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HomeMy WebLinkAboutItem 11a - BLS Ambulance Program ExpansionDATE: March 4, 2025 TO: Honorable Mayor and City Council FROM: Chen Suen, Fire Chief By: Maria Lourdes Taylor, Sr. Management Analyst SUBJECT: RESOLUTION NO. 7619 AMENDING THE FISCAL YEAR 2024-25 GENERAL FUND BUDGET AND AUTHORIZING A SUPPLEMENTAL BUDGET APPROPRIATION FOR THE EXPANSION OF THE BASIC LIFE SUPPORT PEAK HOURS AMBULANCE PROGRAM IN THE AMOUNT OF $23,900, OFFSET BY ADDITIONAL REVENUES FROM THE EXPANDED PROGRAM CEQA: Not a Project Recommendation: Adopt SUMMARY In Fiscal Year 2023-24, the City Council approved the Basic Life Support Peak Hours Ambulance (“BLS Program”) to help address increased demand for medical services in the City of Arcadia. The BLS Program’s peak hours ambulance has improved the Fire Department's services to the community by reducing the need for automatic aid responses, reducing response times, and maximizing cost recovery. The current BLS Program was funded to operate Monday to Friday, from 8:00 a.m. to 8:00 p.m. Based on the positive experience thus far, adding Saturday and Sunday transports will further enhance the City’s ability to triage its EMS transport response, while adding cost recovery for such needed emergency services. Therefore, it is recommended that the City Council adopt Resolution No. 7619, amending the Fiscal Year 2024-25 General Fund Budget and authorizing a supplemental budget appropriation for the expansion of the Basic Life Support Peak Hours Ambulance Program in the amount of $23,900, offset by the anticipated additional revenues generated from the expanded program. BACKGROUND Over the years, the Fire Department had experienced a sustained increase in Emergency Medical Services (“EMS”) calls without adding resources to the system, leading to a substantial increase in automatic aid received by the City of Arcadia for medical transport Resolution 7619 - Budget Appropriation to Expand the BLS Ambulance Program March 4, 2025 Page 2 of 4 conducted by nearby agencies. This resulted in both an increase in response times for patients and revenue loss for the City. Medical incident calls have continued to increase, with approximately 74% of call volume now coming from Emergency Medical Service (“EMS”) incidents. An example of Arcadia’s total call volume breakdown is shown in Table A. As shown, EMS calls have increased by over 37% in the past four years alone. Most EMS calls required ambulance transport. Table A: Total Call Volume Calendar Year EMS Calls % of EMS Calls Total Calls 2020 3,286 66% 4,974 2021 3,845 69% 5,576 2022 4,283 70% 6,128 2023 4,420 72% 6,100 2024 4,525 74% 6,136 Noting the continued increase in calls requiring transport and a trend of relying on nearby agencies to respond to medical calls during daytime hours, in 2023, the Fire Department proposed the Basic Life Support Peak Hours Ambulance Program. When a neighboring agency responds into Arcadia, they benefit from the cost recovery when the patient is billed for services rendered. By providing an additional ambulance during peak hours that would specifically respond to the less critical basic life support (“BLS”) calls, the City would avoid having to rely on outside agencies and would be able to recover more of its operating costs. In addition, the BLS ambulance would free up the City’s two advanced life support (“ALS”) ambulances to more quickly respond to life threatening incidents. In March 2024, the BLS Peak Hours Ambulance Program commenced with a Monday through Friday schedule covering 8:00 a.m. to 8:00 p.m. These hours were historically the primary hours where transportation assistance was needed from nearby agencies and also allowed the City to test the benefits of the Program at a manageable scale. Since the BLS Program’s rollout, it has been operating successfully in service to the community by providing 406 hospital transports. Staffing with a cadre of part time employees has been successful and has provided a developmental opportunity for future paramedics and firefighters. In addition, the BLS Program has been more successful financially than anticipated. The Fire Department’s projected ambulance billing revenue for this Fiscal Year is $3,012,249, which is $312,249, or 12%, more than the adopted budget. The BLS program has been integral in contributing to this revenue experience. For instance, when looking at the average cost recovery for calls that otherwise would have required automatic aid, the City has retained over $346,500 in funds. Resolution 7619 - Budget Appropriation to Expand the BLS Ambulance Program March 4, 2025 Page 3 of 4 DISCUSSION While the BLS Program has been successful, the City continues to see an increase in call volume and has had to rely on automatic aid when the BLS Program is not available. Most notably, on weekends during peak daytime hours. Expanding the BLS Program from a five- to a seven-day schedule will be advantageous both functionally and financially. This increase in service can be accomplished by staffing two additional benefitted, part- time Ambulance Operators working a 12-hour shift from 8:00 a.m. to 8:00 p.m. Over the past three years, the City used automatic-aid to respond to an annual average of 84 weekend calls, or about 1.62 calls per weekend. Using this data, for the remaining 17 weekends in this current Fiscal Year (March to June 2025), it is expected that the City would necessitate a total of 28 automatic aid responses (17 weekends x 1.62 calls) without expanding the program. Should the City expand the program to weekends and retain these 28 automatic aid calls, based on the current blended average cost recovery rates of $852.46 per call, approximately $23,900 in additional recovery would be achieved. While it cannot be estimated at this time, it is expected that the City would be in a position to also respond to additional automatic aid calls on behalf of nearby agencies; thus, increasing the revenues generated under the expanded service. As shown in Table B, at a minimum, expanding the program is expected to be cost neutral before taking into account the additional revenues generated by assisting nearby agencies. Additional Budget Appropriation A supplemental budget appropriation would be required to staff the BLS Program two additional days per week. Between March and June 2025, a total of $23,900 would be required, which includes personnel, training, fuel, and uniform/gear costs (see Table B below for the cost breakdown). Table B: Additional Expenditures (March - June 2025) Category Cost Personnel (2 Ambulance Operators @ 12-hours) 18,940 Training @ 30 hours 1,913 Vehicle – Fuel 500 Uniforms and Gear 2,500 Total $23,853 This year, overall ground ambulance transport billing revenues are expected to total $312,249 more than budgeted, even before adding the two additional days. Therefore, the additional expenses from the proposed BLS Program expansion for the remainder of FY 2024-25 will be sufficiently covered. Further, for the next three months, an estimated cost recovery of $23,869 is expected to be collected from an additional 28 BLS and ALS weekend calls that would have otherwise been transported by automatic aid response. Resolution 7619 - Budget Appropriation to Expand the BLS Ambulance Program March 4, 2025 Page 4 of 4 In addition to the cost recovery, the City will also benefit from the advantages afforded by expanding the existing BLS Program, such as the reduction in response times and the City’s need for automatic aid responses. Both of these factors will increase the overall quality of care provided to Arcadia residents and businesses. ENVIRONMENTAL ANALYSIS The proposed actions do not constitute a project under the California Environmental Quality Act (“CEQA”), based on Section 15061(b)(3) of the CEQA Guidelines, as it can be seen with certainty that they will have no impact on the environment. FISCAL IMPACT With the inclusion of Saturday and Sunday transports beginning March 2025, a supplemental budget appropriation of $23,900 is being proposed for the BLS Program to fund the unanticipated personnel and operating costs for the remainder of this Fiscal Year. With the higher revenues of $312,249 from the overall ground ambulance transports in FY 2024-25, the current Fire Operating Budget will be able to manage the proposed budget appropriation of $23,900. In addition, it is expected that the cost recovery from calls covered by the expanded weekend BLS Program team will, at a minimum, cover these additional costs over the remainder of the Fiscal Year. Future costs will be incorporated into subsequent budgets and offset by future revenues from the BLS Program. RECOMMENDATION It is recommended that the City Council determine that this action does not constitute a project under the California Environmental Quality Act (“CEQA”); and adopt Resolution No. 7619 amending the Fiscal Year 2024-25 General Fund Budget and authorizing a supplemental budget appropriation for the expansion of the Basic Life Support Peak Hours Ambulance Program in the amount of $23,900, offset by additional revenues from the expanded program. Attachment: Resolution No. 7619 1 RESOLUTION NO. 7619 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF ARCADIA, CALIFORNIA, AMENDING THE FISCAL YEAR 2024-25 GENERAL FUND BUDGET AND AUTHORIZING A SUPPLEMENTAL BUDGET APPROPRIATION FOR THE EXPANSION OF THE BASIC LIFE SUPPORT PEAK HOURS AMBULANCE PROGRAM IN THE AMOUNT OF $23,900, OFFSET BY ADDITIONAL REVENUES FROM THE EXPANDED PROGRAM WHEREAS, the Fiscal Year 2024-25, the City Council adopted and approved funding for the new Basic Life Support (“BLS”) Peak Hours Ambulance Program (“BLS Program”) to help address the increased demand for medical services in the City of Arcadia and to help reduce the Arcadia Fire Department’s need for automatic aid from other agencies for additional ground emergency medical transportation services for the City of Arcadia, and thereby maximizing cost recovery for the City of Arcadia; and WHEREAS, the BLS Program was funded to operate Monday to Friday for a 12- hour shift from 8:00 a.m. to 8:00 p.m. staffed by two Ambulance Operator personnel; and WHEREAS, with the positive outcome of the program thus far, the City desires to expand the existing BLS Program by adding Saturday and Sunday transports, following the current program’s work schedule and staffing deployment, to further promote the benefits of the current BLS Program and enhance the City’s ability to triage its emergency medical services transport response while adding cost recovery for such needed emergency services; and WHEREAS, the expansion of the BLS Program was not budgeted as part of the Arcadia Fire Department’s Fiscal Year 2024-25 Operating Budget; and WHEREAS, a budget appropriation in the amount of $23,900 is needed to fund the expansion of the BLS Program for the remainder of Fiscal Year 2024-25, covering 2 the period from March 2025 to June 2025; and WHEREAS, the budget appropriation will be offset by additional revenues from the expansion of the existing BLS Program; and NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF ARCADIA, CALIFORNIA, DOES FIND, DETERMINE AND RESOLVE AS FOLLOWS: SECTION 1. The expansion of the current BLS Program by adding Saturday and Sunday medical transports following the existing program’s similar work schedule and staffing deployment. SECTION 2. The sum of twenty-three thousand nine hundred and zero cents ($23,900) is hereby appropriated, offset by additional revenues from the expanded program. SECTION 3. The City Clerk shall certify to the adoption of this Resolution. [SIGNATURES ON THE NEXT PAGE]