City Council

January 12, 2012 CITY OF SARATOGA SPRINGS City Council Meeting Agenda 12:00 PM CALL TO ORDER ROLL CALL SALUTE TO FLAG PUBLIC COMMENT PERIOD / 15 MINUTES PRESENTATION(S) 1. Ambulance Service Options for the City of Saratoga Springs EXECUTIVE SESSION: CONSENT AGENDA 1. None MAYOR’S DEPARTMENT 1. None ACCOUNTS DEPARTMENT 1. None FINANCE DEPARTMENT 1. None PUBLIC WORKS DEPARTMENT 1. None PUBLIC SAFETY 1. None SUPERVISORS 1. None City Council Meeting 1/12/12 ADJOURN Page 2 of 12 City Council Meeting 1/12/12 January 12, 2012 CITY OF SARATOGA SPRINGS City Council Meeting City Council Room PRESENT: Scott Johnson, Mayor Michele Madigan, Commissioner of Finance John Franck, Commissioner of Accounts Anthony Scirocco, Commissioner of DPW Christian Mathiesen, Commissioner of DPS STAFF PRESENT: Shauna Sutton, Deputy Mayor Lynn Bachner, Deputy Commissioner, Finance Sharon Kellner-Chille, Deputy Commissioner, Accounts Eileen Finneran, Deputy Commissioner, DPS Joe Scala, City Attorney EXCUSED: Tim Cogan, Deputy Commissioner, DPW RECORDING OF PROCEEDING The proceedings of this meeting were taped for the benefit of the secretary. Because the minutes are not a verbatim record of the proceedings, the minutes are not a word-for-word transcript. CALL TO ORDER Mayor Johnson called the meeting to order at 12:03 p.m. PRESENTATION Ambulance Service Options for the City of Saratoga Springs Mayor Johnson advised this workshop was called to address the EMS situation facing the City. Commissioner Mathiesen advised the purpose of the meeting is to provide the City Council the opportunity to discuss ambulance service in the City due to the recent announcement that SEMS will no longer be operating in the very near future. This will also allow the City Council to share information regarding meetings with SEMS, Mohawk Ambulance, Empire, and Chief Williams. He wants to ensure the seamless Page 3 of 12 City Council Meeting 1/12/12 transition to another entity as SEMS ceases activity and discuss the financial implications of the options facing the City. The options, as presented to Commissioner Mathiesen are as follows: o Empire Ambulance could take over the SEMS Certificate of Need (CON) with a rental agreement for the West Avenue station and a schedule of reimbursement for ALS services provided by the Saratoga Springs Fire Department. o Mohawk Ambulance to provide transport services in the City with a rental agreement and reimbursement for ALS services provided by the Saratoga Springs Fire Department. This would be income for the City projected to be between $100,000 - $200,000 per year. o Saratoga Springs Fire Department could put their 2005 ambulance into service and provide transport as well as emergency medical services. Empire Ambulance would provide the additional ambulance service needed and rent the West Avenue location. o Saratoga Springs Fire Department could put their 2005 ambulance into service and share ambulance service responsibility in the City with not for profit ambulance corps from surrounding communities including Wilton, Malta, and Ballston. Commissioner Mathiesen advised that Chief Williams has projected the need for 1 additional fireman under the scenario of his department operating one ambulance. The revenue generated by the operation of the Saratoga Springs Fire Department could be substantial. The Fire Department has been providing emergency medical service since 1992 without being reimbursed for this service. The firefighters are either EMTs or paramedics. Chief Williams advised the Fire Department was as surprised as everyone else was when SEMS announced they were no longer going to provide a service. They found this out the Monday night before Thanksgiving and on Tuesday morning they started an action plan to address what could be a shortage in a service. He thanked Mike McEvoy from Saratoga County EMS, Community Ambulance (Ballston Spa), Wilton, and Malta for stepping up and advising they would assist in filling any voids. The problem is how they get the patient from the scene to the hospital. They have 34 paramedics, 9 ALS intermediate providers, and others who are EMTs. They have done first response since 1992 but have not done transport. The business model they are proposing is no different that what is used throughout the USA and locally in Watervliet, Troy, etc. They are looking to follow what has already been established and not break new ground. They looked at for profit, not for profit, and transport while trying to get the most for their dollar and keep the expenses down while maintaining the highest quality of care. They have determined the combination of contracting with a second party and the Fire Department taking over everything is the most cost effective and will generate the greatest revenue for the tax payer. They are trying to get a consensus from the Council regarding if they want to move forward with the Fire Department ambulance or do they want to do an RFP with another provider. They support moving forward with the Fire Department ambulance as it minimizes the cost and maximizes the revenue. They are currently doing the service and leaving a lot of money on the table as they are providing a service and not getting any money back for it. A hand-out was provided to the Council. Chief Williams explained they took the anticipated cost, indentified the variables, looked at personnel, and projected out costs for 5 years. They also projected revenue that would be provided based upon figures provided by Multi-Med. Multi-Med did the billing for SEMS and other ambulance services in the county. They took the revenue provided by Multi-Med and subtracted the costs therefore getting the net result. The following points were proposed: o They are looking for 1 additional person to bring all their shifts to 13; which is their 2009 level. o They have an ambulance so they would look to buy a used ambulance for a second vehicle at a projected $20,000 cost. o Radio communications would need to be installed. o Computer hardware and software not required as they can use what they have. o Insurance cost for transport is $800. o No capital equipment for the first year. o Projecting the increase of EMS supplies by $1,500 per year. o Training is $3,100. o Fuel and maintenance cost is projected at $10,923. o Cost for additional person is $57,816. o Overtime costs are projected at $70,000 for the first year. Page 4 of 12 City Council Meeting 1/12/12 o The numbers projected out 5 years were increased by 3%. Chief Williams explained they did revenue estimates at the low end of responding to 50% of the calls andat the high end of responding to 90% of the calls. Chief Williams has been asked what he is going to do when the SAFER grant runs out – how is he going to fund those positions. They took those positions and put them in their cost estimates. His recommendation is to get the ambulance in service for the first call basis and contract with another party for back-up. The topic of an ambulance was originally put on the table by Commissioner Curley’s administration. Commissioner Kim came to the same conclusion, and Commissioner Wirth wanted to put the ambulance in service. Fire service EMS is prevalent throughout the U.S. If they put this in place 10 years ago when first suggested we wouldn’t be in the position we are in today. Commissioner Mathiesen confirmed this would be for a trial period. Chief Williams stated it would be for 2 years. At that point they would file for the full Certificate of Need to become permanent. After 18 months, the Council would need to decide if they wanted to become permanent or not and start the process to become permanent. Commissioner Madigan asked if the 50% and the 90% figures were for transport revenue only. Chief Williams advised that is true. Commissioner Franck asked if there is a sufficient number of ambulances to hit the 90%. Chief Williams stated it is somewhere in-between. There is a 30% overlap in call volume. They will never get to 90% of the calls with one ambulance in service. Commissioner Franck confirmed the revenue projections stay the same each year. Bill Shipman of Multi-Med stated historically the dollars have gone up over the years for the same amount of calls. Commissioner Madigan asked Mr. Shipman how he sees ‘Obama Care’ playing out in this scenario. Mr. Shipman stated they have been billing for SEMS for 19 years. The self-pay population for 2010 is at 12%. No one knows what rate ‘Obama Care’ is going to reimburse at. Hopefully those 12% would have the some kind of coverage under ‘Obama Care’. Mayor Johnson asked how providers handle the service for people who don’t have the means for payment; such as the elderly. Mr. Shipman stated there is a good chance the elderly has Medicare. Medicare will pay 80% of the amount for the trip in an ambulance. Most elderly have a supplemental policy that will pick up the 20% or they pay out of pocket. Right now they are collecting for 97% of Medicare patients. He wouldn’t expect much collection from the 12% group mentioned before. Mayor Johnson asked if those balances are normally written off. Mr. Shipman stated the City could choose to go the collection route or write it off. Mayor Johnson confirmed the average claim amount provided to Chief Williams was for transport only. Mr. Shipman advised Medicare, Medicaid and most carriers don’t pay unless you transport the patient. Page 5 of 12 City Council Meeting 1/12/12 Mayor Johnson asked Mr. Shipman what has his experience shown to be the average amount for ALS service. Mr. Shipman stated any carrier pays a set amount for a BLS call and a higher amount for an ALS call. Again you need to transport the patient to collect that amount. The average amount for an ALS 1 transport is $400 and then a mileage reimbursement. Mayor Johnson confirmed there is an ALS 2. Mr. Shipman stated that is true, however, most Medicare transports are going to be ALS 1. Commissioner Scirocco asked who sets the reimbursement rates. Mr. Shipman advised it depends on the payer. Medicare has a fee schedule, Medicaid is based upon the County the person lives in, and commercial carriers have a different reimbursement scheme. Commissioner Mathiesen advised the average net per claim for SEMS was $349 in 2006, $344 in 2007, $356 in 2008, $366 in 2009, $374 in 2010, and $380 in 2011. Chief Williams reinforced the point that under the current system, they would continue to provide the ALS service and would have to have a contract with an agency to collect the ALS portion. The agency would get the mileage and the BLS level. In order for the Fire Department to get this reimbursement, they would have to continue to go in the ambulance with the patient to the hospital. There is a longer out of service time for that. The cost benefit it not there for ALS reimbursement with the amount of time they would have to be out of service compared to if they provided the whole service. They feel it is the best option for the tax payers and the City as a whole. Commissioner Madigan asked Chief Williams if he is recommending an option. Chief Williams stated he is recommending they put the ambulance they have in service and contract with another agency for the back-up in the second and third call status. Commissioner Franck stated in 2006, 2007, 2008, and 2009 before cutbacks, it was stated there aren’t enough firemen. He is receiving e-mails asking how this can been done with the addition of only 1 fireman. Chief Williams stated they are going to reconfigure the way they handle their resources. They are going to manage and deploy the staff differently. Commissioner Mathiesen stated they are going to staff one ambulance. The second ambulance is for back up in case there was a mechanical issue. Commissioner Franck confirmed they wouldn’t have both ambulances in service at the same time. Chief Williams stated they would call in the back up service if the need for a second ambulance is needed. Commissioner Mathiesen stated SEMS currently has 2 ambulances fully staffed in the City. We will have one ambulance fully staffed and the back up will act as the second fully staffed ambulance. Commissioner Madigan confirmed by using a commercial service provider or a mutual aid provider the firemen would not need to go on the call to Albany Medical Center. Chief Williams stated that would depend upon how they set up that arrangement. If they contract with a commercial ambulance who is going to provide a BLS ambulance and there is an ALS call, they would have to maintain custody of that patient. If they use our neighbors who are all paramedics, we can get back in service. Page 6 of 12 City Council Meeting 1/12/12 Mayor Johnson asked Chief Williams if he has had any discussions with any of the commercial ambulance companies regarding being second and third responders. Chief Williams advised he has had discussions with Empire and Mohawk. Empire is based out of Saratoga Hospital and has a contract with Saratoga Hospital therefore they are in the City often. They said they would be willing to be a back-up. Mohawk was asked the same question and indicated they were not interested in Saratoga Fire Department being the first responders. Mohawk does not feel there is enough resources for that to be an option for them. Conversations with our neighbors (Wilton, Ballston Spa, and Malta) show they are willing to come up with some arrangement. Mayor Johnson stated it is his understanding that if we went the recommendation of Saratoga being the first responder and Empire being the back up; this couldn’t happen right away as Empire does not have a certificate of need to operate in the City yet. Chief Williams stated it is his understanding they will have the certificate January 23rd. Mayor Johnson stated he wanted the public to understand that there are some steps that still need to be followed. He also asked if the first responder was put in place and a call was received and known to be a medical call, not a fire call, will a fire truck still respond with the ambulance. Chief Williams stated right now they do send a truck – a 2 tiered response. They will probably maintainthat but they are working on training dispatch so that they can work on tweaking their response. Many times what sounds to be a simple call turns out to be a lot more. Mayor Johnson confirmed if we were to respond with an ambulance, both responders in the ambulance will be paramedics. Chief Williams advised at least one will be a paramedic. Mayor Johnson asked how many firemen in our current staff are not paramedics. Chief Williams advised we have 34 paramedics, 11 intermediates, leaving 10 people who are not paramedics. Two or three of those are not EMTs. Mayor Johnson asked if the need is seen to increase the training for those who are intermediate. Chief Williams stated most who are intermediates will remain that way as they are the ones who are close to retirement; up in the seniority. Commissioner Madigan asked how many of the calls today are EMS related. Chief Williams advised 66% of the calls are EMS. Commissioner Madigan confirmed we do not receive reimbursement for those calls. Chief Williams advised that is correct. Mayor Johnson inquired as to how many of the calls received today require advanced life support/paramedic level care. Chief Williams advised 15% of their calls involve them doing ALS care. Sometimes the ALS care is provided on route to the hospital. The trend is 40 – 50% of the calls are ALS calls. Mayor Johnson asked of the 50% ALS calls; what number are the lower ALS calls. Page 7 of 12 City Council Meeting 1/12/12 Chief Williams stated 10%. Mayor Johnson asked if reimbursement of our staff was ever discussed in the past. Chief Williams stated in 2007 and RFP was put out which included transport, rental of the facility, and revenue for their services. The range back then was around $150,000 - $200,000 just for ALS service. Mayor Johnson stated in 2007 there was an analysis done by the union regarding staffing required if they were to assume the EMS service in the City. He recently received a copy of that report and it showed projections on staffing to institute that service are different than what they are hearing now. The report said about 10 additional minimum hires are required to assume the EMS service in the City. He asked Chief Williams to explain the difference of what that report said and what they are hearing now. Chief Williams stated the report is based upon a perfect world scenario. Things change and now we have to re-evaluate our resource management. We have tight cost parameters, we still have to provide the services, and we are looking at the NFPA 1710 and how we meet those standards within the same framework we currently have. He would love to have the staff they suggest but they have to face financial realities and think outside the box. They are prepared to accept the reality. Mohawk Ambulance (Richard Brandt, VP of Operations; James McPartlon, VP) Jim McPartlon, Vice President of Mohawk Ambulance stated they are the largest ambulance provider in the Capital Region and one of the largest in New York State. They have 250 professionals that provide services to 60,000 patients per year. At times they provided advanced life support services but those services are predominantly provided by a private party. This is a program they development and implemented in the mid ‘90’s. They estimate that $150,000 - $200,000 in revenue would be generated and given to the City of Saratoga Springs. They would respond to all the calls in the City according to the national response times. Commissioner Madigan asked if the figure provided included rent. Mr. McPartlon advised that did not include rent. Commissioner Mathiesen confirmed they would be willing to pay rent. Mr. McPartlon stated they would rent, lease or purchase a facility. Mayor Johnson asked what they envision their presence being in the City if they were to take over the entire service. Mr. McPartlon advised they would probably have a fleet of 3 or 4 ambulances and staffing would be contingent upon volume. Mayor Johnson asked if they were willing to collect the fees for the paramedic services that our firefighters would perform if they were to provide the entire service. Mr. McPartlon stated they are willing to do so. Mayor Johnson asked if they currently provide second or third call response for any municipality in the area. Mr. Brandt advised at times they will provide mutual aid to Watervliet only because of their close proximity. Commissioner Mathiesen confirmed that Mohawk is more interested in taking over the entire service in the City based upon the need to have a certain amount of volume to justify coming into the City. Page 8 of 12 City Council Meeting 1/12/12 Mr. McPartlon stated it is not economical for them to come into the City based upon a few hundred calls. Mr. Brandt advised what they are proposing to the City they have done for others without any additional cost or further financial risk to those cities. No additional personnel was hired. Mayor Johnson asked if those cities have firemen who are paramedics and do they transport the patient with them to the hospital. Mr. Brandt stated they normally do accompany them. Mayor Johnson asked if they are offering paramedic trained personnel to the City. Mr. McPartlon stated they would have a combination. Mayor Johnson confirmed if there would be any call that would not have a paramedic. Mr. Brandt advised there will be a minimum of 2 people on the ambulance and both could be EMTs. For the City of Saratoga Springs, they would rely upon the City’s Fire Department to provide the advanced life support when needed for the patient. They find 1 out 3 calls require advanced life support care. Mayor Johnson asked if they would be able to absorb some of the employee of SEMS once they are out of business. Mr. Brandt stated assuming those people passed all their employment qualifications, those people would be given first preference for jobs. Mayor Johnson asked if they foresee the need to hire as opposed to their current staffing. Mr. Brandt stated they would need to hire. Mayor Johnson confirmed they are available to provide service on short notice should the City decide to go with them. Mr. McPartlon stated they already hold a certificate of need in the County of Saratoga. Empire Ambulance (Steve Retzlaff, President; Mike Aquino, VP of Operations) Commissioner Mathiesen stated he met with Empire last week. One option discussed was Empire entirely taking over SEMS services and the other option was Empire acting as a back up. Mr. Retzlaff stated Empire has been providing services to Saratoga Hospital for over 20 years. They operate 2 ambulances in the City daily and both are 100% advanced life support. They were approached by the members of the board of directors for SEMS and advised SEMS would no longer going to be able to continue to operate in the near future. SEMS met with them many times and came to an agreement that would transfer the certificate of need to Empire. The service is here and available for the City to use however the City chooses. The reimbursement will go along accordingly with the use. They are willing to lease the facility where SEMS is currently. Mayor Johnson asked them to discuss their willingness to allow the City to be reimbursed for ALS services at the scene. Mr. Aquino stated any services the City provides will be reimbursed. Reimbursement for the advanced life support model would be between $150,000 - $200,000. They do have to lease space in the City. The other model of being a back up is also an option. They would have to add staff and ambulances with this model. These models are at no cost to the City on their end. If they were to bill for the advanced life support, they would absorb the billing fee as they are doing the billing anyway. Page 9 of 12 City Council Meeting 1/12/12 Commissioner Madigan asked if they were the second or third provider would they still need to rent space. Mr. Aquino stated they would still need to rent space and willing to rent the space on West Avenue. Mayor Johnson asked them to speak to the transfer of the certificate of need from SEMS. Mr. Retzlaff advised there are several steps to the transfer. The application has been submitted, reviewed and will be acted upon on the 23rd at the Medical Council meeting. At that point it goes to the Health Department who holds that for 30 days before they issue the operating certificate. In that 30 day interim, an application is made to the Attorney General’s Office for the transfer of operations from a not for profit to a for profit organization for transfer of assets. Malta Ambulance (Brian Taft) & Wilton EMS ( Nash Alexander) Mr. Taft stated their primary goal is to ensure a resident who contacts ‘911’ is not left without service. It is not their intention to be the primary ambulance transport for the City of Saratoga Springs. They do not send patients to collections. They accept what the insurance pays and if the patient does not pay the balance they do not go beyond that. They have the resources and capability to provide mutual aid in the short term. If it were to be long term they would like to discuss further to determine if it would be one or multiple agencies providing the service. Commissioner Madigan asked time-wise how close they are in proximity to the City. Mr. Taft stated have always done mutual aid calls. Commissioner Mathiesen asked if they were providing back up for the City if they would be manning their ambulances in the City. Mr. Taft advised that has not been discussed at this point. It is a possibility as they have the vehicles and equipment. Mr. Alexander stated they would work with the Fire Department on that. Commissioner Mathiesen asked if they would be able to absorb a number of people from SEMS. Mr. Taft stated their employees would have priority if staff was needed. Mayor Johnson asked how their organizations are composed; for example volunteers and paid people. Mr. Taft explained both their organizations and Community Ambulance have a combination of career providers and volunteers. Mayor Johnson asked if all ambulances are staffed with at least one paramedic. Mr. Taft stated they are. All ambulances are ALS ambulances fully equipped with ALS providers (either 1 or 2). Commissioner Madigan confirmed that meant the City would not be required to be down a resource on transport. Mr. Taft stated that was correct. Commissioner Franck asked if the City could legally hard bill as a municipality. Page 10 of 12 City Council Meeting 1/12/12 Mayor Johnson stated he believed we could but could get a legal opinion on that. Mr. Taft stated he believed they had the capability of hard billing but choose not to and that is also part of their contract with a municipality that they will not do that. Commissioner Franck confirmed we are not doing any of the billing. Commissioner Mathiesen stated we will not be doing the billing. Mr. Alexander stated there are avenues within the health care industry to help determine a person’s ability to pay. Everyone will be expected to pay the same, but there are avenues for indigent people to have discounts applied to their bills. Mayor Johnson asked what would happen if they were a secondary call in the City and upon arrival at the scene one of our firefighters is already provided ALS service at the scene and you have your paramedic in the ambulance. Mr. Taft stated it would call dependant and to what degree the primary paramedic is involved. It would be on a per call basis. Mayor Johnson asked if the City would receive reimbursement for their paramedic service before they arrived if they do the transport. Mr. Alexander stated reimbursement for ALS would occur if the City transported with them. Firefighters Local 343 (Joe Dolan, President) & Gary Favro (Labor Rep.& EMS Coordinator of UPSU for SEMS and Retired Captain of Troy Fire Department) Mr. Dolan provided a copy of 46 signatures from the firefighters to provide ambulance transport service. They have been providing this service since 1992 and haven’t received any revenue. The service also requires compassion. He hopes they see these signatures and e-mails as a commitment by the firefighters to participate and provide an excellent service. Mr. Favro stated he has been in the EMS industry for 30 years. He has worked with a lot of other municipalities to help them achieve some of the things being done here. There is no simple resolution and there will be tweaking as you go. A lot of this has to do with scheduling. There can be a gap free system using seasoned paramedics you have had working in this community for 20 years. You want the best system for the community that will also bring in some revenue. Commissioner Madigan asked Mr. Favro if he knows if other municipalities are realizing revenues. Mr. Favro stated they are all realizing revenues. You already have existing manpower in place so anything you bring in revenue is offsetting existing cost. He suggested using an outside billing company that municipality friendly. Commissioner Madigan asked Mr. Favro if he sees a trend where municipalities are taking EMS services in-house. Mr. Favro stated it is now in the 60% range. Commissioner Franck asked Mr. Favro to further explain the commercial services. Mr. Favro stated commercial services are structured differently. They are not necessarily structured for ‘911’ calls; they also do hospital transports, etc. That is where they make their money. Municipalities normally want to do ‘911’ oriented services. Page 11 of 12 City Council Meeting 1/12/12 Mayor Johnson confirmed that response times are mandated by regulations. Mr. Favro stated they are not mandated but they are recommended; they are guidelines. Commissioner Mathiesen stated people have communicated concerns to him. He asked if they could touch on resistance to the idea of firemen doing transports on part of the firefighter community. Mr. Dolan stated a lot of people are resistant to change. When this was started in the ‘90’s there were fears and the fears went away when they realized they could do both. We need to set benchmarks in this City on safety. The program puts together a cost effective program that provides adequate, safe response to the public and firefighters in the City. Mr. Favro stated you will always have a few who are not in support. Mayor Johnson asked Chief Williams to explain overtime that will be incurred. Chief Williams stated the cause for the increase in overtime is because they will be going from a 9 man minimum to the 10th person. The will take the drive off the ladder truck and ‘jump’ them to the ambulance to be with the paramedic. They are raising their minimum staff in order to maintain a full response capability of all the other things they do. They are projecting $78,000 in year one. Mayor Johnson stated the overtime amount has been going down. Chief Williams explained they have a trend now as they had guys in school. Right now they have 3 shifts with 12 members. They have experience from the first half of the year to the second half of the year and used the highest salary figure. Mayor Johnson asked if he used the 2011 figures to come up with this figure. Chief Williams stated they used the 2011 figures. Mayor Johnson asked for the overtime in 2011. Chief Williams stated he has the overtime figure in hours. In 2009 they have 3,300 hours in overtime, in 2010 they had 5,200 hours, and in 2011 they had 1,700 hours. He went on to explained how they came up with the projection of overtime. PUBLIC COMENT Mayor Johnson said the public comment period is limited to a total of 15 minutes and individuals are limited to two minutes each according to the rules approved in February of 2004 by the City Council. Mayor Johnson opened the public comment period at 1:52 p.m. John Tighe of Milton thanked SEMS for the service they provided to the City. They also used soft billing all these years. As someone who used them, he appreciated the soft billing. There is also the question of malpractice and about the billing that will be used. He also heard liens would be put on people’s property. These are questions that have to be answered. Al Callucci of 9 Lexington Road stated he is concerned about who is going to soft bill and who is going to hard bill. He is concerned for the senior population. Some people have to decide now between buying groceries or paying their utility bill. Putting those people in a collection agency would be an insult to them. Page 12 of 12 City Council Meeting 1/12/12 He also would have preferred to see a 10 year plan. It also hasn’t been stated where the projected revenues are coming from. Chief Williams stated the figures are coming from Multi-Med who did the billing for SEMS. Mr. Callucci stated if were to take over completely, we would have to have a separate contract with each insurance company. Chief Williams stated the billing company will take care of that. Mr. Callucci asked what the increase in costs are for insurance and liability. Marilyn Rivers, Director of Risk and Safety state the ambulance has been covered since it has been purchased. The paramedics have also been covered since the City has had professional liability coverage and the Fire Department has expanded its service. The additional coverage is for placement of the patient in the ambulance and transporting them. This cost is approximately $800 per year. Mayor Johnson asked what the limits of liability are for the City. Marilyn advised it is the full limit. Mayor Johnson asked if the ambulance has been used since the purchase. Marilyn advised it has been used as a rescue vehicle but not for transport. Mary Flannigan of Phila Street stated when she needed the use of an ambulance and received the bill; the charge for the transport fee for SEMS was $460 dollars. She couldn’t understand why the City was throwing out revenue. During her second experience, she again saw the Fire Department as the first responders. The people transporting her granddaughter went the wrong way. She hopes whoever does transports for us knows our City. Mayor Johnson closed the public comment period at 2:08 p.m. Another workshop was set up for January 17, 2012 at 6:00 p.m. ADJOURNMENT Mayor Johnson moved and Commissioner Mathiesen seconded to adjourn the meeting. Ayes – All There being no further business, Mayor Johnson adjourned the meeting at 2:10 p.m. Respectfully submitted, Lisa Ribis Clerk Approved: 2/21/12 Vote: 5 - 0 Page 13 of 12