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.
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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
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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
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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
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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
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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
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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.
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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.
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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.
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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
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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
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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.
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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.
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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.
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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".
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