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Minutes - 01/30/1995 Workshop TAPE READING 0001 0003 0036 0121 COUNCIL WORKSHOP MEETING MINUTES January 30, 1995 DATE. COUNCIL CHAMBERS, CITY HALL, CITY OF WOODBURN, COUNTY OF MARION, STATE OF OREGON, JANUARY 30, 1995. CONVENED. At 7:00 p.m., Mayor Kirksey convened the workshop session for the purpose of discussing Ambulance Franchise issues. ROLL CALL. Mayor Councilor Councilor Councilor Councilor Councilor Councilor Kirksey Chadwick Figley Hagenauer Jennings Pugh Sifuentez Present Present Present Present Present Present Absent staff Present: city Administrator Childs, City Attorney ShieldS, city Recorder Tennant Also in attendance: Marion County representatives - Michael Hanson, Asst. Legal Counsel, and Joe Fowler, Health Dept. Manager; Woodburn Ambulance Service - Randy Garner and Shawn Baird; Richard Van Orman, Mt. Angel city Administrator; and Helen Buzenberg, Intern from University of Oregon. Administrator Childs reminded the Council that the franchise ordinance had been extended to April 30, 1995 in order to address the issue as to whether or not a franchise should be renewed and, if renewed, whether or not a franchise fee should be charged for this service. He stated that staff has further researched the issues since the November workshop and staff memos on this subject were distributed to the Councilors at the start of this workshop. Marion County staff members were asked to attend this workshop in order to provide the Council with information on the Ambulance Service Area plan. Joe Fowler stated that the County has been working on a county-wide plan for 5 or 6 years. The plan involved participation from the public, Fire Departments, 9-1-1 agencies, ambulance service providers, local government agencies, and hospital service providers. The plan was approved by the State last year and the County is now in the process of implementing the plan. Mike Hanson stated that the County is only doing the Ambulance Service Area plan because state law gives them the responsibility to develop and coordinate ambulance services. The plan lays out the ambulance service areas which generally Page 1 - Council Workshop Meeting Minutes, January 30, 1995 r -.,' "'~"~"-""-"-'"<~-~'-' ---'---"---"'-~'---"._-'--+^.._.._- TAPE READING 0547 COUNCIL WORKSHOP MEETING MINUTES January 30, 1995 goes by geographical boundaries. There is only one service provider in a specific service area. The County has exclusive 5 year franchises with the ambulance services which will expire on December 31, 1997. At the expiration date of the franchise, the providers will need to re-apply and a competitive process could be followed by the County to select the ambulance provider for the next franchise term. An advisory committee is in place which sets performance standards and assures that all state standards are met. Under the state law, the city does have the authority to franchise, however, the franchise ordinance must conform to and comply with the County plan. The City franchise allows for rate regulations whereas state law does not allow County plans to regulate rates. The County can set a fee for administrative services, however, the County has elected not to set any fees at this time. Once the plan has been fully implemented, they may need to hire someone part-time to handle complaints and to review and check performance standards of the ambulance service providers. The County may then decide to impose an administrative fee to offset costs to oversee the Ambulance Service Plan. In establishing a City franchise fee, consideration should be given regarding the overall impact fees may have on the franchisee and their ability to operate. Under the County plan, the provider is not at liberty to discontinue ambulance service at anytime during the franchise period, however, the County could take over the ambulance service's operation. Coordination between the County and city is a key element in making the ambulance service franchise work within the city. Councilor Jennings questioned the need to have a franchise if ambulance service is closely regulated by the county and state. He also suggested that if an ordinance is adopted, the ordinance would basically adopt the county plan and state regulations. Administrator Childs stated that he has had some experience in writing an Ambulance Service Plan through his previous employment and policy issues need to be addressed by the council before final determination is made as to whether or not a franchise ordinance is adopted. Issues that would make it favorable for a franchise include (1) regulation of rates, (2) County's obligation to consult with City, (3) County follow-through with their obligations, and (4) provide for the City to collect some fee for oversight of the franchise even though the County may impose some fees. Brief discussion was also held on the issue of exclusive versus non-exclusive franchise. Even though the City's ordinance may be non-exclusive, the County's franchise will still only provide for one ambulance provider within the City. Page 2 - Council Workshop Meeting Minutes, January 30, 1995 r' --+..-..~. -'.._._-~_...<-_..".__.-"-- --".<>--",."-_..,,,~ ,~-,--~~,-- - w COUNCIL WORKSHOP MEETING MINUTES January 30, 1995 'H.PE READING It was noted that the state law provides that the County consult with appropriate agencies, however, a franchise would give the city the right to accept or reject any service provider for the City. 1023 Randy Garner stated that, after hearing the comments made by County legal counsel, he feels that there probably is some benefit to having a franchise with both entities as an added protection for his business. He also stated that he had prepared written information for Council review which focuses on the franchise fee issue. Discussion was held on the overall concept of a franchise ordinance and it was the consensus of the Council that the ordinance should only address issues that are not covered by state or county regulations. Randy Garner stated that the City does incur some administrative costs, however, he felt that the City should only impose fees actually incurred to administer the franchise rather than charging a percent of gross income. He reiterated his concerns regarding potential violation of the Federal Medicare Anti-Kickback statute. He suggested that the following issues were identifiable problems: (1) franchise fee is a regressive tax since the burden of the fee is paid by only 50% of the patients with the rest of the accounts uncollectible; (2) franchise fee elevates rates and discourages the use of the service to avoid the bill; (3) Medicare has changed their category of payments and it is unknown as to what effect it may have on reimbursing the ambulance service for services provided; (4) people are reactive to ambulance rates and, as a provider, would like to keep the base rate below $600; (5) he does not feel that the franchise fee goes back to the citizens in providing emergency services; (6) County will eventually have to establish a fee to offset administrative costs; (7) franchise tax should not be compared to a utility tax in which service can be discontinued for failure to pay; and (8) higher ambulance rates may weaken Woodburn Ambulance's position to continue this service when the time comes for re-applying for a franchise with the County. He stated that he is not at odds with the City and he feels that it is totally reasonable to expect the City to recover documented costs. He strongly objects to the current percentage of gross franchise fee currently being charged. Discussion was held on the fee issue and whether it should be assessed on the percentage basis, flat rate, or a per patient basis. Administrator Childs stated that he was reluctant to lose the current franchise fee payment which amounts to approximately $8,000. Additionally, he did not feel that the Pilge 3 - Council Workshop Meeting Minutes, January 30, 1995 r -... -~ .--~--~---,.....,_.,-~._......__._<,_.._---... .. . -~~ TAPE RFADING 'rape 2 ~L457 SJ'l12 M~TEST COUNCIL WORKSHOP MEETING MINUTES January 30, 1995 City was violating the Medicare law by charging on the percentage basis. After further discussion on the issue, it was the consensus of the Council that staff analyze costs incurred by the City to administer the ambulance franchise and report back to the Council. Randy Garner stated that he would not remit any funds to the City until the issue is resolved since he is at a much greater risk at the federal level with the Medicare issue. He feels that the City needs to show that the fees paid benefit the people who receive the service. It was also noted that ultimately, the County must approve any franchise adopted by the city for ambulance services. Richard Van Orman stated that Mt. Angel is following on the heels of Woodburn since their franchise with Woodburn Ambulance expires June 30, 1995. He commented on how the emergency medical service franchise fee concept is divorcing itself from the regular franchise theory whereas the franchise fee paid is for allowing the business to use City streets. Attorney Shields commented on how the parties agree to disagree with the main issue being the use of federal money collected towards the payment of franchise fees. The workshop adjourned at 8:55 p.m.. fYI~~-J- Mary Te ant, Recorder City of Woodburn, Oregon Page 4 - Council Workshop Meeting Minutes, January 30, 1995 r h. ,. --"._.._..._..__~~""____" ._n~ " ,..__.-----.__~_~~. I 'I