February 13, 2018
MEMO TO: Mayor Barber and Board of Commissioners
FROM: Frank A. Rush, Jr., Town Manager
SUBJECT: EMS Transition – Procedural Items - (Summary & Suggested Motions)
The Board of Commissioners is scheduled to consider 7 formal items associated with the transition of emergency medical services to a new Town EMS Department at the February 13 meeting. All 7 items are procedural in nature, and are consistent with the Town’s goal to provide for a smooth transition and, at least initially, are intended to simply continue current practices for employee compensation, service fees, and billing and collections. As discussed previously, the transition to a Town EMS Department is on track for March 1, 2018.
Resolution Amending FY 17-18 Pay Plan
The attached resolution formally assigns all EMS positions to the Town’s formal Pay Plan, and assigns salary grades that are consistent with the salaries paid to current employees. The following new position classifications are added: EMT-Basic (2 current employees), EMT-Intermediate (1 current employee), and EMT-Paramedic (3 current employees). In each case, the hiring rate (the lower end of the salary grade) is closer to the current salary amounts, thereby providing maximum flexibility for future salary increases for EMS personnel. The salary grade assigned to the EMS Chief is consistent with the salary of the current Chief and as advertised in the Town’s recent Town EMS Chief recruitment materials.
As discussed throughout the EMS transition process, all current EMT-Basic, EMT-Intermediate, and EMT-Paramedic employees have been offered employment with the Town at the current salary for their position, and all have accepted. I believe that current EMS salaries are lagging somewhat, and I am hopeful that that Town will be able to increase EMS salaries in the future as funds permit. I will be working toward that goal in the future, with associated amendments to the Town’s Pay Plan at that time.
Resolution Amending Alcohol and Drug-Free Workplace Policy
The Town maintains a formal Alcohol and Drug-Free Workplace Policy to promote a safe and efficient workforce, and to promote the safety of the general public. The policy includes drug testing requirements and procedures, both at the time of initial hire, at random intervals during employment, and in situations where an employee is suspected of being under the influence at work.
The policy designates certain positions as “Safety Sensitive” positions, and these positions are subject to more stringent requirements than other positions. All emergency medical services personnel are employed in “Safety Sensitive” positions, and the attached resolution simply adds these positions to the list of “Safety Sensitive” positions in the Town’s policy.
The attached resolution also includes a few additional “housekeeping” amendments for Police Telecommunicator positions (the Town no longer utilizes this position classification, and it will be deleted), the Landscape Supervisor position (new position added last year), and Lifeguard positions (simply a change in the title from Beach Patrol to Lifeguard).
Resolution Amending FY 17-18 Fee Schedule – EMS Service Fees
The attached resolution incorporates the current fees and billing practices utilized by Emerald Isle EMS, Inc. (with increases implemented on January 1, 2018) into the Town’s official FY 17-18 fee schedule. In most cases, fees are charged for services involving transport only, and depending on the nature of the emergency and the level of care provided, the fees range from $525 to $1,010, plus $18.50 per mile of transport. In most cases, the individual’s health insurance provider is primarily responsible for the charges.
During FY 16-17, EIEMS, Inc. responded to 945 total calls, and 476 of these calls involved transport. During FY 16-17, total gross net charges (after contractual adjustments) for EMS services were nearly $315,000, and total net payments were slightly more than $200,000. We expect to experience similar call volumes and transports, with normal growth, in the future, thus we anticipate similar annual service fee revenues in the future.
As noted earlier, the Town’s intent is to simply continue current service fees and billing and collection practices initially, and Town staff and the Board can certainly revisit these fees and amend as desired in the future.
Resolution Authorizing Contract with Ambulance Pro Consulting for Billing and Collection Services
Emerald Isle EMS, Inc. has contracted with Ambulance Pro Consulting, Easley, SC, for billing and collection services since 2015, and the attached resolution authorizes the Town Manager to execute a new 1-year contract with Ambulance Pro Consulting upon transition to a Town EMS Department on March 1.
The fee for billing and collection services is 6.75% of total net payments, and is expected to be approximately $13,000 - $15,000 during the 1-year contract term, depending on actual collections. This expense is budgeted in the EMS budget, and is comparable to recent historical experience. The Board should note that the new contract for the Town includes a slight increase in the fee percentage (from 6.5% in the current contract with EI EMS, Inc. to 6.75% in the new contract, and this equates to an approximately $500 increase in fees annually).
According to EIEMS, Inc., Ambulance Pro Consulting has performed very well, and the majority of other EMS providers in Carteret County also contract with Ambulance Pro Consulting. Assuming continued good performance, I would expect the Town to continue this contractual relationship beyond the 1-year noted in the attached resolution, and appropriate contract recommendations will be presented to the Board in the future.
EMS Station Lease Termination
I have attached an executed copy of the lease termination agreement for the Board’s information. No further action is required by the Board on this issue, unless the Board has specific concerns that Town staff should address. The attached lease termination agreement was prepared by Town Attorney Richard Stanley and has been executed by Gerry Albright, Chairman of the EIEMS, Inc. Board and Mayor Barber.
As you know, the Town constructed and owns the EMS Station, but leases the station to EIEMS, Inc. at essentially no cost. The original construction and lease agreement executed in 2007 envisioned the future transition to a Town EMS Department, and included provisions to this effect. Thus, the attached lease termination agreement is essentially a formality.
Budget Amendment – General Fund
The Town’s adopted FY 17-18 General Fund budget formally appropriated only the Town’s $390,000 annual contribution to EIEMS, Inc., and did not include the anticipated $180,000 of service fees (for the entire fiscal year). To date, EIEMS, Inc. has already received approximately $138,000 of service fee revenues during FY 17-18, and the attached budget amendment appropriates an additional $60,000 of anticipated service fees for the final 4 months of the fiscal year. These additional service fees, combined with the remainder of the Town’s annual contribution ($390,000), are expected to be sufficient to cover all EMS expenses for the remainder of FY 17-18.
Budget Amendment – EMS Volunteer Fund
The attached budget amendment formally establishes a new special revenue fund to segregate any EMS fundraising proceeds and donations from other General Fund revenues. The initial budget amendment appropriates a total of $5,000 to this new fund, and is intended simply to establish the new EMS Volunteer Fund. Initially, there will be no actual revenues credited to the new fund until the full dissolution of EIEMS, Inc. occurs. We anticipate the deposit of any remaining EIEMS, Inc. volunteer funds into the new Town EMS Volunteer Fund sometime prior to June 30, but do not expect a significant amount, as EIEMS, Inc. has indicated that they expect to expend nearly the entire balance remaining.
Based on discussions by the Joint EMS Committee in recent months, we envision the new EMS Volunteer Fund being managed by the Town, but granting the leadership of the new EMS volunteer group the authority to expend up to $5,000 without approval of the Board of Commissioners. In reality, I am hopeful that there will be a close, cooperative relationship between the volunteer leadership and the Town EMS Chief, and that this initial $5,000 cap will eventually be eliminated in the future. If and when that occurs, we would simply rely on the appropriation amount in the EMS Volunteer Fund to serve as the “de facto” cap.
I am pleased that we are essentially on the eve of the EMS transition, and believe that all significant tasks associated with the transition have already been completed or will be completed in the next couple of weeks. I greatly appreciate the hard work and diligence of everyone involved in this process from the Town and EIEMS, Inc., especially Town Clerk / HR Specialist Rhonda Ferebee and Laura Rotchford, Finance Director. I believe we are ready for a smooth final transition on March 1, 2018.
I recommend approval of each of these procedural items at the February 13 meeting.