City of Alexandria, Virginia
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MEMORANDUM
DATE: MARCH 26, 2024
TO: THE HONORABLE MAYOR AND MEMBERS OF CITY COUNCIL
THROUGH: JAMES F. PARAJON, CITY MANAGER /s/
FROM: JAMES SCHWARTZ, INTERIM FIRE CHIEF
DOCKET TITLE:
TITLE
Public Hearing and Second Reading of an Ordinance to increase the Ambulance Service Charges by amending Article J (SERVICE CHARGES FOR CITY AMBULANCE AND HAZARDOUS MATERIALS INCIDENT RESPONSE SERVICES) to Chapter 2 (TAXATION) of Title 3 (FINANCE, TAXATION AND PROCUREMENT).
BODY
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ISSUE: Consideration of an ordinance to increase ambulance transport fees to coincide with cost increases in the EMS System. The higher rates, which are based on the levels of service provided, will allow the City to offset a higher percentage of EMS costs.
RECOMMENDATION: That City Council consider the proposed ordinance (Attachment 2) on first reading and set it for second reading and public hearing on April 13, 2024, and final passage on May 1, 2024, with budget adoption.
BACKGROUND: This memorandum provides detailed information regarding a proposed Ambulance service fee and per mile charge increase for FY 2025. The last time the City of Alexandria increased fees was in 2021.
DISCUSSION: Since the inception of fees, EMS transport fees, or user fees, have helped recover part of EMS service, but the cost of EMS transport service has always exceeded the amount charged for this service. Staff recommends that ambulance transport fees be increased, since they have not been increased since 2021.
The ordinance provides definitions of Basic Life Support, Advanced Life Support (Level 1) and Advanced Life Support (Level 2). When a patient is transported to a hospital/medical facility, the proposed ambulance service fee schedule will be one of the following:
• For Basic Life Support (BLS): Proposed New Fee is $750. Basic Life Support is the transportation by ground ambulance vehicle and the provision of medical supplies and services without Advanced Life Support intervention.
• For Advanced Life Support, Level 1 (ALS-1): Proposed New Fee is $1,000. ALS-1 service is the transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including the provision of an ALS assessment and at least one ALS intervention.
• For Advanced Life Support, Level 2 (ALS-2): Proposed new fee is $1,200. ALS-2 service is the transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including: (1) at least three separate administrations of one or more medications by intravenous push/bolus or by continuous infusion; or (2) ground ambulance transport and the provision of at least one advanced life-saving procedure.
In addition,
• For all transports, the proposed new fee of $18.00 per mile (an increase from $12.00 per mile) will be charged based on the number of miles a patient is transported to a medical facility.
In summary, these service charge proposed increases would be:
• BLS Transport to $750 from $600
• ALS-1 Transport to $1,000 from $780
• ALS-2 Transport to $1,200 from $900
• Ground Transport Mileage (GTM) to $18 per mile from $12 per mile
A large portion of the billed fees are paid for by insurance companies and Medicare. The intent of the City’s BLS and ALS fee policy is to have (1) rates that are close to the cost-of-service provision, and (2) have rates comparable with Arlington and Fairfax since with mutual aid an Alexandria resident may receive service from an ambulance dispatched from another jurisdiction (and vice-versa). This proposed increase would bring the City’s fees mostly in line with Arlington and Fairfax.
FISCAL IMPACT: Increasing the Ambulance Service fees is projected to generate approximately $1.1M in additional revenue each year. The new fees will be effective for services rendered on or after July 1, 2024.
ATTACHMENTS:
Attachment 1 - Ordinance Cover
Attachment 2 - Proposed Ordinance
STAFF:
Yon Lambert, Deputy City Manager
Travis MacRae, Senior Assistant City Attorney