1. City of Lynden Ambulance Utility Cost of Service and Rate Study
Presented by
Fire Chief Gary Baar

2. Agenda RCW 35.21.766 Ambulance Utility Requirements and Approach
Project Tasks
2014 Fire Department Budget and Responses
Cost of Service Analysis and Results
Alternative Rate Scenarios
Questions

3. Key Elements In RCW
Provides for ambulance service to be operated as a public utility
Authorizes the City Council to set and collect rates and charges for regulating, operating, and maintaining an ambulance utility
Requires that rates and charges be based on a cost of service study
Does not allow capital costs for construction, major renovation, or major repair of facilities
Categorizes costs by availability of ambulance service and the demand placed on the service
Exempts Medicaid eligible persons in a nursing home, boarding home, or adult family home and persons who receive in home services

4. Ambulance Utility Approach
Availability costs include the basic infrastructure needed to respond to a single call for service and may include dispatch, labor, training, equipment, patient care supplies, and equipment maintenance costs
Demand costs are based on the burden placed on the ambulance service by individual calls, such as those costs associated with the frequency of calls, distance from hospitals, etc.
Availability costs are uniformly applied across customer classes, while demand costs are based on the calls for service by each customer class

5. Consultant Project Tasks
Conduct Kick-off Meeting
Review and Analyze Fire Dept. Ambulance Costs and Workload Data
Develop Cost of Service Framework and Establish Cost of Service
Identify Customer Classes and Cost Allocation Methods
Calculate Availability and Demand Rates for Each Customer Class
Prepare Reports
Make Presentation

6. Lynden Fire Department 2014 Budget
2014 Budget Plus Additional Billing Costs

7. 2012 Number of Incident Responses

8. Key Cost Assumptions: Labor
An average of 2.9 full-time line staff and 1.1 volunteers are on duty 24/7
76% of the time spent by full-time line staff and 70% of the time spent by volunteers is for EMS/ Ambulance activities
Administrative staff time (i.e. Fire Chief, Assistant Fire Chief, and Support Services Manager) was split between EMS and Fire based on full-time line staff and volunteer hours, except for 10% of the Fire Chief’s time which is spent on fire plan review and inspections

9. Key Cost Assumptions: M&O
EMS and Fire supplies, including EMS medical supplies, were split 60/40 between EMS and Fire
What-Comm 911 and Whatcom County Fire Agencies Radio System (FARS) dispatch services were distributed between EMS and Fire based on total calls for service
Dispatch services provided by the Prospect Fire Dispatch Center are associated with BLS transports to Bellingham and were assigned entirely to EMS
Fleet & equipment maintenance costs were split 44/56 and fuel costs 33/67 between EMS and Fire
Facilities (i.e. fire station) costs were split 40/60 between EMS and Fire
Also included $15,250 of new costs identified by the Finance Department for utility billing services

10. Key Cost Assumptions: Availability vs. Demand
For full-time line staff costs, 85% was assigned to availability and 15% to demand. For volunteers, 78% was assigned to availability and 22% to demand
The costs of administrative staff were assigned entirely to availability
Ambulance billing services, EMS supplies, fuel, and Prospect Fire Dispatch Center were assigned to demand
Professional services such as insurance costs and biohazard waste disposal were distributed between availability and demand using the availability to demand ratio for full-time line staff
All other costs were assigned to availability

11. Cost of Service Results

12. Cost of Service Adjustments* *
*According to RCW , revenues from the direct billing of individual users of the ambulance service must be netted against the costs of demand.
**The $241,743 in budgeted 2014 SAFER Grant revenue has been allocated between fire and EMS based on the results of the cost of service study. Based on the distribution of full-time staff hours, 76% ($182,801) was attributed to EMS, and 24% ($58,942) to fire.

13. Customer Billing Units
*Includes 72 independent living units at Meadow Greens.
**Includes 85 rooms at Christian Health Care Center, 107 rooms at Lynden Manor, and 32 rooms at Meadow Greens.

14. Customer Class Costs

15. Full Cost Recovery Rates - $812,189

16. Alternative Rate Scenarios
Full Cost Recovery
50% Cost Recovery
SAFER Grant Cost Recovery
10 Month 2014 Cost Recovery

17. Alternative Rates

18. Questions