO ORDER: Mayor Hart called the meeting to order on Wednesday, October 29, 1986 at 10:00 A.M. in the Council Chambers. ROLL C Mayor Bernard Hart Vice Mayor Jack Stelzer Councilman Sydney M. Stein Councilman Arthur H. Gottesman Councilwoman Helen Massaro ALSO PRESENT: John P. Kelly, City Manager A. Bryant Applegate, City Attorney Pauline Walaszek, Secretary MEDITATION -.-AND PLEDGE OF ALLEGIANCE: Mayor Hart called for a moment of Silent Meditation followed by the Pledge of Allegiance. The following meeting is transcribed as a Verbatim requested by C/W Massaro. City &ttorngy t : Mayor, I was planning to sit here today and advise you when needed, but apparently the City of Tamarac is being sued over the election items. I discussed the preliminary legal items on the ambulance contract with our City Manager so he is going to advise us to any basic legal questions even though this is a workshop and I doubt if any detail questions would come up. On the elections case as your City Attorney, I'll assure you that I'll do my best in representing the City. I feel that we are on solid ground in defending the case but again, from a legal position, even if the City is unsuccessful in defending the suit, the only thing that could happen is that you would have to order a special election and the election would be held as soon as possible on the same items. So from a legal position we will try and be successful but if not, a special election could be ordered at the direction of Council. I'd like to get back to my office because we still haven't been served and I'm trying to work on the preliminary response if that is okay. Mayor Hart: Now, before we go into this workshop, which is called for the preliminary purpose of members of the public and members of the Council discussing a proposal and adding our comments, our feelings, our suggestions to it, I just want to give you a moment of how this thing came up. I have been a little upset because this is a matter that has been going on now for a couple of years and we know that. We applied many, many times to the County for permis- sion to have our ambulances to transport people to hospitals and you know we have been turned down. At the moment it doesn't look like we can get a County approval. I do know we have two members of the County Commission and two only that are on our side. I called in Councilman Stein and I told him I wanted him to make a special effort, on my behalf, to get this thing solved once and for all because people constantly are asking me, rightfully so, questions, what is happening with the ambulances, what is happening. I said go ahead let us settle this thing once and for all. It has been going on for too many years I want it settled in the best interest of the people. Get in touch with Medics, find out what kind of a proposal they will give us and whether it is to the advantage of the people. Now, I know Medics have submitted a proposal to our City Manager and I will turn the meeting over to him to discuss and to explain the proposals that they have made and then turn it back over to the Council and the Public for their discussion. Mr. Kelly. 10/29/86 !pw City Managgi- Kelly: Thank you. Good Morning, I'd like to start this off on a positive note and wish C/W Massaro a happy birthday. C/W Massaro: Thank you very much. City Managed Kel_l_Y: Then, to follow --up on an observation that was made earlier, if you seen the play 1776, or if you haven't, there's a phrase that echoes out throughout and it seems to apply somehow to the meeting here today. George Washington is constantly writing back to the Congress and his phrase is "Is anybody there, does anybody care" and you know, the amount of attendance we have on an issue of this importance, I am a bit disappointed that there are not more people here. In regard to the proposal let me address a few points that need to be made. One, we do have an Ordinance on the books now which provides that we have a Municipal Ambulance Service. Among the things that the Council will have to address is a determination whether or not the Ordinance is to be repealed. Following up on that, the Council needs to make some of the following determinations. First, whether or not it wants to provide ambulance service as A) a municipal service, B) through a contract with a private sector or C) simply through the existing program through which Medics Ambulance is assigned the service to this area by Broward County. If this Council pursues A), which means that it will provide a municipal service, it would need to get certification through Broward County and while we have not been successful in the past, I am reasonably confident now that the City could secure that approval from Broward County for certification with a contingency or a condition and that condition being that the City implement 2 additional men per shift or 6 additional people which was proposed sometime ago by the former Fire Chief Simon. Which would mean about 140 thousand up front commitment by the City to finance and fund those personnel. There would of course be some rebate back for the service provided but the initial commitment that would be required from us for that certification would appear to be that we hire 6 additional people or 2 men per shift. The Second option, if we decide to contract with a private ambulance service, the only ambulance service with which we have that option is Medics because Medics is again, assigned this area. We are in Zone 2, Medics by Broward County is assigned coverage of Zone 2 and 3. So the only ball game in town is through the service provided by Medics ambulance. The Third option, obviously, is to simply continue the existing program through which Medics already provides us but the cost would continue to be born by the individual homeowners. Any attempt to contract would, in effect, be a subsidization by the City of that effort on behalf of the residents to minimize their costs. Now, you've had an opportunity to review the proposals by Medics Ambulance. The initial proposal for cost was and is extremely sketchy as Bryant Applegate, our Attorney, advised. We have set down with Mr. Cohen and a Mr. Craig Oden, representing Medics, also to try to refine this proposal, which again, is rather sketchy to say the least and we have come to some considerable terms. We have agreed, for example, that there would be certain non-negotiable items in the contract and those non-negotiable items would include that they have the adequate insurance, that their records be open and to be able to be audited by the City, that they secure all the necessary licenses and approvals, that they provide us with the necessary Hold Harmless and Indemnification provisions and a Resolution of disputes for any concerns about their capacity to perform. Among the side agreements that we have agreed on as 1 1 10/29/866w _2_ % preliminary is that, in no way, would the ambulance service be housed in a Municipal Complex. They would not, for instance, share a space with our present Fire Department and they have agreed with that. That they agree with me that that would not be an acceptable arrangement and we don't think would provide the good service that we need. Mr .... another term that is important that you understand is, what kind of service is it and it is limited in that what we're talking about is that they would be providing emergency service only. And we ask for a definition of what constitutes emergency service, basically, that will be that they will respond to 911 emergency calls only. We added to that clause that they would also respond to public safety agency request meaning that whether our Police or Fire Department on a determination that there was an urgent or a need for a response by the ambulance service. They would in fact respond to that, in addition to the 911 services. It would exclude baker act coverage, that would separate, which is a condition that is in most contracts with other Municipalities. We are very fortunate that Bryant Applegate has considerable experience in this field and has in fact, negotiated the contract with the City of Pompano Beach for their ambulance service and he is in touch with the attorney's who have drawn all the contracts and we are reviewing them to make sure that anything that would eventually go into a contract if one is in fact, recommended by Council and to be voted on by Council to be forthcoming, we will have that expertise. We have also added the Northwest Regional Hospital to the 2 hospitals that would be coveredr which right now, only University and the Broward Community. What we are now doing is looking at the track record, the performance and what they are going to be able to provide to us. There are specific terms, the coverage, the amount of insurance rebates, the discussion of trade- offs or selling the ambulances if that is to be a viable option. We have now 2 excellent, excellent, ambulances that are well maintained and with very little mileage on them. In review with our Fire Chief, it has been determined that we probably got some cadillacs up there, some very good quality. They did not skimp as Fire Departments do not usually do, volunteers or paid. They went out and got some very good equipment and we want to make sure that we are going to get the full value for that. So, we have the it is not real option to putting out to bid or accepting it since property and I was incorrect in any statements that I may have made to any of the Council relative to the need for us to go to bid for them because Bryant Applegate advised us that they are not real property and as such, do not fall into that requirement as far as declaring it's surplus by the Councilmen going out. Since the ambulances are not real property, that limitation is not imposed on you and you could make a determination as to Council as to how you wanted to sell or make any transactions with them. Other than that, as you probably note from his proposal, he is looking to provide service for 11 months to begin November 1, 1986. By his proposal, which would mean through September 30, 1987, and that is not acceptable. There is no way we could sit down to negotiate and come to those kind of terms in that timeframe and he is amenable to that and will extend that timeframe to whatever accomodates the City. As we have indicated at the last Council meeting, we hope to be prepared to bring a report back to you by the end of November for action by the Council to move on it. We can expedite that and would be happy to sit with Cohen and come to the terms on anything you want to discuss. C/W Masaa ro: You know it is impossible to absorb everything that I would like a Verbatim of this John has indicated this morning and discussion of Mr. Kelly's so that I can study it properly. There is much here to think over and much to be considered and we are dealing with a very, very, important subject. We are talking about the lives of our people and we better be very careful how we move 10/29/86 -3_ /pw �/ on this. So, I would like it in Verbatim so that I can come back with any questions that I might have and I would be happy to address the questions to you or I could put them in writing, what- ever Council would prefer, but I certainly want to study this very carefully. City Manager Kelly: I would like to add another observation. My initial concern, I think people know we have talked about privatization and the drift by many municipalities to try to secure services through the private sector and my initial feeling is that in many instances these should go user -fees and I am a big proponent of user -fees and for all intents and purpose that would be my initial recommendation here and in most municipalities that would be my recommendation, that the service be provided on a user fee basis. Those who use it, pay for it. This City is unique because of the demographics of the Community. This is one of the few Cities where I would be inclined to find some substance for supporting and providing this,kind of a subsidization. Because of the elderly population, the significant sizable segment of our Community it could work here. 'It would not work in a Cooper City or Davie or Coral Springs where you got a 30 year age median group. It is a viable option here. and again this is one of the reasons why this really got to be reviewed thoroughly. C/W Massaro: What is a viable option? You've lost me. City Manager Kelly: The consideration of providing a subsidization to a ambulance service for the City. C/W Massaro: A subsidization might be one thing but the very fact, you just said it, the type of resident we have here are retirees and this is a different question then a community of younger people. They would have less need than a community of retirees and that is where possibly your first recommendation, a user -fee of some sort, to help to subsidize this because I still want to know where is the money all coming from. City Manager Kelly: Fine. I am in total agreement, I want you to understand that on your position. I agree that my original position as relative to user -fees well known in another City with a a younger age group, is appropriate. Here, it has to be reconsidered because of the demo -graphics and you are exactly correct. C/W_Massaro: Mr. Mayor, I am trying to just complete this, and I am almost through because if you absorbed all the costs, the people are going to pay for it anyway in taxes. There is no free lunch and people might as well understand that right off the bat. That, whatever we subsidize, they are going to have to pay for it in taxes. May-or__Hart: Councilman Stein. C/M Stein: Mr. Mayor, I was going to address just that ... we are having a discussion and a lot of people here obviously do not have the preliminary proposal and may not even know what we are talking about. Medics is providing the service; there will not be any additional service by Medics. In other words, what Medics is doing now, they will continue to do; however, because of most of our inhabitants are on Medicare, and the reduced amount the Medicare is now paying, I think that Medics is receiving somewhere about 50 not quite 60 dollars a call. The amount that the County has allowed Medics to charge is $92.50 plus mileage, plus oxygen so that when one of our inhabitants has to call 911, Medics immediately demands payment for the difference even if they can get it from Medicare, and, I do not even know that Medics takes assignments. I think they usually require the amount L]_ 1 11 10/29/86 /pw -4- and let the people ... but if they do, it is still the difference. What we are talking here, is the difference between what Medicare or any insurance or non -insurance ... by the way, if anybody visits anybody or anybody in the City is not covered either by Medicare or insurance, they will still provide this service without any cost, if that person is a guest in your home. Now, what we are talking about is the thing that most people buy as an auxiliary to Medicare for other things. We are talking about the 30 some odd dollars that each person in this City is responsible when they go to the hospital for oxygen, mileage, etc., that is what we are talking about. At this moment, the person who calls the ambulance pays for it. 'What we are talking about is, there will be absolutely zero costs to anybody calling 911 for any emergency. Now, C/W Massaro,is correct. Medics is not going to do this as a good guy, we know that. The reason that it is possible for us to even discuss this at this time, is that we do have the 2 ambulances sitting in there and that somewhere about 90 thousand dollars, I do not even know the number, whatever number comes up, will be sufficient to pay for the 11 first months of this program so that; otherwise, we would not have it in the budget or we could not do it anyway. We would be just talking, and, yes, next year, it will probably cost ... if the City subsidizes, it will cost each inhabitant about $3.00 a year counting the fact that we have an excess of 30 thousand people in the City of Tamarac, the contractor's estimated somewhere between 88 and 90 thousand dollars. So by quick figuring that is about $3.00 each person and the City will be paying if they decide to go with this thing. So, that is a question for us to decide. That is what we are talking about, to get the first year. Next year when we renew the contract, it will cost the City 88 to 90 thousand which means $3.00 a person in your taxes, or user -fee as John mentioned. Either way, it does not really make any difference. Someone has to pay for it. So, what we are trying to discuss, which we have been trying for 3 years, is to get a service in this City so that the person is not required...as they go to the hospital to pay a fee to Medics. They can rest assured that when they get called in emergency, they will be transported without paying a cent to the hospital, whether they need oxygen or the mileage involved. That is what is on the table, nothing else, nothing special service, nothing else. The same service that we have today but without our inhabitants paying the difference. That is what this is all about, nothing else. I mean, I do not want to go into semantics about other things that we can get, that is not what we are talking about. We are talking about subsidizing the deductible, that is what we are talking about. Now if the deductible drops to $50.00 from Medicare, it still goes. There is still no fee. They will accept and collect any fees that they can from Medicare, the insurance or whoever but the person calling the ambulance will not have to pay. That is the story. Mayor Hart: Vice Mayor. V/M Stelzer: This talk of user -fees grates on my nerves when they talk about ambulances. I can understand user -fees on water, electric, telephone, garbage removal, everybody in this City uses these services and if you pay a user -fee, you pay for what you are using. When it comes to ambulances and talking about user -fees and ambulances, it annoys me. We have millions of people that belong to automobile associations so that they can get emergency road service. We have hundreds and hundreds of thousands of people that get flood insurance, tornado insurance, all kinds of insurance, those are not user -fees because you are not using, you are not having tornados and floods every day. You do not have automobile emergencies every day, you are insuring yourself so that if some- thing comes up, you would have the facility available and it would not be an exorbitant cost. Now that is exactly what this kind of a program is doing. The people that are now using ambulance service get stuck every time there is a call because Medics collects from them everything above or is allowed by Medicare. What they are thinking of providing here is, as Syd said, for $3.00 a year, us 10/29/86 -5- everybody is insured but, should an emergency occur, whether you it or not, should an emergency occur, the ambulance would be available to you. Now, that is not a $3.00 user -fee. That is, strictly you are paying $3.00 a year for insurance. Your AAA costs like 40 or 50 dollars a year. Now, if you belong to some of the cheaper towing services it costs you a little less but that is what we want to provide in the City here. We are providing insurance for all other residents for approximately $3.00 a year, you are covered any time you need an ambulance and I do not like the word user --fees. Thank you, Mr. Mayor. Mayor Hart: Before I go to the public......... C/wK,assgro: I want to speak before you go to the public, please. Mayor Hart: Before I go to the public, I just want to make a couple of comments too. They are suggestions that I would give to our City Manager, in continuing negotiations until we get this down on paper, exactly the way we want it and the comments I want to make is this. You know, when we talked it will cost $3.00, as you say, per person, in our taxes for the year which come to ... divided by twelve is what...25 cents a month, we are not talking that. The question is, does the City have an obligation to the people. I remember the statement was made many years ago by, may she rest, Golda Meir, when somebody said "Can you afford all this money for defense?" and her answer was simply, "Can we not afford it." and here is the same question. Can we not afford working something out? The interesting thing is I have 2 suggestions to make that 1) when we discuss a price for selling the ambulances, this has to be a separate deal not a swap and whatever price Medics would pay for our 2 ambulances should be subject to us securing more money from an individual, whether it is by auction or bid or whatever. If we could get more, they could have a first option to pay that price, if not, the ambulances could be sold to somebody who is willing to pay more and then the balance being paid in cash to Medics. The second thing is, I would suggest our City Manager try to work out something very similar to what we have in the BSO proposal. A renewable fee at no more than X numbers of percentage of an increase for the following year or two. Sure, maybe it will not be 5% like the other one because you are talking maybe 88 to 100 thousand dollars in comparison to 3-1/2 million, so it may be a matter of 10%, but some reasonable figure giving the City the option to renew. Questions have been asked and some people have said to me, what happens in 2 years if we do not renew this and we do not have the ambulances. What happened 2 years ago? We never did have ambulances, only bought those ambulances when we hoped that we would get approval from the County to use them, which we have not gotten. Before that, we never had ambulances and was stated Medics had the right to pick up. There is only one other thing that comes to my attention. When they originally are proposing 88 thousand, which I hope City Manager can get to a lower figure, but their 88 thousand was probably based on 2,061 planned calls at $43.00, which is the amount that is deductable or the individual had to pay. But, I am looking at figures submitted on June 12, 1986, by former Chief Simon and he estimates for the year of 1986, 3,016 calls, total calls, medical and accident calls, and based on that figure, you would be talking like 129 thousand instead of the 88 so I think all in all, I am glad, and press please do not repeat it, because then Mr. Malcolm Cohen is liable to say I want more money. I am glad he is not here because this figure is far lower than the 3,016. But these are things I believe that our City Manager should negotiate before a final proposal comes to Council for our adoption or not. The only other things that strike me very good in this proposal, of course, which has been said before, that Tamarac residents would never experience out of pocket expense for emergency transportation from injury or illness and the important thing is for those younger people ... and there is no saying that somebody below the age 65, who is not on a` 10/29/86 / /pw -6- I i Social Security or Medicare, will not have a heart attack, an illness, an automobile accident. It says with the company assuming bad debt on those citizens without governmental or private insurance, not the City resuming that responsibility but the company and also when you talk about people who are not residents... all residents of the City of Tamarac plus all guests residing in the home who need emergency transportation to the nearest hospital regardless of their ability to pay. Councilman Gottesman has not spoken yet. C/M Gottesman: I think what we said so far is quite true. There is one question in my mind. We are mandated by the County to use Medics, I think, until next year. At that time, I think if we do not renew with Medics, we would leave the door open to negotiate other ambulance services. Is that correct John? Mgypi Hart: Let John answer it. C/ CQtt%sman: I think we did discuss this partially that we would have something available to us in a year or so of being able to negotiate with other companies because Medics would be out of the picture of we did not go along with them . In other words, if we did not renew the contract. I know the zones have been defined and Medics is picked up 2 zones and that is an agreement they have with the County. Is that right?... of which we are forced to use. City Manager Kell_v: If you want to use that term. They are the only ball game in town. C1M Gottesman: There is no other ambulance service that we can go to to negotiate? Not this year, 2 years from now? City Manager_Ke. l�lv: No Sir. Unless the County changes their mind and assigns another ambulance service to the zone. C/M Gottesman: I do not know. I got an impression that that was a possibility in the future. City Manager Kelly: I am sorry if I gave you that impression, but that is incorrect. C/M Gottesman: All right, because I was thinking that maybe in terms of negotiation we have some other company to compete with Medics so that we can get the lowest price. My thinkings are only... it is based perhaps, on information that I received. V/MOtglggr: I can not understand the renewal. What do you mean by renewal? We have no contracts of any kind. Mayor Hart: Councilman Massaro, and then we will go to the public. C/W Massaro: John, I have discussed this with Medics several times. C' M n K 1 : Yes, Mr. Fegman. C/_W_Massaro: I beg your pardon. City Manager Kelly: Mr. Fegman. C/W Massaro: Yes. And their indication to me was that they would be willing to buy our ambulances and that they would not have the need for any Medics from us, means that we would not have to give them no 6 men, and that they would accept Medicare payments in full payment. City Manager Kelly,^ That is correct. 10/29/86 /pw -7- C/W� Massaro: Now, you know so far I have not heard that anything.... and in this contract, or proposals, I am using the wrong term. In this proposal, they are saying that we would give them these 2 ambulances fully equipped and they state each and everything that they expect in there. City Manager Kelly: Don't they. C/W Massaro: Don't they, but they sure do. And I do not know whether anyone has addressed that to see if they are equipped to this extend or, and I am not asking for an answer to it now, but for your consideration as you are examining this because there is an awful lot of examination that has to go into this. And if this is not already available, what our cost would be. But from what I am hearing in these different proposals, it is a far cry from what he told me personally. NAyor Hart: Before I go to the public I just want to make one other comment. When we talk about the public paying in taxes. Remember, as soon as an emergency call comes in, which happened before we bought our own ambulances too, the Broward Emergency EMS Service, and I believe that they are located at our fire stations, they respond and this is County and we are paying this in our County taxes anyway, there is no way from that. I would like to go to the public. CZM Gottesman: I know, but one further thought. I had reason to use the Medics last year. They did take assignment. They did not ask me for any money. All they asked, are we covered by Medicare. And they did take assignment. And the difference with the bill that I got from them was only about $15.00 or $18.00. It was 80 some odd dollars that I got from Medicare. Now, we are talking $43.00. I think that is an area that has got to be explored. Now, maybe the rates that is giving less this year, it is very possible, but I am saying I do recall that all I have to pay in...I got the bills and I could show them to whoever is investigating...was either $15 or $18, that was the differential between their payment. And, we did use oxygen and we were charged for mileage. In other words their total bill then was, what, $100.00 or something like that? It should be reviewed and questioned. City Manager Kelly_: Mayor, I need to make a clarification with an understanding with the members of the Council and what you read. Mr. Stein commented relative to the contract providing service to residents and guests and while that may be the intent, that will have to be negotiated because at this point, his discussion very emphatically yesterday, where limiting it to residents only. C/M Stein: This proposal says in here and guests residing in the house. Mgyr Hart: In the house. CfM Stein: That is absolutely in there. C/W Massaro: Like I said, there is a lot here that needs to be investigated. MayorHgrt: I would say I have got enough confidence that if the Council leans toward adoption to a contract along this basis and the public thinks there is a lot to it, I would depend on the City Manager to negotiate all questionable things and when it comes to the Council in the form of a concrete contract, we can then make further suggestions. But, I have that much confidence in Mr. John Kelly. At the moment, I would like to get the opinion of the public. Mr. Gerstein. Just give your name and address. I 1 10/29/86 /pw / JUICs stein: Jules Gerstein, resident of Bermuda Club, Phase A, I am speaking for myself. I think this is the best thing in a long time that came along. I think that we discussed that way, way, before and as far as I know many, many, people in this City were very happy to get something like that even they would pay the $3.00 and they know they are secured in case an emergency. They do not have to pay $118 or $120, they know they are safe with getting the ambulance and they have no other expenses. The only thing I would like to know, if somebody... this is only for Tamarac right here in our hospitals? What happens somebody hospital? Will you have any arrangement has to go to another made for them, like to Florida Medical or so on? Will they have a flat price or you will take us for a ride? ...just charge us as much as he wants. I think that would be very good if our people would look into it and see that we have a certain amount to pay and not how much they have just asking us, and then we are exposed to their goodwill and that is not too good. Mayor, Hart: John, I ... I think you can answer that from the way this is worded. Well, it says very clearly here, Medics ambulance service is willing to provide emergency basic life support tran- sportation from the scene of the occurrence to the nearest hospitals, University Community Hospital, Northwest Regional and Florida Medical Center without any determination to citizens...... CZM Stein: He is not talking about that. My answer to you, Jules, is this, 1) once you get to the hospital you have the right to call any ambulance. You understand that, you are no longer stuck with Medics. However, Medics is going to provide us with an auxiliary sheet what they will charge. You all know what Medics charged before but, more important is, you are not bound. You see here you are bound because they are the only game in town on emergency. Once you get to he hospital, the emergency is over, your doctor is in Miami, the Heart Institute, you may call any ambulance you want. Medics can not say you have use them but Medics, as part of their proposal, is going to give us a sheet of what it will cost flat rate to go to any of the hospitals that you are talking about and I can assure you it is probably going to match what every other ambulance company charges because they are going to be in competition with them. So that is an auxiliary part, you do not have to use them to go outside of the 3 hospitals, once you are in that hospital, the emergency is over or they ask that you go to Heart Institute or whereever you have to go, then you have the option of calling any ambulance to take you there. Jules Gerstein: I thank you. Mayor Hart: You are welcome. Mr. ,Shulman: Henry Shulman from Bermuda Club, John, a question to you. Is the door completely locked for further negotiations to get certification? City Manageg Kelly: No, the door is not locked at all. Mr. Shulman: Oh. It is still open. We may have certification? City Manager. Kelly: What I indicated initially among the options that we have is to continue to pursue certification, in which case, the condition that we anticipate that would put on that approval would be the requirement that the City hire 6 additional manpower for that coverage, which the Fire Chief has estimated it about 140 thousand dollars, ball park. Which would be an out front commitment by the City to initiate that service. Mr. Shulman: So, in other words, if we do get certification it is going to cost the residents money. 10/29/86 /pw -9- City Manager Kelly: Either way. Stelzer: Why can't the City file the Medicare, we can get the _V/M Medicare payment in here. So it might break even. So I would not say that it might cost the City money. City _Manageg Kelly_: I am saying up front. C/W ass4ro: That was one of the questions I asked, was the Medicare paying? They said they would take Medicare payments. M Stein: Wait a minute, you can not do it that way here. The 6 transporting additional men .... you are not counting the cost of people. You know there is insurance involved, there is tran- sporting, there is maintenance, you can not just take these numbers out of your hat. What we are saying is that in all probability, be covered by the cost of just running the ambulances will probably Medicare but not the additional men that we have to have on there, that is the whole point. We have been talking about, if you remember when Bernie Simon came, he said $75 a person. I do not is the big know if we can run the service for $75 a person, that discussion here. Can we? C Massaro: He said later we can not. M n: And he said later we can not, that is right. So now we need the 6 men. C/M Gottesman: Well, he also said no additional manpower. C/M in: Right, and then he said 6 men. I think what the Council has to get in ... do we want to be in the ambulance service business, that is really the story, because the Fire Department is still going to be there. We are not closing out the Fire from the Fire Department. We are taking ambulance service away We it strictly in the hands of a private Department. are putting ambulance company. That is the whole story. So I think that is .... you brought the question up. one of the decisions as John made, one of the three we have to make, 1) do we want to be an ambulance service, if no, then do we want to subsidize or we just want to say "you guys pay your own and leave this alone", which we had up until now. Alright, that is true because our ambulance service does not transport. We are not licensed to transport right now. Medics is doing the transportation. The Fire Department does come to the scene but they are not allowed to transport and they are not paramedics. Number one, the County sends the paramedics right now. So, I think what you are asking is a viable question and I think that is why it is here because the Council is trying to seek a way whether they want to even if they could get service, which we are not guaranteed at all. And, even if we could, do we want to be in the ambulance business or, as most other Cities are going to privatization, allowing a private company to do it. We know our fixed cost. We do not have insurance, we do not have negotiations with additional men, you have to remember, and it is all very nice to say 140 thousand a year, that is this year. Next year, when the Firemen come up to renegotiate their contract and their pensions, it becomes a different number. Nobody is going to 140 thousand give us a guarantee that for the next 10 years it is to. So, I think all those dollars any more than Medics is going factors, as Helen said, have to be considered and that is what we will do before we come back and say something. We will consider all the options, all the discussions and, by comparison, and then come back and say this is what we thought we should do. M t: i just wanted to add, it is easy to say the only additional cost if we got certification will be 6 additional Fire Department personnel and it is more than that. You are not going to have a service that is going to file Medicare and collect Medi- care and everything else without costing us additional clerical. So all these things will have to be taken into consideration. The only other question I want to raise is as far as certification. ge 10/29/86 /pw -10- Sure we can continue. Now do not forget, we have been trying to it for a couple of years. My personal opinion is as long as the board, which must summit their recommendation to the County Commission, consists of the owners of the various ambulance service their recommendation will not go, or their recommendation will not be for us to compete with them. I have also spoken personally with most members of the County Commission who would have to approve their recommendation and I can assure you this way, we only have 2 County Commissioners who would be on our side at the moment. So I doubt personally, if certification is ever going to come through. I believe, Mr. Fenichel, you asked for the floor. Mr. Shulman: I am not through, Mr. Mayor. Mayor t• Oh, I am sorry. ME, Shulman: Then I would humbly suggest to the Council that we drop all efforts for certification. I know one unit owner in Bermuda Club payed $500.00 for ambulance service. It is not $100 or $120, it can go as high as $500. So, I think the smartest thing for us is to drop all efforts on the certification and let the City subsidize. Some people will use an ambulance 3 times a year, some people will not use it for 10 years. CZE s Some will never use it. I still say to John, please do not forget the discussion with Mr. Fegman on the basis that he was willing to take it with no cost to us other than the money that he would get from Medicare. And, he was going to buy our ambulances. Irving F c : Irving Fenichel, Section 14, as a previous operator of the West Broward ambulance in the City of Tamarac, since 1972 and 73, I think Mrs. Massaro will remember me when I brought in the first ambulance in the City of Tamarac. Which at that time, we were being served by a funeral home where the people did not know if they were coming or going. In 1983, the Council saw it fit to make me Chairman of the ambulance feasibility in the City of Tamarac. As a professional, I discussed with the City the feasibility of bringing in the 2 ambulances into the City of Tamarac and all the knowledge that I had of operating for the past few years an ambulance in the City of Tamarac and then I came back before the City of Tamarac and gave them my concept of the ambulance, which the Council at that time approved the concept and I think in 1984 a Resolution was adopted by the City Council specifying at that time that we will charge the residents of the City of Tamarac a flat fee of $75. There will be no mileage involved, there will no oxygen involved and at that time we did not have the population like we have now about 33 or 35 thousand people. I think that we have the 2 best ambulances that can be bought for money. I remember when I went up to Orlando to buy the 2 ambulances and outfit them. I know what I paid for them and the equipment that we have in these 2 ambulances I think Medics does not have 1 ambulance completed, updated with all the equipment that we have in there for any type of emergency that we have in the 2 ambulances. I would compare those 2 ambulances with the County's ambulances that have 1 station in Fire House 2. Second of all, as was stated tonight ... this afternoon... the reimbursement of Medi care, which we have in our Resolution that as far as collecting, a private contractor will be hired by the City and, at that time, we brought in approximately about 5% of collectable fees that we would collect from the individual. Second of all, as a previous owner of ambulances, the people are told with their paramedics, regardless if they have a cardiac arrest, we had one of our previous Council- men.... Mayor Hart: Ray Munitz. Irving Fenichel: Munitz... his wife had a coronary attack and the paramedics told them that they would not leave him ... leave her out of the ambulance unless they got paid for it. And this is the way 30/29/86 /pw .� -11-- they operate to this very day. And in my opinion, I think that with the City of Tamarac and with the Broward County Commis- sioners ... now, before your Mayor became Mayor, he was down several times with Ray Briant, our former Fire Chief, Bernie Simon, and they denied us this certification. Our previous Attorney, Jon Henning, said to the Broward County Commissioners, "Gentlemen, what do you want from us to be certified", and they stated, "Well, we do not want to fragment the system that we have." And, he explained to them, "Why do you certify 11 other Cities that we have in Broward County. Why are we denied the certification?" and this has been going on for almost 3 years. And, a matter of fact, in the Council with, I think, last year, the Council approved that if we have to go into litigation, they will put a cap up to a 10 thousand if we have to go into litigation with the Broward County Commission. And, I see no reason why we should not be certified and have our own ambulances, which I think we can do a better job than the private sector can do. They are having their units, which cover sector 2 and 3. They cover 5 Cities and, as Ray Briant has stated, our response time is much better, much faster and, although we have the County ambulance, which stabilizes the patient, we do the transport but we are right on top of them that if they stabilize them we can bring them to the nearest hospital. Thank you. Mayor Ugrt: This gentleman in the front. Mr. Land man: Morris Landsman, Bermuda Club. It seems to me although I did not read the contract, it is very attractive and I certainly feel we should go ahead with it. But, there are certain items which I think we ought to look into. When signing the contract, we should try to get at least 2 years on it if possible, at this rate or the option of renewing possibly for the cost of living index so we know at the rate it is going. We know where we are going to go in the next few years. The negative conditions in which I want to ask I think, were proposed by the previous speaker. He told us why we should not enter and, of course, if there is for it or against it, we should consider that also. And my question, when we call 911 now we always get the Fire Department as well as the Medics coming in there and the Medics come from the County. If we go into contract with the Medics now, will the Fire Department still come in on the 911 call? Mayor Hart: No. Mr. Landsman: They will not? In other words, Tamarac is out of the picture completely. Because I notice that when we dial 911 at the Bermuda Club the Fire Department is right there. Sometimes it takes a minute or two before the others come and those minutes are very important to us. I was wondering how we could still work them together, I do not know. 9ZM Stein: Mr. Mayor, I want to make one correction. Everybody said no. The Fire Department will respond only in cases of accidents. Alright? In other words, they have the Jaws of Life, etc., in order to get somebody out as well as the Police Department responds to those. But in medical they would not respond anymore. Mayor Hart: Yes, sir. Irying Lopatgy: Irving Lopatey, Lime Bay. The talk of private operator versus City operation. We have been talking about City operation of ambulance service since 1983. I do not know how many hearings have been held before County Commissioners, I have spoken to the County Commissioners and I get the same answer that Mayor Hart has received about they have gone as far as they intend to go in fragmenting the service. If they go any further they would not be able to get any service. And, I would suggest that we continue to move on the present track and let us get something as rapidly as possible instead of waiting another 3 or 4 years in hope that the County will okay our running our own ambulances. 10/29/86 /Pw -12- F� 1 I Maygr Hart: Thank you. I just want to make one other ... one comment, I believe Irving Fenichel said it. It is possible in negotiation when he said we have the finest ambulances far better equipped than Medics, that it is possible that Mr. Kelly can work out in his agreement that if Medics purchases these 2 ambulances they may be the 2 ambulances that could be used in our City. That is a matter of negotiations. C/M Gottesman: Mr. Mayor, included in the material that we have received regarding this proposal was a review by our Acting City Fire Chief in which some of the items be discussed were not very complementary to Medics. I also further understood that he spent yesterday down at the County Commissioners, some place to check to see if they have improved any of these. I wonder if he has any comments that he might offer to us. Sitting now where we can hear his comments if it changed. Mayor HAIL: After all the public I was going to ask Ray Briant if he had any further comment. Ray Bri nt: Ray Briant, Acting Fire Chief. City Manaspr Kelly: May I prep this before Mr. Briant comments? I agree with your initial observations about the previous report. I have received the latest report and relative to the contents, that is part of my negotiating fodder, if you will, and I would prefer not to have it specifically discussed at this point. It is negotiating.... if it is not complementary to them than that is certainly to our advantage in any negotiating posture that we may take and we will assure that it will be corrected. C M Gottesman: Yes, but it also might be detrimental to the people. cij;v manager K,: Well, then we would not get the service. Ray Briant: I believe Mr. Kelly answered the question. What I... the information I picked up, I submitted to John Kelly, our City Manager, and I am sure that he will be in touch with Council and maybe to negotiations with Medics and I would not want to discuss some of the facts that maybe we did receive yesterday for it might hurt some of the contract negotiations. C M Gottesman: Alright, okay. I will accept that but I was just going by the report that I got earlier this week, you have some new information which you want to submit to us at a later date after you had a chance to talk. Fine, there is nothing wrong with that as long as we do receive the information. Mayor Hart: Any further public comment. Councilman Massaro. ('/W Massage: Yes, there are 2 questions...2 subjects that I would like to have John address and 1 is the Hold Harmless because, from Mr. Applegate, he has indicated to me that this was a useless thing because they still would sue the City anyhow. And so, I do not want to attach too much emphasis on that. Although it might be good to have it in there, I do not think that we should mislead people by thinking that we would be held harmless because we would not, according to our own Attorney. And, the second thing I want you to remember, please, is that I know of at least 3 people that are suing the ambulance people because of someone dying on the way and they held them responsible for the way they have handled the case. Now, I just want to keep that in our minds, if the City takes it over, what kind of responsibility are we letting ourself in for. 10/29/86 V /Pw -13- r City Manager Kelly: Very good point. The one aspect that was not brought up before when you talk about the relative cost and obviously the risk management aspect of the insurance, could probably far exceed any salary cost for personnel or bookkeeping people. C/W Massaro: That is why I wanted to bring it to your attention. Mayor Hart: I would suggest at this time if the public has no further.... just listening to the comment of the public. And, I believe to most of our Council people. I would suggest that the City Manager continue his negotiations and, as soon as practical and possible, bring to Council a suggested contract for us to either approve or tear apart and deduct and all along the lines of what we have discussed. C/W Massaro: Mr. Mayor, with all due respect to you, please. I do not think that we are ready for that. I think the next thing that should come to us again is a proposal and if the Council finds that acceptable, then the City Manager goes and sits down and prepares a contract. I think it much too serious to just go into a contract. Mavgg Hart: The proposal has been made and it is up to negotiate. C/M_.Stpin: There are 2 things I want to straighten Helen out. Maybe if we do it in ... it is not only for the ambulances but she continues to... says the Hold Harmless Agreements are worthless and take my word as an attorney, they are not worthless. Okay? C/W Massaro: Well, I will take our City Attorney's word. (;/M Stein: He did not say that either because that is what he said and I am going to quote him, "It does not stop anybody from suing the City", that is correct. If you have an insurance policy with any insurance company, they have a right to sue you and they usually do sue you but the insurance company comes in and picks up the liability. What Bryant is saying ... it is more important to see how much insurance they have then the Hold Harmless, because the Hold Harmless without a back up of insurance only means that Medics is guaranteeing it and they may not be worth a quarter. So that is what he is saying but I would not want to do this without a Hold Harmless because then, his insurance company will not come in. They will say you are liable, do it. So the Hold Harmless does have a reason but it should not be the primary thing, it is the secondary thing. What is primary is how much insurance does Medics have, what will we require and what does every other City have. The second thing Mr. Mayor, you know when Helen says we could have another proposal instead of a contract, I do not know what difference that makes. If he submits a contract and we want to cut the contract apart again, we will do it anyway so what difference a proposal or a contract, to me they are identical. I would like to see the proposal in a contract form because then if I do not like some of the crossing and the is that are not dotted, I can say so. If I have a proposal, I am liable to say I like this and come back with a contract that I do not like so I have no objection, Mr. Mayor, to your suggestion that it be a proposed contract ... not a contract...obviously, and then each member of Council can give their objections or corrections they want to of the contract. CZE M ss ro: Mayor Hart: Mr. Mayor. Vice Mayor. V/M Stelzer: Is it all right if I get 2 cents in for a minute. CZN MgIssago: Absolutely. You have my permission. V/M Stelzer: I do not need your permission,. I need the Mayor's permission. g/W__-ii.saro: You have mine too. 10/29/86 198641/pw 1 P-J, r-J -14- M zer: I would like to point out something additional that Irving Fenichel was talking about. When this proposal came up in 1983 or prior, Bernie Simon, the Fire Chief at the time, assured the City it would not cost the City one cent if we went into the ambulance business. As a matter of fact, he said in 2 years we would get enough additional income in to pay off all the ambulances. Now that has changed. In a couple of years it has changed. Now it is going to cost us 140 thousand dollars only for the 6 people. Now, John has already mentioned to you and Syd has touched on it, this insurance is a tremendous item. The doctor's are complaining about the malpractice insurance, we will have the same problem here if we do go into our insurance. The other item I would like to talk about John, is in talking about the tax 3 ambulance vehicles that they want free and clear title to, do they seem fully equipped, to mean all items included at time of purchase? I can understand that. They buy an ambulance as is. But then they go through and give us 5 or 6 lines indicating equip- ment that is supposed to be in an ambulance. I do not know if we have this in the ambulance or not, but further down they say if the equipment is efficient then they have the right to seek compen- sation. Do they mean we have to put the ambulances with whatever they are listing is in their proposal or do they buy the ambulance as is? Because I would not like to see that we now have to go out and put further equipment into the ambulances to come up with what they want. Let them put their own stuff in. City Man er Kelly: All we are doing now to assure that we are getting full value for the ambulances. The Fire Chief is going out and making inventory of all the equipment that we have on it get- ting some quotes around the community and throughout the State relative to the cost, whether it is appreciated or depreciated, whatever, so that we will assure that we are going to get the real evaluation. C/M Gottesman: It may have gone up. C n: He said appreciation. r: What I mean, John, we do not have to put additional equipment to meet their core. C/M atein: No. Well then this whole pack I feel should be dumped out. CYMt in: We know that. We know that. Maws Hart: If there are any ... no further comment, I think we will leave from this point on to the matter of our City Manager and City Attorney in drawing up a proposed contract to come back to the City after negotiation. Thank you for attending. Meeting adjourned at 11:05 a.m. ILARRY PERRETTI ACTING CITY CLERK "This public document was promulgated at a cost of $133.74 or $3.73 per copy to inform the general public and public officers and employees about recent opinions and considerations by the City Council for the City of Tamarac". 1 10/29/86 198641/pw _15-