HomeMy WebLinkAbout03-26-2001 Meeting (2)
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AMBULANCE STUDY
SUBCOMMITTEE
COMMITTEE ROOM - March 26, 2001
11 :30 A.M.
Present: J. Brigham, Chairman, A. Cheek, W. Mays, Mayor Pro Tern, R. Colclough, M.
Williams, Commissioners; W. Hornsby, Interim Administrator; J. Wall, Attorney; D.
Hooten and E. Doss, Rural Metro; C. Lunsford and E. Burr, University Hospital; D.
Dlugolenski, EMA; B. Mack, Fire Dept; T. Schneider, Gold Cross EMS; L. Bonner,
Clerk of Commission.
MEDIA: H. Coryell, Augusta Chronicle.
Discuss Ambulance Contract.
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Mr. Wall: Rural Metro and University Hospital have been negotiating in so far as
amending the existing subcontract between University and Rural Metro to carry the
services through December 31, 2001. They have also agreed to an extension in so far as
the date by which the option to renew has to be exercised until April 9. The issue that is
remaining is whether or not we wish to terminate the contract with University Hospital,
which is a September 23, 1971 agreement that I have distributed to the Commissioners.
Whereby after the existing subcontract between Rural Metro and University Hospital,
when it expires, that we then would be in a position to contract with whatever provider
we choose to contract with and go through whatever process we wish to go through in
selecting that provider. When the extension came before the Commission a couple of
weeks ago it was my recommendation that we accept an assignment of the contract from
University Hospital and terminate the underlying contract between the county and
University Hospital. This would allow us to. deal directly with Rural Metro through
December 31,2001. And also allow the Commission to make decisions about what type
of process they wanted to go through in continuation of services beyond December 31.
In summary, my recommendation is that this Committee goes ahead and authorizes the
termination of the contract with University Hospital upon the assignment of the existing
contract between University and Rural Metro to Augusta. You have then eliminated a
third player, which is University Hospital. We can then deal directly with Rural Metro in
so far as the terms of the contract through December 31 and be in a position to make our
own decisions about how services beyond that date should be provided.
Mr. Cheek: I move that we follow the recommendation of our Attorney.
Mr. Brigham: Second
Mr. Brigham: What do you see as the downside of us eliminating this contract as
opposed to the upside? And the other question is what is the upside?
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Mr. Wall: The only downside I see is it forces the Commission to make a decision
about how it wants to have ambulance services beyond December 31, 2001, if you
consider that a downside. Because as it currently exist in the event no decision were
made, University, I think would be in a position of having to provide ambulance service
by some means January 1,2002. But the downside of that arrangement is that we would
end up paying the cost of whatever it is and have very little say so in how those
arrangements were made. So, it's not really a downside from the Commission standpoint
in my opinion, in being in the position of having to address ambulance services beyond
December 31, 2001. The upside would put us in control, we have multiple options, we
can go out for qualifications, go out for RFP's, negotiate extensions of the contract, look
at providing ambulance services through some combination involving the Fire Dept, and
others. Build in a phased in operation in so far as the Fire Dept. is concerned. It frees up
all of the options where we have control of the situation to the extent of choosing
multiple alternatives.
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Mr. Burr: The old ambulance contract is actually with the Hospital Authority and
still is came about because of the availability of federal funding. The county didn't want
to get into the ambulance business, so they asked the Hospital Authority to operate the
ambulance service. The contract was worked and the Hospital Authority agreed to take
on the ambulance service to help get this federal funding. But the condition was that the
County paid the full cost of the ambulance service above and beyond what the hospital
could collect for ambulance service. This was a year to year renewable contract and was
renewed automatically every year. As a result of the Rural Metro contract, the hospital is
no longer in the ambulance business.
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Mr. Mays: I raised the question last week in reference to us getting out of the
contract. My reason for raising that question at that time, it didn't matter whether it was I
with University or cmybody else, it was just a matter of a contract that we were getting
out of. I thought that the Commissioners needed to be abreast of what was involved. I
think we are very clear that this is going to be a business that exists between a provider
and us. I would hope that as a major health care provider in this area, one that we still do
business from the standpoint of indigent care and other operatives that we can still call
upon you for advice to lend in this process that we do. One of the things that I brought
out at the meeting last week was that like it or not, thirty years later, a different set of
circumstances, we're back in the ambulance business again. I think it's very prudent that
whatever happens between this govenll11ent and a provider, whether it's the same
provider, a different provider or multiple providers, whatever comes out of this equation,
I don't think we can wait until a December time table, number one, and deal with it. I
think it's something that we should set some realistic goal for, but that we need to be
deciding within the next ninety days where we need to be going. Whether it's the
continuation of what's there or something different, but if we're in the business, if we're
going to deal with the responsibility of it I think we need to have some serious numbers
that we're talking about. I think the Chief is right in terms of what the Fired Dept, may
not be able to do at this point. But I agree we need to have numbers even coming from
within out of our own department on estimates to a point that it's an option that's put on
the table with whomever we talk with that even if we look towards a contract that phases
in something. Whether or not we may have a party that's susceptible to be phased in at
some point, over a year or two. Those are all numbers we need to discuss. Because in all
fairness if you all are out of the loop in this process of it, we're in the loop, then we have I
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to first may sure that what our citizens get is the best and what it's going to cost us to get
there.
Mr. Wall: The way the contr<lct works, Rural Metro has job has an obligation to
provide the ambulance service. They bill the individuals, they are responsible for the
collection of it and if they don't get paid they suffer a loss. We pay as a subsidy $50,000
per month to them and the financial risk is theirs beyond that.
Mr. Mays: We need to get some quotes from the different ambulance services.
.._. _._.._ ____..___Mr. .Brigham.;,J.-.YY9PJJQ.llave ~u~lal} in.plac_e}J~f~!"~_!J!!c!g~t tiIT.!e9J.ho""we:~.___
going to provide ambulance service for next year. Whether it's going to be contracted,
request for qualifications renewed or whatever.
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Mr. Wall: The contract that we have with Rural Metro and University Hospital
expires July 1, 2001. And there was a time period so that Rural Metro had to notify
University Hospital that they would or would not extend their contract beyond the July 1
2001 date. So that date was the March date and that's the reason we brought the item
before you in March. Because Rural Metro had indicated to the County and University
Hospital that they were in fact losing money, that they were not going to extend the
contract without a subsidy. So they had fulfilled the terms of their existing 5-year
contract in that they had not sought nor obtained any subsidy from the County during the
last two years of that existing contract. But they were saying that they were not going to
continue under that arrangement beyond July 1,2001. When the staff met we were not in
a position to begin ambulance service on July 1, nor were we in a position to go out and
negotiate with another provider to begin service effective July 1. So the concept was to
keep in place what we have now, buy ourselves some time until the end of December in
which to look at the Fire Department taking over or the Fire Department phasing in. To
continuing the contract with Rural Metro, contracting with Gold Cross, going out for bids
or any number of options. So the idea of extending the subsidy was in to a new six-
month contract period between Rural Metro and the University Hospital. And you all
approved that subsidy for this continuation, a short-term continuation of the existing five-
year contract, that expires the first part of December. The issue in so far as the Hospital
Authority or University Hospital, from my perspective is, that yes they do have obviously
health care experience. But we're having to ask University Hospital too, since we have
an obligation to pay the cost, whatever those cost are to University Hospital to provide
ambulance service. We want to be involved in the process of choosing who the new
ambulance provider is going to be. We want to be involved in the process of deciding
how that selection is made and what the ultimate cost are going to be because the cost
under the 1971 contract all of that comes back to us. And that's the reason this Rural
Metro contract was brought to us for approval, because in essence it saved us two-years
of ambulance service cost that otherwise we would've had to pay. So this extension of
the Rural Metro contract in my mind buys us some time. We've budgeted the $300,000
to $50,000 per month that is a subsidy. Rural Metro still has to assume the risk of the
collections. And it gives you, Commissioners the opportunity to look at all the various
options that are out there in choosing one as to where we go beginning January 1, 2002.
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Mr. Williams: Jim, from what I've heard and my point was that we dissolve or
sever the contract with University Hospital. That they are not key players now, they're
just in the loop?
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Mr. Wall: They're in the loop, but potentially they're in the loop to the extent that
it says: "that monthly and during the time of this agreement the County shall pay to the
Authority on a monthly cash basis a sum of money equal to the difference between the
total cost and expenses incurred by the Authority in operating the ambulance service and
the total cash collections received from citizens or customers for such services and
,m. _ ..._ _n~Jederal.and. statesour:c~s~" ..That'S..a b lank ~he~k._AndJbar s..w.hat.:w.e}Yere. und.er..____... _ .... .... ...- n
Mr. Williams: Is that what we're doing now?
Mr. Wall: No. Today we're not paying anything.
Mr. Burr: When we did the contract five years ago, we put in a subcontract with
Rural Metro which essentially fixed those costs. So we established a fixed cost, so for
the first three-years of the Rural Metro contract the county was paid $600,000 for
subsidies to University which we in turn paid to Rural Metro. So instead of having a
blank check for those operating cost and in addition to that having insurance, liability and
the cost of maintaining the vehicle the county paid $600,000, $50,000 a month for three-
years. The last two-years of that contract the county didn't have to pay anything. So
basically, Rural Metro said that we'd operate the business in a way that there won't be
any deficit. Unfortunately, for Rural Metro that's what they thought would really happen
but it didn't come too past. Rural Metro has been absorbing substantial losses for the last
two-years according to the information they provided us. So they said we can't go
forward on that basis and that was their right under the five-year contract.
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Mr. Mays: Mr. Wall is there an exit clause in the contract?
Mr. Wall: There was a prevision that says "it was to be renewed automatically
unless either party terminates by written notice. The termination would be delivered at
least ninety days prior to the termination date."
After an in-depth discussion,
Mr. Brigham: I think we have a ninety-day notice that we have to give University
Hospital that we're not going to renew their contract. I want to provide the most efficient
ambulance service to all of our citizens. I think that the next thing we have to do is, we
need to have some kind of extension of a contract.
Motion carries 2-1 with Mr. Williams voting no.
ADJOURNMENT: With no further business to discuss the meeting was adjourned.
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Lena J. Bonner
Clerk of Commission
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lVlarch 26. 2001
PROPOSED ARTERIAL AND INTERSTATE STREET LIGHTING
PROGRAM
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. Establish Commercial Corridor Street Lighting Districts when the commercial
frontage is greater than 80% between logical termini. Property owners in
these districts would pay a flat rate per frontage foot of $0.70 annually.
. Establish a Suburban Services District Street Lighting Fund. This fund will
cover the costs of interstate lighting and remaining arterial lighting charges.
. Street lighting on arterial roadways will be installed based on the street
lighting mas!er plan if the specified arterial roadways are. .80%. commercial or
if the street lighting warrants are met. In both cases, commission approval is
required.
. Intersection lighting may be installed when intersection lighting warrants are
met with the approval of the Traffic Engineer.
. Provide for a three (3) year Interchange Lighting Program. The program's
capital cost would be funded by the Suburban Services District Street Lighting
Fund.
Program phases and annual costs to a $100,000 homeowner:
1. First three years: Existing lighting charges plus installation and maintenance charges
of High Mast Lighting ($13.30)
2. Following years: Energy and Maintenance charges for the existing and proposed
lighting. ($3.05) As the Street Lighting Master Plan is implemented, this cost will
nse.
3. Completed Street Lighting Master Plan. ($12.04)
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Interchange Lighting:
1-20 @ Riverwatch Parkway
1-20 @ Washington Road
1-20 @ Wheeler Road
1-20 @ 1-520 (Programmed in Interchange Project)
1-520 @ Wheeler Road
1-520 @ Wrightsboro Road
1-520 @ Gordon Highway
1-520 @ Deans Bridge Road
1-520 @ Windsor Spring Road! Peach Orchard Road
1-520 @ Highway 56 (Programmed in Interchange Project)
1-520 @ Doug Barnard (Existing)
1-520 @ Laney Walker / Sand Bar Ferry Road
Approximate annual cost for a $100,000 home:
1. 983000/2587901194= .000380 x 35000= $13.30
2. 225000/2587901194= .000087 x 35000= $ 3.05
3. 890000/2587901194= .000344 x 35000= $12.04
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