City Council

February 2, 2012 CITY OF SARATOGA SPRINGS City Council Meeting Agenda 5:00 PM CALL TO ORDER ROLL CALL SALUTE TO FLAG PUBLIC COMMENT PERIOD / 15 MINUTES PRESENTATION(S) 1. None EXECUTIVE SESSION: 1. None 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. Discussion and Vote: Resolution to Set Saratoga Springs Fire Department Ambulance Service Fees SUPERVISORS 1. None ADJOURN City Council Meeting 2/2/12 February 2, 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 ABSENT: 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 5:02 p.m. 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 5:02 p.m. Page 2 of 7 City Council Meeting 2/2/12 John Tighe of Milton stated he has a lot of experience with insurance companies and reimbursement rates. A lot of the insurance companies won’t pay for an ambulance ride where patients aren’t hospitalized. You are getting into areas you don’t understand. He doesn’t believe we will get $100,000 per year for rent of the West Avenue location. Phil Diamond of 29 Waterview Drive asked what is the rush that caused a meeting to be called today. He thinks the urgency has been fabricated. When something is fabricated; usually people are afraid of scrutiny. He is not concerned about the fees but what is the net profit to the City. Mayor Johnson closed the public comment period at 5:05 p.m. MAYOR’S DEPARTMENT Nothing at this time. ACCOUNTS DEPARTMENT Nothing at this time. FINANCE DEPARTMENT Nothing at this time. PUBLIC WORKS DEPARTMENT Nothing at this time. PUBLIC SAFETY Discussion and Vote: Resolution to Set Saratoga Springs Fire Department Ambulance Service Fees (12- 31) Commissioner Mathiesen thanked everyone for coming together tonight. They are going to be putting EMS into service soon and need to establish a fee structure. Commissioner Mathiesen moved and Commissioner Madigan seconded to approve the resolution to set Saratoga Springs Fire Department ambulance service fees. Commissioner Mathiesen read the following into the record: A RESOLUTION OF THE CITY OF SARATOGA SPRINGS, NEW YORK BE IT RESOLVED, by the City Council of Saratoga Springs as follows: Ambulance fees for the Saratoga Springs Fire Department Ambulance Service are hereby established. The fees shall be as follows: BLS (Basic Life Support) $600 ALS 1 (Advance Life Support) $800 ALS 2 $900 Non-transport RMA (Refuse Medical Aid) BLS $100 Non-transport RMA-ALS $150 Mileage $15 per mile Commissioner Franck asked if these rates are approximately the same as SEMS. Commissioner Mathiesen stated these rates are a little higher. SEMS had not upgraded the fees in some time. Page 3 of 7 City Council Meeting 2/2/12 Commissioner Franck asked how they came up with the fees. Commissioner Mathiesen stated they consulted with a billing service that provides service to others for the current market amount. Commissioner Franck asked how are rates changed. Commissioner Mathiesen stated the rates can be changed at any time with Council approval. Commissioner Franck wanted to confirm Public Safety plans to review these rates on an annual basis. Commissioner Mathiesen advised they will. Commissioner Franck asked if the rates are comparable to the ambulance company that will be the back up for the City? Commissioner Mathiesen stated they are. They have been talking to Empire to do secondary service. Commissioner Franck asked if there is a balance to be billed to the patient, will the billing company do the billing for that and if so, will it be a soft billing. Commissioner Mathiesen stated the billing service will do that billing and it will be a soft billing. The back- up service will be responsible to do their own billing. Commissioner Franck asked if it is known if major insurance companies pay these rates. Commissioner Mathiesen stated he does not know. Commissioner Franck asked if SEMS had their fees paid in full. Commissioner Mathiesen stated he wasn’t sure. This does not include Medicare and Medicaid. They are waiting to become part of those 2 systems. They are not able to bill those entities at this time. Commissioner Franck asked if we are able to back bill for services once we are part of those systems. Commissioner Mathiesen stated you can’t bill into those systems until you are part of those systems. Commissioner Franck asked if we will be balance billing patients who have Medicare or Medicaid. He stated younger and older patients have a higher probably for ambulance need due to injury. His concern is if 60% of the calls are for patients over the age of 65; they are the people who are not able to pay. Commissioner Mathiesen stated SEMS collected $1.3 million in self pay last year. The billing company will be helpful in how to interact with the outside. He stated they plan to go to Multi-Med for billing service. Commissioner Franck asked if they were able to get a reduction in percentage with Multi-Med from what SEMS received. Commissioner Mathiesen stated they did. Commissioner Madigan stated people may be confused as they may see different rates depending upon if our Fire Department transports of if another company does. Commissioner Mathiesen stated he presented Empire with our fees and asked they be similar; to which they agreed. They can’t be exact due to conclusion. Page 4 of 7 City Council Meeting 2/2/12 Mayor Johnson stated he is not sure what the emergency is here for this meeting. Not all the approvals are in place and now he is hearing Public Safety is negotiating with Empire. He thought that had to be an RFP. Commissioner Mathiesen stated he brought everyone here because our Fire Department may be in service as an ambulance as soon as tomorrow. This will keep transparency. Mayor Johnson stated there is service through SEMS for at least the next 5 days when our next Council meeting is scheduled. The fees will be charged to the residents without them being able to comment. This is being rushed. This is a serious issue for our community. Commissioner Mathiesen stated that is the mayor’s opinion that this is being rushed. He doesn’t believe that is the case. There has been little communication between SEMS and the Fire Department. This is the last step before they provide service. There is no need to put the City in a position where they may not be able to provide service. They also are not sure how firm that date is or if their employees will continue to show up. Mayor Johnson asked if they have contracted with Multi-Med as the billing service. Commissioner Mathiesen advised they have not contracted yet but will be soon. Mayor Johnson asked if that is going out to bid. Chief Williams advised it is not as it is a professional service. Mayor Johnson stated he disagrees; it is not professional services. Chief Williams stated he was informed this is professional services. He was told by the supervisor of SEMS they may end service this weekend. Mayor Johnson stated he thought we had back-up from our neighbors. Chief Williams stated they have a plan in place. We have the ability to do it. Commissioner Mathiesen confirmed with Chief Williams if they cab back bill private insurance for services they provide. Chief Williams stated as far as he knows they can back bill. Mayor Johnson stated there are so many things unanswered. The fees are being raised a considerable amount from what SEMS was charging. The public should have the opportunity learn about this and comment before we set fees. It will take 90 – 120 days to get certified to bill Medicare and Medicaid. They are looking at giving away free services to a certain population. They will treat other differently if they don’t have Medicare or Medicaid. Can that legally be done and not charge someone back. Commissioner Mathiesen we haven’t been getting paid any fees since 1992. The system is Medicare and Medicaid patients have always been treated differently. People who have private insurance or no insurance are billed at a higher rate than Medicare or Medicaid patients. They are just trying to get going with their system. Mayor Johnson stated there isn’t a comprehensive plan; there is a lot of confusion. We are getting this one step at a time. We could have given Empire temporary service while we got all our ducks in a row. This is not serving our taxpayer the way they should be. He hopes Chief Williams took all variable reimbursements into consideration when he did his calculations. Chief Williams stated he received numbers from Multi-Med with all variables. Page 5 of 7 City Council Meeting 2/2/12 Mayor Johnson asked if we will be soft billing. Chief Williams stated there is a process where a letter goes out. They have the option to send a second letter. They can pick ones they want to hard bill; for example they can hard bill the people who get a check directly form their insurance company. All people will get at least one letter and after that we have an option. Commissioner Mathiesen stated he hasn’t heard any complaints about how Multi-Med operated with SEMS. Commissioner Scirocco asked if we know how much money is on SEMS’ books. Commissioner Franck advised that information is on-line and look at their 990. Chief Williams stated our rates are compatable with our neighbors. There are varying rates now. Mayor Johnson stated the public does not know we were doing this tonight. Commissioner Franck asked how many billing companies are out there. Chief Williams stated there are 3; Multi-Med, Empire, and Certified Ambulance Group. Commissioner Franck advised if there are 3 they have to get written quotes. The SEMS rates were too low. It would be nice to have a chart showing comparisons. The only thing giving him pause is not having comparisons. Chief Williams provided a comparison chart. Commissioner Madigan asked if the back-up ambulance service is going to require an RFP. Chief Williams advised there are only 2 commercial ambulances and Mohawk stated they were not interested. Commissioner Franck asked if there have any discussions on rent. Commissioner Mathiesen stated they have had discussions. The assessor evaluated the location to come up with a rental rate; approximately $59,000 per year. Commissioner Franck stated he can support the numbers but his concern is there aren’t a lot of people here. Chief Williams stated if there are no rates in place they cannot back bill for the service. Commissioner Franck stated he can support the rates but he has a problem with people not seeing them. Chief Williams stated they will be operational tomorrow. Commissioner Mathiesen stated SEMS will be secondary and the County has been notified. Commissioner Franck stated he is not trying to stop them from taking the ambulance service tomorrow. He would like to see this before the public for a regular scheduled meeting. Commissioner Madigan stated they are bringing all fees to the table on Tuesday night so they can bring these fees back then. It might be helpful to set the fees for the next 4 days. If we don’t set the fees the tax payers will pay for this service. Page 6 of 7 City Council Meeting 2/2/12 Commissioner Franck stated again his biggest issue is there is no input from the pubic. Mayor Johnson stated other than the article in today’s Saratogian, there was no notification. It is an important issue for the community. Commissioner Mathiesen asked Tony Izzo what is required in terms of notification for an emergency meeting of the City Council. Tony Izzo stated if it is not a regular meeting, the Opens Meeting Law states to the extent practicable. No legal notice is required, notice must be given to the meeting and it must be posted. It was posted on the bulletin board. Commissioner Madigan stated again all the fees are coming back to the table Tuesday night. Is there a way to set the fees for the next 4 days? Commissioner Franck stated you can go with SEMS fees. Commissioner Mathiesen suggested going with the SEMS fees until the Council meeting on Tuesday. Commissioner Franck stated SEMS fees won’t work long term but he can vote for SEMS fees to get something and bring the fees back on Tuesday. Commissioner Mathiesen moved and Commissioner Franck seconded to establish the fees for the Fire Department transport based upon the SEMS fees and the schedule will be extended until the evening of February 7th for the following rates: BLS $500; ALS1 $575; ALS2 $652; Non-transport RMA $125; and mileage $12. Mayor Johnson stated he still will not support this as convening this meeting is against what they should be doing and he is not convinced it is an emergency situation. If we weren’t fully ready to take over ambulance transport we should have contracted with someone who is until we were fully able to do so. He is also concerned about losing the Medicaid and Medicare reimbursement for up to 4 months with no valid reason. Commissioner Mathiesen stated they are ready to provide the service. Mayor Johnson stated we are ready to provide service at the scene but we are not ready to recoup (financially) what we should be for the service. We are doing things one step at a time and unresolved questions. He still hasn’t received the report he requested. Chief Williams stated that Mayor Johnson was provided the report by Kevin Genier per the union president. Every member of the City Council received it. Ayes – 4 Nays – 1 (Mayor Johnson) ADJOURNMENT Mayor Johnson moved and Commissioner Franck seconded to adjourn the meeting. Ayes – All There being no further business, Mayor Johnson adjourned the meeting at 6:10 p.m. Respectfully submitted, Page 7 of 7 City Council Meeting 2/2/12 Lisa Ribis Clerk Approved: 3/6/12 Vote: 5 - 0 Page 8 of 7