ORDER N0.29289 EMS CONTRACT CITY OF KERRVILLE Came to be heazd this the 25`h day of July 2005 with a motion made by Commissioner Letz, Seconded by Commissioner Williams, the Court unanimously approved by a vote of 3-0-0 to approve the counterproposal to the City of Kerrville for EMS service as modified, and authorize the County Judge to provide a cover letter for the proposal and fax to the City this afternoon. a ~~Z~ ~ COMMISSIONERS' COURT AGENDA REOUEST PLEASE FURNISH ONE ORIGINAL AND NINE COPIES OF THIS REOUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT. MADE BY: Jonathan Letz MEETING DATE: July 25, 2005 OFFICE: Commissioner, Pct. 3 TIME PREFERRED: SUBJECT: Consider and discuss EMS Contract with City of Kerrville. EXECUTIVE SESSION REQUESTED: NAME OF PERSON ADDRESSING THE COURT: Commissioner, Pct. 3 ESTIMATED LENGTH OF PRESENTATION: IF PERSONNEL MATTER -NAME OF EMPLOYEE: Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter 551 and 552, Government Code, is as follows: Meeting scheduled for Mondays: THIS REQUEST RECEIVED BY: THIS REQUEST RECEIVED ON: 5:00 P.M. previous Tuesday. All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will be appreciated and contribute towards you request being addressed at the eazliest opportuniTy. See Agenda Request Rules Adopted by Commissioners' Court. Based on our workshop I feel we should discuss this and attempt to develop a counter offer to the City of Kerrville per their request. Consider and discuss EMS Contract with City of Kerrville. Based on the documentation provided by the City of Kerrville 26.11 % (based on information provided the City on May 3, 2005) and % based on of the EMS runs are made to the county. I feel customer usage is the most accurate measure of service because of the following: Dispatch costs are essentially a fixed cost. Management and administration costs are essentially a fixed cost. Building and infrastructure costs are essentially fixed costs. Labor costs have a variable component based on a number of calls and length of calls. Vehicle costs have a variable component based on number of calls and distance of runs. The city provided no data that indicated run cost in the county was higher than in the city other than the length of time and distance of the EMS run. The city data states that 50.90% of the actual time EMS units were dispatched for EMS runs in the county. However, the city provided no data concerning the location of the runs within the county. Based on population distribution the majority of the calls in the county were likely in the ETJ where run times should be similar to within the city limits. The county has taken action or is negotiating to reduce City of Kerrville EMS coverage in some of the remote areas of the county, far west and far east. Therefore, the run times in the county should be reduced in the future. I propose the county pay 25% of the EMS proposed budget shortfall which is in line with the usage in the county and the county pay a mileage or distance surcharge of $5000. The city shall keep accurate records of all runs in the county and the location of these runs and in future years this surcharge will be replaced with a per run surcharge for all runs in the county. ~. ~~ POINTS TO BE CONSIDERED IN COUNTER PROPOSAL 1.) Revised User rate fee structure should include: a. Capital Replacement Costs b. Admn.Overhead c. Medicare/Medicaid disallowables d. Bad debts e. Operational Expense f. Other Expenses 2.) a. Dispatch is a fixed cost and should not be included in calculations. b. 5% fund balance should be eliminated from cost calculations. 3.) Agree on a new county service area map to identify primary and secondary call response. 4.) Develop formula for mileage into county in excess of average distances for round trip city calls. Establish zones, if helpful. 5.) Kerr County to continue funding for Medical Director,1st Responder Program and EMS office space lease. 6.) Kerr County will be responsible for collections of delinquent accounts for service provide to county after 90 days. Kerr County will also entertain doing collections of delinquent accounts attributable to city service deliveries. 7.) (a.) Kerr County will pay up to 25% of any projected system shortfall (b.) County should excess mileage in ETJ and/or zones. KERB COUNTY COUNTER PROPOSAL TO CITY OF KERRVILLE REFERENCE EMS 1.) Revise User Rate Fee Structure to reflect aUser-Pay System that will include: a. Capital Replacement Costs b. Admn.Overhead c. Medicaze/Medicaid disallowables d. Bad debts e. Operational Expense f. Other Expenses 2.) a. Dispatch is a fixed cost and should not be included in cost calculations. b. 5% fend balance should be eliminated from cost calculations. 3.) Agree on a new county service azea map and identify primary and secondary call response areas. 4.) Develop formula for mileage into county in excess of average distances for round trip city calls. Establish zones, if helpful. 5.) Kerr County to continue funding for Medical Director,1st Responder Program and EMS office space lease. 6.) Kerr County to review ability of Kerr County Collection Department to collect delinquent accounts for service provided to county EMS users after 90 days. Kerr County will also entertain doing collections of delinquent accounts attributable to city service deliveries, if requested. 7.) (a.) Kerr County will pay up to 25% of any projected system revenue shortfall based on incorporation of above revisions to fee structure. This percentage is based on statistical use percentages presented to Kerr County. (b.) County will pay excess mileage for service calls in county as calculated in ETJ and/or zones as established. L7U ~•0S ~ ,v> PUBLIC PARTICIPATION FORM FOR KERR COUNTY COMMISSIONERS' COURT Instructions: Fill out all appropriate blanks. Please print or write legibly. Present to the County Clerk prior to the time that the Agenda Item (or Items) you wish to address are discussed. Name ~~ (~ ~ . ~i/j9.t/f Address: /~p~9~ ~©~a/ ~//P¢'idL / I ~~jQd~//-~ '~d L.8 Telephone: (Ca J ®) ~/ t~ ~i J~~O J~~ Place of Employment: Employment Telephone: ~1 Y'"'° Do you represent any particular group or organization? Yes ~ No ~~. If you represent a group or organization, please state the name, address and telephone number of such group or organization. Which agenda Item (or Items) do you wish to address? ~ ~ 2 In general, are you for or against such Agenda Item (or Items)? For Against ~/ ,d~ Signature NOTE: This Public Participation Form must be presented to the County Clerk prior to the time the agenda item(s) are discussed. Once you reach the podium, please state your name and who/what you represent clearly for the court reporter to accurately record who you are. ~~ 1 L~ PUBLIC PARTICIPATION FORM FOR KERR COUNTY COMMISSIONERS' COURT Instructions: Fill out all appropriate blanks. Please print or write legibly. Present to the County Clerk prior to the time thatpt~h~e A/genda Item (or Items) you wish to address are discussed. Name: GVI,~/. /~ ,/~ >~a~~ Address / d c~ C'l~7T,C E ~~ rL ~ 7 Telephone: Place of Employment: Employment Telephone: Il~~ (/~C',Cl~ Do you represent any particular group or organization? Yes ~No If you represent a group or organization, please state the name, address and telephone number of such group or organization. 3Z~ ~Lyti~,~lu1S%~ ,~~2 ~~'~UR~~ F Ti Which agenda tem (or Items) do you wish to address? ~%IG - / ~/C - ~ 2 3 In general, you for or against such Agenda Item (or Items)? For ^ Against f, lG-- cuR~~~~ -,t%~R cc,>Pf~~~ ~,~ / , 23 ' ~~+SS ^~ '~F~ 1~ Co~~'~) c7 Signature ins r7E1 Q ~T NOTE: This Pu61ic Participation Form must be presented to the County Clerk prior to the time the agenda item(s) are discussed. Once you reach the sodium, please state vour name and who/what you r_Cpresent clearly for the court reaorter to accurately record who you are.