5.B. Discussion regarding an Interlocal Agreement with Dallas County to provide emergency response services to the unincorporated portions of Dallas County adjacent to the city limits of Rowlett.

[5.B. Discussion regarding an Interlocal Agreement with Dallas County to provide emergency response services to the unincorporated portions of Dallas County adjacent to the city limits of Rowlett.]

>> ALL RIGHT. THANK YOU, CHRISTOPHE AND PD NEXT 5B DISCUSSION [INAUDIBLE] PROVIDE EMERGENCY RESPONSE SERVICE TO UNINCORPORATED PORTION OF DALLAS COUNTY TO AGATE ENTASIAY OF ROWELLETTE. MAKE THE PRESENTATION IS CHIEF.

>> SHORT. >> STILL LET'S PAUSE FOR A MOMENT DO WE NEED A REPRESENTATIVE FROM CITY MANAGEMENT IN HERE? IS THAT OKAY?

>> SURE. >> THANK YOU.

>> SORRY, CHIEF. >> NO.

>> NOT THAT I DON'T TRUST YOU, JUST ALL OUR CITY MAPPINGERS DISAPPEARED SO I AM MAKING SURE WE ARE GOOD.

>> WELL, YOU PROBABLY SHOULDN'T TRUST ME BECAUSE I CAN'T PUT THE RIGHT DATE ON HERE. BUT, FOR WHATEVER REASON 16TH WAS STUCK

IN MY MIND. >> ARE YOU NOT POINTED IT OUT NO

ONE -- >> PROBABLY NOT, I AM TRANSPARENT. ANYWAY, THANK YOU MAYOR AND COUNCIL FOR THE OPPORTUNITY TO SPEAK WITH YOU THIS EVENING. AS YOU GUYS PROBABLY ARE AWARE, CITY AND THE FIRE DEPARTMENT HAVE ENTERED INTO AN AGREEMENT WITH DALLAS COUNTY IN 2023 TO RUN COUNTY AREAS. REALLY ADJACENT TO THE WATERVIEW NEIGHBORHOOD KIND OF IN THE NORTHEAST SECTION OF THE CITY. SO, WE HAVE BEEN DOING THAT SINCE 2023 THAT AGREEMENT EXPIRED IN SEPTEMBER OF 2025.

SO, THEY ARE WANTING TO RENEW THAT CURRENT OR THAT RENEW THE

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AGREEMENT. SO, TO GIVING YOU A LITTLE BACKGROUND ON SEPTEMBER 19TH, OF 2023, CITY COUNCIL APPROVED RESOLUTION AUGUST IDENTITIESINGS CITY OF ROWLETT AND FIRE DEPARTMENT TO ENTER INTO AN AGREEMENT WITH DALLAS COUNTY TO PROVIDE EMERGENCY RESPONSE TO UNINCORPORATED PORTIONS OF DALLAS COUNTY. AND THAT INITIAL AGREEMENT WAS FOR ONE YEAR WITH ONE OPTION YEAR.

THE TOTAL TERM OF THAT AGREEMENT RUNNING THROUGH SEPTEMBER OF 2025. AT THE TIME, THE CALL VOLUME IN THE COUNTY WAS ABOUT 20 RUNS PER MONTH. AM THAT'S DIVIDED OVER FIRE, EMS CALLS.

THAT WAS AND IT WAS BELIEVED TO BE WELL WITHIN OUR RESPONSE CAPABILITY. ESPECIALLY SINCE THE LARGE NUMBER OF THE CALLS WERE MUTUAL AID CALLS TO SAXY AS WELL WHO PREVIOUSLY SERVED THE COUNTY. THEY WERE KIND OF INCORPORATED IN OUR RESPONSE MATE RIBBING. SO AT THAT TIME, THE COUNTY AGREED TO PAY A $500 FLAT RATE FOR FIRE BASED CALLS. AND $600 FLAT RATE FOR EMS CALLS. CERTAIN RESPONSES LIKE CHEST PAIN OR HIGH ACUITY CALLS YOU COULD BILL FOR AN ENGINE AND AN AMBULANCE AND SO YOU WOULD GET BOTH FEES AND THEN OF COURSE AN ALLOTMENT FOR ADDITIONAL BILLING FOR EXTENDED FIRE RESPONSE. THAT WAS NOT PER HOUR BUT PER TWO HOURS SO IF YOU WENT TO FOURTH OUT YOU GOT AN ADDITIONAL $600. IT'S KIND OF CHANGED [INAUDIBLE] BUT, SO, FROM A PERFORMANCE STAND POUND POINT WE RESPONDED TO 241 SERVICE IN THE COUNTY OVER TWO YEARS UNDER 10 A MONTH. ALL RIGHT. 165 OF THOSE WERE EMS BASED CALLS AND ONLY 49 OF THOSE EMS CALLS WERE TRANSPORTS. AND THEN 66 FIRE BASED CALLS WHICH COULD INCLUDE ACCIDENTS, STRUCTURE FIRES AND DOWNED POWER LINES. AVERAGE TOTAL RESPONSE TIME FOR ALL COUNTY CALLS NOT TO GET THERE, THIS IS TIME ON THE CALL, NO TRANSPORTS WAS 29 MINUTES, TRANSPORTS BY AMBULANCE 72 MINUTES AND FIRE BASED CALLS WERE 33 MINUTES. SO, AS A PART OF THIS, WHAT WE FOUND IS THERE WERE NO SIGNIFICANT OVERLAPING CALLS REQUIRING MULTI-UNIT RESPONSE. AND SO, ANOTHER WAY OF SAYING THAT IS OUR RESPONSE INTO THE COUNTY DID NOT CREATE IMPACT THAT HINDERED OUR RESPONSE. FROM A REVENUE STAND POUND WE COLLECTED $154,000 OVER TWO YEAR 108,000 FROM THE COUNTY FOR EMERGENCY RESPONSE AND 46,000 FROM MEDICAL AND FIRE BILLING. SO IT'S PART OF THE CONTRACT AGREEMENT WE ARE ALLOWED TO BILL EMS AND FIRE SERVICES LIKE WE WOULD OTHERWISE. BUT WE REALIZE THERE'S A COST ASSOCIATED WITH RESPONDING SO THE COST TO DELIVER THE SERVICE BASED ON FEMA RATES, FOR THOSE MEDICAL NO TRANSPORTS COST SHY OF $4,000.

FOR THAT TWO-YEAR PERIOD. FOR THE MEDICAL TRANSPORT IT WAS 23,000. AND FOR FIRE CALLS IT WAS 13,000 TOTALING JUST OVER $40,000. WHICH NETTED US AROUND $113,000,1771. TO BE HONEST WE HAVE 17,000 IN THE ADDITIONAL BILLING THAT WE ARE WAITING TO COLLECT FROM THE COUNTY. PART OF THAT IS BECAUSE THE COUNTY IS ABOUT A CYCLE AND A HALF BEHIND. AND THEY HAVE ALWAYS BEEN THAT WAY. WE HAVE NOT EXPERIENCED THEM NOT PAYING. BUT TRULY THEY ARE A CYCLE AND A HALF BEHIND, SO WHEN WE SEND A BILL, BY MID MONTH OF THE FOLLOWING MONTH, THEY ARE A MONTH AND THEN SOME

CHANGE BEHIND. >> WITH WHEN YOU SAY 46,000 MEDICAL IS THAT MONEY COLLECTED OR MONEY.

>> MONEY COLLECTED. THAT'S MONEY THAT WE BUILD AND RECEIVED. WE PROBABLY BUILD MORE THAN THAT AND YOU WILL SEE THE BIG PERSPECTIVE IN THE NEXT PRESENTATION. WHAT THAT LOOKS LIKE BUT THAT'S MONEY WE ACTUALLY COLLECTED.

>> SO WHAT DALLAS COUNTY IS PROPOSING A NEW CONTRACT. IN PROPOSING A ONE-YEAR CONTRACT WITH TWO ADDITIONAL TWO ONE YEAR RENEWAL PERIODS RUNNING THROUGH SEPTEMBER 30TH OF 2028. AND THEY HAVE MADE SOME ADJUSTMENTS TO OUR FEE ALLOTMENTS IN THE NEW CONTRACT. NOW WE ARE AT 600 FOR FIRE BASED CALLS AND FLAT RATE.

AND 700 FOR EMS CALLS. AND WE STILL HAVE THE ABILITY TO BILL MULTIPLE UNITS ON CERTAIN RESPONSE IE CHEST PAINS SHORTNESS OF BREATH AND STROKES AND OTHER CALLS AND INSTEAD OF DOING IT IN TWO HOUR INCREMENTS WE CAN BILL IN ONE HOUR

[00:45:02]

INCREMENTS WHICH ALLOWS US TO GET $300 PER HOUR FOR EVERY HOUR WE [INAUDIBLE] SO, NOT A BAD AT LEAST WE ARE MOVING IN THE RIGHT DIRECTION. NOW THIS CONTRACT THAT WAS IN THE PACKET HAS BEEN REVIEWED BY THE CITY ATTORNEY. SHE DID HAVE A COUPLE POINTS OF CONCERN, I THINK PRIMARY AMONG THOSE WAS LIABILITY ISSUE WITHIN THE CONTRACT IT SAYS WE ARE LIABLE AND RESPONSIBILITY FOR NEGLECT ACTS WHILE RESPONDING TO THE COUNTY. THAT'S PRETTY STANDARD FAIR FOR THE CONTRACT. WITH THE COUNTY, IT WAS IN THE LAST ONE. IT IS IN THIS ONE. WE CAN DEFINITELY GO BACK TO THE COUNTY. AND SEE IF WE CAN HAVE THAT CHANGED. BUT, IT WAS CONSISTENT WITH THE LAST CONTRACT THAT WE SIGNED WITH THEM. AND SO, GOING FORWARD, WE ARE LOOKING FOR CONSENSUS TO MOVE FORWARD WITH THIS AGREEMENT WITH DALLAS COUNTY. FOR SERVICES. WE DEFINITELY WILL PLAN IF APPROVED TO BRING IT TO A COUNCIL SESSION. COMING UP ON CONSENT AGENDA SO WITH THAT I AM

HAPPY TO ANSWER QUESTIONS. >> IF THIS IS APPROVE CAN WE GET DALLAS COUNTY BRING ACCOUNTS RECEIVABLE UP-TO-DATE.

>> I AM SURE WE CAN WORK THROUGH THAT. P.

>> WELL, I AM NOT A FAN OF THIS. AND REASON WHY I AM NOT A FAN OF THIS IS THAT I THINK THAT IT COST US MORE THAN WHAT WE PROBABLY HAVE WITH COMING BACK THE TIMES WE ARE NOT CAPTURING.

TRAVEL THERE AND BACK HOW MANY TRUCKS HOW MANY APPARATUS TO GO TO A STRUCTURE FIRE. OTHER THINGS. I THINK IT IS GREAT DEAL FOR PEOPLE LIVING IN THE COUNTY. YOU DOESN'T HAVE TO PAI PAYROLLLET TAXES AND WE ARE HELPING ON HOUSE FIRES AND MEDICAL. I GET THAT BUT THERE ARE FOLKS LIVE LIKE LIVING IN THE COULDN'T IY. AND POLICE SERVICE COMES WITH THAT TOO AND WE HAVE TO SHOW UP. I AM NOT A FAN OF US GOING UP THERE TAKE CARE OF THE PROBLEM AND LEAVING AND THEN WE HAVE TO CLEAN OUR SUITS, CLEAN OUR BUNKER GEAR AND CLEAN EVERYTHING ELSE AND PUTS THEM OUT OF SERVICE WHILE THEY ARE DOING STUFF AND THERE'S DOWNTOWN. I DON'T THINK $600 A MONTH IS WORTH IT.

>> PER CALL. >> PER CALL.

>> IS THAT PER CALL REGARDLESS OF NUMBER OF UNITS?

>> SO, HON A STRUCTURE ON A STRUCTURE FIRE ONE FLAT RATE AND ADDITIONAL RATE OF BILLING. THAT'S WHERE THE ONE AREA WHERE IT'S CLOSER. WE HAVE HAD CONSTRUCTTURE FIRE AND AT THAT WAS NOT IN THIS PERIOD. IT WAS IN THIS CURRENT PERIOD. AND IT INITIALLY CAME IN AS A CITY CALL. BECAUSE IT WAS ON THE AREA THE BOARDER. WE SENT A FULL RESPONSE. NORMALLY WE DON'T SEND A FULL STRUCTURE FIRE RESPONSE. THEY GET TWO UNITS.

>> TWO ENGINES. >> YEAH.

>> SO WE DON'T SEND A FULL COMPLIMENT OF STRUCTURE FIRE RESPONSE. THE REST OF THAT RESPONSE WE RELY ON MUTUAL AID IN ORDER TO FILL OUT THAT COMPLIMENT. SO WHETHER THAT'S

SAXY OR WILEY. >> [INAUDIBLE]

>> THE AGREEMENT ENDCHED THE END OF SEPTEMBER.

>> YES. >> ARE WE PROVIDING SERVICES.

>> WE ARE PROVIDING SERVICES. AND THEY HAVE AGREED TO PAY US FOR THOSE SERVICES UNTIL WE CAN EITHER DECIDE TO ENTER INTO THE NEXT CONTRACTOR NOT ENTER INTO THE NEXT CONTRACT. PART OF THE DELAY IN THIS IS WE HAVE HAD TO GO BACK AND FORTH WITH THE COUNTY AND COMMUNICATION TAKES A LITTLE BIT OF TIME. THEY HAVE CHANGED IT WHEN WE SET THE ORIGINAL CONTRACT THEY WENT BACK TO THE PREVIOUS CONTRACT THAT HE HAD WITH SAXY, AND WE HAD TO WORK THROUGH THAT AND REORGANIZE IT TO MATCH WHAT WE PREVIOUS.

SO. >> IT'S BEEN A LITTLE BACK AND

FORTH. >> EVEN FOR VICTORIA MY POINT IS THAT WHEN YOU RUN CODE THREE YOU ARE GOING OUT THERE EVERYTHING IS HEIGHTENED AND THINGS GOING ON. PEOPLE REACT TO A FIRE ENGINE OR POLICE CARS GOING BY. AND SO, WE DO HAVE A WRECK, AND GOING UP TO THE COUNTY, AND NOW OUR ENGINE IS OUT AND WE HAVE FOLKS HURT AND FOLKS HURT IN THE A CAR, THERE GOES OUR LIABILITY GOES UP AND STUFF AND WE COULD BE FACING LAWSUITS FOR GOING OUT FOR THAT $600 RUN. SO. I JUST -- I JUST CAN'T SUPPORT IT BECAUSE I KNOW HISTORY OF ALL THAT STUFF OUT THERE. AND IT'S JUST NOT ENOUGH MONEY TO, OR EVEN OUR SERVICES TO LEAVE OUR CITIZENS BEHIND AND NOT BE ABLE A RESPOND TO THEM BECAUSE ONE CALL ON I-0 HAD WIPE YOU OUT AS IT IS. SO, BEING UP THERE AND HAVING NEW STATION COMING UP THERE, AND ET CETERA, THINK WE ARE GOING TO BE PRETTY BUSY. AND I THINK AS THINGS GROW UP AND GET MORE HOUSING AND EVERYTHING, THINK TEN CALLS A MONTH IS GOING TO GO UP AND START AFFECTING US. AND IT'S GOING TO REALLY PUT A

[00:50:02]

STRAIN ON THE FIRE DEPARTMENT MORE THAN WE THINKING IT WILL.

>> DID YOU ASK THE QUESTION FOR FORESEEABLE ESTIMATE DIDN'T

A[INAUDIBLE] >> SO I THINK CLEARLY IT IS BASED ON THE NUMBER OF CALLS THAT WOULD GO WE WOULD GO OUT THERE, RIGHT. WE INITIALLY ENTERED INTO THE AGREEMENT THINKING WE WOULD HAVE ABOUT 20 CALLS, AND ACTUALLY HAD A LITTLE OVER NINE LESS THAN TEN PER MONTH OUT THERE. AND SO, I THINK WE HAVE A WINDOW, PERSONALLY. THAT'S PROBABLY A LITTLE BIT BROADER THAN THAT. I THINK IT WILL BE WELL BEYOND THIS CONTRACT BEFORE WE CAN POTENTIALLY SEE THE IMPACT IF A CALL VOLUME TO THE ON THE I WAS MAKING WE HAVE HAD ONE STRUCTURE FIRE, TOTAL, OUT THERE. DOESN'T MEAN WE WON'T HAVE.

>> I -- >> WE COULD HAVE FIVE, RIGHT? BUT I THINK OVER THIS TWO-YEAR PERIOD, WE HAVE SEEN LESS THAN TEN CALLS. SO I THINK EVEN IF THAT WERE TO DOUBLE OR EVEN TRIPLE, WE ARE WELL WITHIN THE WINDOW THAT IT'S GOING TO HAVE A MINIMAL IMPACT. CAN'T SAY IT WON'T HAVE AN IMPACT, BUT THAT WAS HOW WE EVALUATED IT AT THE BEGINNING. SO.

>> IS THERE ANYTHING IN THE AGREEMENT REQUIRES US TO PRIORITIZE THEIR CALLS OVER ROWLETT CALLS OR VICE VERSA OR GIVE US DISCRETION ON WHICH CALLS WE RESPOND TO IF WE ARE NOT AVAILABLE WHAT HAPPENS DOES IT ROLL OVER TO SAXY OR WILEY.

>> CORRECT. THEY FOLLOW THE MUTUAL AID CALL FOR THE COUNTIES. AND SO, THAT WOULD ROLL OUT AND WE MAY HAVE TO TRANSFER THAT CALL. FROM DISPATCH TO THE NEIGHBORING

DEPARTMENT. BUT,. >> YEAH, I MEAN UP TO THIS POINT THIS HAS NOT BEEN ISSUE. AND I WILL PUSH BACK ON LIABILITY THING, BECAUSE THE LANGUAGE READS THE CITY AND COUNTY A AGREE TO BE RESPONSIBLE FOR THEIR NEGLECT ACTS OR OMISSIONS.

WE ARE NOT TALKING ABOUT TRAFFIC ACCIDENT BUT ONE DIES BECAUSE ONE OF THE GUYS MAKES A HORRIFIC MISTAKE. IN THE PROCESS. AND I JUST DON'T FRANKLY I TRUST OUR GUYS AND I DON'T THINK THAT'S

AN ISSUE. SO FROM A LIABILITY. >> SOMEBODY ELSE COULD --

>> FROM A LIABILITY STAND ON THE I DON'T SEE A HUGE RISK THERE.

AND DALLAS COUNTY IS ASSUMING RISK FOR THEIR OWN ACTS AND OMISSIONS AS WELL. IN ADDITION, THERE'S DETERMINATION CLAUSE WE CAN TERMINATE AGREEMENT WITHIN 90 DAYS OF NOTICE SO IF WE GET INTO THIS, AND THE CALLS PICK UP OR SOMETHING CHANGES OVER THE NEXT SIX MONTHS THAT MAKES US RETHINK THIS, CHIEF COMES AND SAYS OH MY GOSH THIS IS WAY MORE THAN I BARGAINED FOR AND EXPERIENCED IN THE PAST TWO YEARS WE GIVE 90 DAYS NOTICE AND WE ARE OUT AND IT'S SOMEONE ELSE'S PROBLEM OR DALLAS COUNTY PROBLEM. I HAVE A FEAR WE DOESN'T RENEW THIS AGREEMENT AND THAT DAMAGES OUR RELATIONSHIP WITH DALLAS COUNTY BUT WE RELY ON THEM FOR QUITE A BIT. AND, [INAUDIBLE] I KNOW THAT'S WAY DOWN THE ROAD, BUT I DON'T WANT TO GET ON THEIR BAD SIDE SO TO SPEAK. TOTALLY UNDERSTAND WHAT YOU ARE SAYING AND I DON'T WANT TO RISK ANYBODY HERE. I WANT TO MAKE SURE THERE'S NOTHING THAT ALLOWS OR REQUIRES US TO

PRIORITIZE THOSE CALL. >> I AM ONE VOTE.

>> UNDERSTOOD. UNDERSTOOD. >> I GUESS MY BIGGEST CONCERN IS AS LONG AS IT DOESN'T IMPEDE OUR SERVICE. YOU KNOW IT'S A LOW VOLUME AND IT'S NOT -- IT'S NOT CAUSING DETRIMENT TO OUR RESPONSE TO THE CITY AND YOU CAN HANDLE IT AND YOU SAID IT'S NOT [INAUDIBLE] THAT'S KIND OF ONE REALLY CRITICAL ISSUES FOR

ME. >> SO DUE TO OUR RESPONSES IN THE COUNTY, WE HAVE NOT RESPONDED TO A CALL IN OUR CITY.

SO. >> WE NEVER HAD TO CALL MUTUAL

AID. >> FOR US.

>> OTHER THAN WHAT WE NORMALLY CALL MUTUAL AID ON. SO.

>> WE NEVER HAD [INAUDIBLE] >> WE NEVER HAD TO DEFER THAT TO

SAXY OR WILEY? >> I DON'T KNOW SPECIFICALLY, BUT, I MEAN I KNOW WE WOULD IF WE HAD. AND THERE'S A LITTLE AREA UP THERE WHERE IT ACTUALLY IS TECHNICALLY WILEY'S RESPONSE DISTRICT. SO IT IS CONFUSING AND WE GET CALLED OUT THERE AS WELL.

AND WE HAVE WAVED THAT OFF TO THEM AND VICE VERSA WHEN THEY REALIZE THE CALL -- WE WILL RESPOND THERE BUT ULTIMATELY THEY ARE RESPONSIBLE FOR THAT CALL.

>> ONE THING I PUSH BACK ON IS THE AMOUNT. WE HAD A TWO YEAR AGREEMENT PREVIOUSLY AND THIS WENT UP 100 DOLLARS IN TWO YEARS DESPITE INFLATION BEING DRAMATIC AND I MEAN DO WE HAVE -- DO YOU BELIEVE WE HAVE NEGOTIATING POWER WITH DALLAS COUNTY HERE?

OR IS IT. >> THAT'S A A QUESTION BECAUSE.

>> BECAUSE IT IS SUCH A LONG COMMUNICATION PROCESS TO GO BACK

[00:55:02]

AND FORTH. >> I DON'T KNOW THAT. THEY ARE GOING TO BASE IT SIMILAR TO WHAT THEY HAVE DONE WITH OTHER CONTRACTS. WE ARE NOT THE ONLY ONE THAT COVERS THE COUNTY. WE COVER OUR ONE PORTION OF THAT, AND I WOULD TELL YOU THAT THE FEES THAT ARE REPRESENTATIVE IN THE CONTRACT ARE THE REPRESENTED

IN OTHER CONTRACTS AS WELL. >> WE ARE IN LINE WITH OTHER

JURISDICTIONS. >> WE ARE. AND I DON'T -- JUST BASED ON INCREASES WE ANTICIPATE WE WILL SEE INCREASE COLLECTION FROM WHAT WE HAVE OVER THIS TWO-YEAR PERIOD FOR SURE. ON A YEARLY BASIS AND ALSO ON THE EMS FEES AND FIRE FEES.

>> HOW DID SACHSE -- [INAUDIBLE] >> SO, WHEN IN TALKING TO THEM, IT WAS A VOLUME ISSUE FOR THEM. AT THE TIME THEY HAD ONE AND A HALF STATIONS ESSENTIALLY. AND SO THEY WERE SENDING THEIR MAIN PRIMARY STATION OUT THERE. EVERY TIME THEY WENT ON A CALL IN THE COUNTY. AND SO, IT BECAME A BURDEN FOR THEM MORE THAN

[INAUDIBLE]P. >> I MEAN, GIVEN THE CHOICE BETWEEN RESPONDING TO COUNTY AND RESPONDING ON I-30 I WOULD RATHER RESPOND TO COUNTY AND DUMP THE I-30 AGREEMENT WE HAVE BUT I DON'T KNOW IF IT'S POSSIBLE EITHER.

>> IT'S POSSIBLE. EVERYTHING IS POSSIBLE.

>> WHEN DOES THAT COME UP FOR RENEWMENT MAYBE OUTSIDE OF THE SCOPE OF THE DISCUSSION. SORRY. OKAY. SO, TO CONSIDER APPROVING THE AGREEMENT DOES THAT NEED TO COME BACK FOR A REGULAR SESSION ITEM WE NEED A RESOLUTION TO APPROVE? SO I WOULD REQUEST BASED ON COUNCIL MEMBER GIBBS OBJECTION AND OTHERS AS WELL THAT BE AN INDIVIDUAL CONSIDERATION. WE CAN TALK ABOUT IT A LITTLE MORE IN REGULAR SESSION AND TAKE A VOTE WHERE EVERYBODY HAS THE RIGHT TO INDIVIDUALLY VOTE. ANY OTHER

[5.C. Discussion regarding ambulance billing procedures, including the parameters used in billing processes by the Rowlett Fire Department and Emergicon, the city’s third-party billing vendor. ]

QUESTIONS? ALL RIGHT. CHIEF THANK YOU MOVING ONTO ITEM 5 C DISCUSSION REGARDING -- [INAUDIBLE] DISCUSSION REGARDING AMBULANCE BILLING PROCEDURES INCLUDING PARAMETERS USED IN BILLING PROCESS IT IS BY THE ROWLETT FIRE DEPARTMENT AND EMERGENCIES THE CITY'S THIRD PARTY BILLING VENDOR.

>> THANK YOU AGAIN. >> SO, AT A PREVIOUS COUNCIL SESSION IT WAS REQUESTED WE % BRING BACK INFORMATION ABOUT OUR AMBULANCE BILLING POLICIES AND PROCESSES FOR YOU. AS PART OF THE -- RELATION TO FEEDBACK WE GOT DURING CITIZENS INPUT. AND THAT'S WHAT WE ARE HERE TO DO FOR YOU TODAY. WE WILL TALK A LITTLE BIT ABOUT OUR AUTHORIZING ORDINANCES. OUR BILLING BY CALL TYPEAN TYPE, LEVEL LEVEL OF SERVICE WE BILL FOR, AND PAIR MEDE MEDICS AND COLLECTION AND WE WILL SHOW YOU A COMPARISON OF WHERE WE LINE UP FEE STRUCTURE COMPARED TO OTHER CITIES AROUND US. STOW TO PROVIDE BACKGROUND, THE PROVISION AMBULANCE SERVICE AND ABILITY TO BILL FOR THE SERVICES IS AUTHORIZED BY CITY ORDINANCE. OUR FEE SCHEDULED IS APPROVED EVERY YEAR AS PART OF THE MASTER FEE SCHEDULED. WE HAVE UPDATED THE FEES SINCE 2014. AND WE WILL TALK A LITTLE BIT MORE ABOUT THAT AS WE GET INTO THE PRESENTATION. EMERGE CON IS THE THIRD PARTY BILLING-ITY AND OUR AGREEMENT HAS BEEN IN PLACE SINCE 2018.

OVERALL, OUR COLLECTION RACE WITH EMERGI CON IS 45%% AND INDUSTRY NORM IS BETWEEN 30 AND 35%. YOU MAY BE AWARE -- GO

AHEAD. >> IS THAT MEAN 55% PEOPLE JUST

DON'T PAY OFF. >> SO, YES, A LOT OF WAYS. BUT ALSO, THAT'S BASED ON BILLING VERSUS WHAT WE CAN COLLECT. AND I I WILL TALK MORE ABOUT THAT AS WE GET FURTHER INTO THE PRESENTATION. EMERGI CON IS THE FOR THE FIRE BASED BILLING WHICH IS THE HAZ AROUNDOUS MATERIALS AND EXTEND FIRE. SO, WE HAVE TALKED ABOUT THAT PRIOR. SO, THIS IS A COP COPY OF THE CHART FROM THE CURRENT FEE SCHEDULE. WE HAVE A RESIDENT AND NONRESIDENT RATE AND THE RATE IS BASED ON THE CALL TIME YOU WILL SEE ALS1 AND ASL1 I WILL GO INTO DETAIL WHAT IT IS ON THE NEXT SLIDE. I WANT TO TALK ABOUT DEFINITIVE CARE AND NONTRANSPORT. WE GO OUT AND PROVIDE ACUTE CARE, BUT, WE

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DON'T TRANSPORT THE PATIENT FROM THERE. USUALLY THEY ARE REFUSING TRANSPORT. SPECIFIC GUIDELINES ABOUT HOW WE DO THAT AND KIND OF GOVERNED BY MEDICAL DIRECTOR. BUT, TYPICAL CALLS LIKE THAT ARE DIABETIC EMERGENCIES, WHERE WE MIGHT PROVIDE SOME GLUCOSE. OR ASTHMA CALLS WHERE WE PROVIDE INHALER.

YOU KNOW, THESE PEOPLE NEED HELP IN THE MOMENT, BUT THEY DON'T NECESSARILY NEED HOSPITALIZATION OR ADDITIONAL CARE. SO, THAT'S KIND OF WHERE THAT $100 FLAT FEE AND, OF COURSE, $OF $60 FOR OXYGEN AND [INAUDIBLE] SO YOU GUYS ARE PROBABLY AWARE THAT ALL OF OUR MIC U.S. OR MEDICS ARE LIES EXED AS MIUS THROUGH THE STATE AND WE PUT EVERY PEAR PEAR MIDIC ON EVERY MEDIC UNIT WE SEND OUT. THAT'S NOT HOW WE BILL WE BASED ON SERVICES AND SERVICES PROVIDED REGARDLESS OF THE RESOURCES THAT WE SEND. SO, IF YOU ARE LOOKING HERE THE FIRST LEVEL IS BASIC LEVEL OF SERVICE WHICH IS REALLY OUR NONINVASIVE TREATMENTS. EKGS, BANDAGE, SPLINTING, OXYGEN ADMINISTRATION, THOSE ARE THINGS THAT COULD BE HANDLED BY AN EMT LOWER LEVEL CERTIFICATION. AND SO WE BILL BASED ON THAT AS OPPOSED TO TWO PARAMEDICS AND HIGHER LEVEL OF SERVICE. THE NEXT LEVEL IS ALS ONE ADVANCE LEVEL OF SERVICE. 12 LEAD EKGS IVS MEDICATION ADMINISTRATION AND SOME ADVANCED AIRWAY PROCEDURES INTUBATION OR CPAP WHICH WE PROVIDE AND THEN TAKE IT ONE STEP FURTHER WHICH IS ALS2 ADVANCED LEVEL SERVICE THAT INCLUDES SOME OF THOSE ALS TREATMENTS BUT ALSO MULTIPLE MEDICATION ADMINISTRATION. HERE YOU ARE THINKING ABOUT ACUTE RESPIRATORY DISTRESS OR FAILURE.