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Minutes 05-18-92SPECIAL CITY COMMISSION MEETING HELD IN COMMISSION CHAMBERS, CITY HALL, BOYNTON BEACH, FLORIDA, ON MONDAY, MAY 18, 1992 AT 4.'00 P.H. PRESENT Arline Weiner, Mayor Lynne Matson, Vice Mayor Edward Harmening, Commissioner ABSENT Jose Aguila, Commissioner (excused) Robert Walshak, Commissioner {excused) J. Scott Miller, City Manager James Cherof, City Attorney Shannon Burkett, Deputy City Clerk CALL TO ORDER Mayor Weiner called the meeting to order at 4:00 p.m. She reported that Commissioner Aguila will not be in attendance due to illness and Commissioner Walshak would most probably be late due to another business matter. 1. Poinciana School - Ootnt Use Agreement, Street Abandon- ment, use of City property for relocation of restdent~ City Manager Miller reported that this meeting is a continuation of the presen- tation brought before the joint School Board/City Commission workshop on April 30th at Poinciana School. City staff is anxious to continue along the same ave- nue of thought expressed at that workshop. Mr. Miller acknowledged the presence in the audience of Remar Harvin, Director of Palm Beach County Community Development and Doug Dawson, Project Manager. Mr. Hawkins presented the Commission with handouts describing the School Board's ideas. Other information distributed to the Commission covered Poinciana School Area Property Information, The packet of information contained an Information Summary Chart providing a summary of property value by street, total number of units, vacant properties, and whether or not the property is owner occupied. A Relocations Summary Sheet was also included providing information on owner- occupied units identified for possible relocation. A Map of the Target Area which identifies each piece of property and shows which are City owned and those owned by the School Board. Also included in the packet is a Specific Listing of Properties in the Target Area which reveals the assessed value of properties and indicates whether they are owner occupied or rental units. Using the Information Summary Sheet and the Map, Mr. Hawkins explained that PoinCiana School currently encompasses approximately eight (8) acres of land. The new SchQol Board requirements for elementary schools are sixteen (16) acres. Because of these requirements, staff recommends the expansion of the school property. The map was color coded showing City-owned property in yellow, School Board property in pink and vacant properties in green. In referring to the Information Summary by Street, values of the property were displayed. City Manager Miller pointed out that thirty (30) properties are being reviewed; five (5) are vacant, thirteen (13) are rental units and twelve (12) are owner occupied. It was pointed out that there is a vacant property across from the main faci- lity, It was suggested that the City abandon NW 12th Avenue which will provide a connection to the other side of the school. This would allow the School Board to do a structural expansion across NW 12th Avenue for connection purposes. - 1 - MINUTES - SPECIAL CITY BOYNTON BEACH, FLORIDA IVY 18, 1992 The Information Summary By Street shows the total assessed value of the proper- ties on NW 12th Avenue, NW 13th Avenue and NW 1st Street. These are 1991 assessed values. The abandonment of the street is an application process. The City would initiate that process. It would be the responsibility of the City to contact utilities for their comments, and provide the necessary notification to the surrounding properties. This is approximately a a thirty-day process. Mr. Miller pointed out that if the street is abandoned, usually half the street goes to property owners on the north, with the remaining half of the street going to the property owners on the south, unless there are covenants or deed restric- tions which state something else. Mr. Miller would not want to abandon NW 12th Avenue unless there are plans for the relocation of the houses on the south side of NW 12th Avenue. Mayor Weiner feels that the first step would be to approach the property owners to determine their willingness for relocation. Following this approach, the next phase would be discussion on the abandonment of the street. The relocation of the owner-occupied properties might fit into a HCD program. In response to Mayor Weiner's question, Mr, Hawkins stated that most of the property owners are local. The School Board could opt to use Wilson Center as the recreation facility in a joint-use agreement. Staff has figured Wilson Center into the overall scheme because of its close proximity to Poinciana School. However, if the School Board is satisfied with the abandonment of NW 12th Avenue, then there will be no need for a joint-use agreement. Mayor Weiner stated that she and Mr. Hawkins toured the area. Wilson Center is in need of paint-up and fix-up. She reminded City Manager Miller to include this in the upcoming budget process. Mr. Hawkins feels the NW 13th Avenue relocations could be considered a third phase of the project. The School Board would have to determine whether or not they want the project to proceed that far. The number of relocations along NW 13th Avenue would be higher and more difficult. There are only a few homes along NW 1st Street. If the School Board uses Wilson Center, those properties might be considered for relocation. Closing NW 12th Avenue will not incon- venience the residents along NW 1st Street. Commissioner Harmening questioned the date of the last appraisal of these pro- perties. Mr. Hawkins believed the information in the City's computer was current. He further askeO if any thought was given to what the costs would be if the City condemns this property. Mr. Hawkins responded that no evaluation was made since it was unknown whether or not the City would want to get into that process. He suggested leaving condemnation to the School Board. Mr. Hawkins suggests working with the homeowners first. He further pointed out that many of the properties are vacant. Mayor Weiner announced that the City has no intention of condemning land or taking anyone's house away. She asked that no one from the community be frightened by these discussions. It w~s pointed out by Ms. Parker that if the School Board agrees with purchasing the properties, it is possible to work out a 50/50 acquisition with them. Mr. Hawkins feels the 50/50 approach would be a good idea. Vice Mayor Matson agreed this was a wonderful start, but wants to know exactly what this project will cost the City and where the money will come from. She -2- N~NUTE$ - SPECIAL C~TY BOYNTON BEACH, FLORIDA I~IAY 18, 1992 wil not support putting any additional taxes on the citizens of Boynton Beach. Mr. Hawkins stated that direction is needed from the School Board. A commitment is necessary as to the School Board's plan for Poinciana's use. Vice Mayor MatSon pointed out that since there are a lot of members of the School Board up forlelection, the next discussion should include them so that the City can get a handle on who is in favor of supporting what is good for Boynton Beach. Mayor Weiner wondered if abandoning NW 12th Avenue was enough to meet the six- teen (16) acre requirement. Mr. Hawkins stated that it will not be sixteen (16) acres, but it will be close to the requirement. Mr. Hawkins assured Mayor Weiner that the Education Advisory Board has been advised of these proceedings, as well as the Community Relations Board. Mayor Weiner suggested the Advisory Board on Children and Youth and the Chamber of Commerce Education Committee be kept informed. ConSensus There was a consensus of the Commission to continue to look into the properties on the south side of NW 12th Avenue, and to get in touch with the School Board to further define their commitment to this project. Vice Mayor Matson reminded Mr. Hawkins to contact those who are running for a position on the School Board. Mr. Miller stated that the City will do its best to get a commitment from the SchOol Board that Poinciana School will continue to operate as a pre-K through 5thigrade facility. The City will then go ahead with its approach. ~ Harvln concurrs with the efforts to retain Poinciana School. He feels it ~e' ~ation of the community and the neighborhood. With regard to the two owner-occupied structures, when Federal funds are committed, it is done in sup- por~ of voluntary displacement. There is never a combination. Arrangements can be made for those who fall in that category, but that situation is avoided because it comes under the Uniform Relocation Program which is more complicated. It i's incumbent upon the City to work with the residents regarding relocation. If they sign the consent for demolition, assistance can be provided. The County mustI provide freedom of choice, The owners can rebuild on the existing lot or relolcate to another location. Mayor Weiner stated that the City is seeking voluntary relocation. Mr. Harvin stated that Federal dollars would not be com- mitted for anything else. Ther~ was no one present to speak at the public hearing. 2, Discussion on potential level of City funding for pro- posed Congress Avenue,,,HtghSchool site Carrie Parker, Asslstant~~ stated that an in-depth preliminary traf- ~udY has b'6'en don'e b~ the ~gineering Department on the Congress Avenue site; The traffic study was reviewed by the County Traffic Engineers and they haveiagreed with the methodology and cost parameters used. Costs have risen slightly to $1,241,382 for the necessary improvements. A formal traffic study will)be required. -3- #IN!UTES - SPECIAL CITY COHMISSION BOYNTON BEACH, FLORIDA MAY lB, 1992 Staff recommends abandoning review of the recreational amenities. commissioner Harmening questioned the County's policy regarding supplying the school with services. With regard to impact fees, there is a State Statute whebeby they are not required to pay impact fees. They will not give the School Board anything. The School Board will have to fund approximately $140,000 to $150,000 in water and sewer improvements at the Jog ROad site. If the City offers to fund the water and sewer improvements, it would be a positive for us. TheiCity is faced with costs of approximately $1.5 million at the Congress Avenue site. Commissioner Harmening stated that he will never vote to spend $1.5 million of the taxpayers' money to secure a school. Mayor Weiner feels that the Commission would not make such a decision. The Commission can vote to put'it on the ballot and allow the citizens to make the decision. Commissioner Harmening feels it is premature to draft an Ordinance to put this on the September Or March ballot because there is not enough information from theiSchool Board as to whether or not they will choose this site. Mayor Weiner feels although a feasibility study has been commissioned, no results are yet available. The results could be forthcoming within 1½ months. At this point, thelSchool Board is aware that the City is interested in the Congress Avenue site and is interested in an unspecified level of funding at that site. Ms. Par~er pointed out that the appraisals of the two sites may have a bearing on the!School Board's choice. City Manager Miller explained that the School Board will be making a decision within the next month or two. Ms. Parker recommends that the Commission state that they are looking at the possibility of funding water and sewer and traffic improvements which amounts to approximately $1.5 million; however, this will be submitted to a referendum vote. Ms. Parker suggested the School Board be advilsed that the Commission would like to have further discussions at a workshop meeting when the results of their studies are available. Vicei Mayor Matson would like to review the cost analysis from the County which complares the two sites. Ms. Parker explained that that information is confiden- tial! and will not be released. Vice Mayor Matson feels that the largest portion of tihe tax bill goes to school taxes now. Although she would prefer to have a highl school on Congress Avenue, she would like assurances that the taxpayers willI not be burdened any further. Vice Mayor Matson pointed out that our boun- daries will be pushing west in the future and if will cost the citizens nothing to h~ve the school on Jog Road, her decision will be a difficult one. Mayor Wein~r stated that the citizens will make that decision. She feels having the highischool on Congress Avenue will keep the eastern section of the City viable. She does not feel a high school on Jog Road will accomplish that. She pointed out ~hat the window of opportunity will be lost if the school is built on Jog Road~ Consensus There was a consensus of the Commission to make the School Board aware that the commission is favorable on this issue, but will submit it to a referendum and proceed from there. Ms. Parker confirmed that the School Board will be provided with the conceptual traffic study and has already received water and sewer information to serve this site; The City Commission is favorable to agreeing to look at the possibility -4- MINUTES - SPECIAL CITY COI~ISSlON BOYNTON BEACH, FLORIDA NAY 18, 1992 of funding these two items; however, it will be submitted to a referendum vote. Mayor Weiner suggested asking for another workshop meeting. Ms. Parker stated that Chairman Graham has not as yet scheduled the workshop which was already requested, but she will follow up on that request. Bob Olenlk, ~ Executive Vice President of the Greater Boynton Beach Chamber ~ ~nmrmrce, ~u6s~ione'a 'hOw~h'"'$1.5"lmi i l~n""~ep~'6Sents in the ~m~e. Mr. Miller respOnded that figure represents approximately 1.85 to 1.9 if we were to fund this in one year. Mr. Miller explained that the City could secure a loan over seven to ten years, or finance a small bond issue over fifteen to twenty years. In his opinion, it would not be fair for the taxpayers to pay for an improvement in one year that People would benefit from ten to fifteen years down the~road. Mr. Miller would be inclined to go with a fifteen to twenty year bond. That would make the annual impact 1/10 of a mil. Mr. Olenik suggested the~City Commission set a date for a referendum so that the School Board may be more endearing to the Congress Avenue site as opposed to the Jog Road site. City Manager Miller pointed out that the financial impact study may determine that the Congress Avenue site is out of reach. The City is awaiting a commit- ment from the School Board. 3, Advance~ Life ~Jpport (ALS) - City Emeriency Medical Service Division (,Fire Department) transportin9 ALS Patients ' Cityl Manager Miller supplied additional information to the Commission. He explained that this issue was discussed at the last City Commission meeting. Staff has met to refine the figures and respond to Bethesda Ambulance staff con- cerns. Bill Guibrandsen will provide an overview and Jim Ness will cover the proposals on how this is working in West Palm Beach. Chief Bob Boike and Paul Franzalis were present to review the programs as well as staff representing Bethesda. BtlllGulbrandsen showed a slide presentation. He explained that when a 911 call is received, a'fire rescue unit responds to the scene regardless of whether it is ALs or BLS. Accompanying the unit is an EMS Supervisor's unit. The City provides three people on the scene. At least two of them are paramedics. City equiPment is taken to the scene of the accident. If advanced life support pro- cedures are required, the paramedic will follow the protocol of the Medical DireCtor and begin that procedure. The Fire Department has two types of units available; the transport capable unit and a non-transport unit. Regardless of which unit responds to the scene, it is necessary to await the arrival of Bethesda Ambulance to proceed to the hospital. UponlBethesda's arrival, the City's equipment and personnel go in the Bethesda unitj This procedure iS wasteful because a truck must follow the ambulance to the hospital to retrieve the City personnel and equipment. Mr. Gulbrandsen showed slides of the rescue units currently available. He pointed out that 2/3 of the front line units are transport capable. The remaining older unit will be disposed of or be rechasised. There is a non pick- up unit in service now. The Fire Department intends to get another modular box fromiDelray Beach. That would give the Fire Department three transport capable units. This would allow one unit to transport one patient which will be more cost)effective for the City and less costly to the patients. -5- ~IINUTES - SPECIAL CITY COMHISSION BOYNTON BEACH, FLORIDA MAY 18, 1992 41m~Nes$~ EMS Coordinator, supplied the Commission with a rebuttal of statements m--~-~e by Be~h'esda AmbUlanCe staff at the last City Commission meeting. {A copy of this rebuttal is attached to the Original copy of theseminutes on file in the City Clerk's Office.) He addressed the issues as follows: This issue referred to Mr. Clair's statement that the City would have to bill people for whom Medicare assignments were accepted and stated it is illegal and considered Medicare fraud not to bill for the 20% difference. The Fire Department stated that the remaining 20% is the patient's responsibility and included the 20% in the revenue figures. It was mentioned that the Fire Department would decide on how agressively the collections would be made. 2. Mr. Clair stated that contrary to the proposal, there would be a net decrease in total units available for response. The Fire Department feels this statement has no merit because the number of units available will remain the same. The City units are now following the ambulance to the hospital. :3. Mr. Clair stated the Fire Department vehicles used for ALS transport would be out of service longer because of the collection of billing information, decontamination of the vehicle, and the possibility of going back into service without a stretcher. That would result in the need to purchase more stretchers and equipment. With regard to billing information, the Fire Department gets back into services as quickly as possible. One individual turns the patient over to the doctor and the other individual gets the truck back into service. During that period, addi- tional calls are handled by back-up units. The billing information which was not gathered is collected when the unit returns to the hospital. Regarding decontamination, there are Federal and State stand- ards to be followed, but the majority of ALS patients are not trauma patients. These procedures occur infrequently; however, a back-up piece of equipment can then be put in place. Most ALS patients require immediate treatment by a doctor. It is unlikely the patient will remain on a stretcher in a hall- way. The Fire Department has additional stretchers available if the need arises. 4. Mr. Clair gave a figure of $20,000 to $40,000 for billing, accounts receivable and customer service. The Fire Department based their figures on West Palm Beach's history of collection over 4½ years. Mr. Boike will address this comment. -6- RINUTES - SPECIAL CITY COHHISSION BOYNTON BEACH, FLORIDA HAY 18, 1992 It was pointed out by Commissioner Harmening that the Fire Department currently transports patients now. Mr. Ness confirmed that procedure is followed when there is a high-priority patient and-the ambulance is delayed or unavailable. The City is not licensed for these transports, but occasionally the State will allow the transport in certain emergencies. Be According to Bethesda, there would be a need for two clerks because of the need for information which must be included in the packet before it is sent to the billing service. During interviews with West Palm Beach EMS, Lake Worth Fire Department and ADT Billing President, it was determined that one clerk would be sufficient. 6. This item deals with the replacement of supplies. The small disposable items are occasionally used but no major cost is. associated with these items. ~7. Mr. Clair stated that financing of accounts receivable must be provided and feels it will cost at least $10,000 to finance the accounts receivable. There would be no need to finance the accounts since all overhead costs are fixed regardless of transport status. money received will be money not available before. Any 8. Mr. Clair stated the Fire Department concept relied on too many erroneous assumptions. The Fire Department based their assumptions on valid histori- cal data taken from various Fire Rescue sources having a track record in ALS transportation. Bethesda's data was presented with no reference as to how or where the data was obtained. Chief Bob Bolke of West Palm Beach,~ explained that the West Palm Beach Fire Department began AL~ansport service in June of 1977. They respond to both ALS ~and BLS calls. When billing began in June of 1987, they contracted out because of their lack of expertise in this area. The rate of return outweighed the cost of the service. For one year's statistics, from 1991 to January, 1992, the total accounts billed were 3,523, which amounted to a gross billing of $709,857.60. The total collec- tions fOr that time period amounted to $401,261.54 for a total 56.5% collection rate* Chief Boike further broke down those figures by private individual paying for the service, Medicaid who was billed and paid, Medicare and private insurance. Of the total dollar amount received, 8.94% was received from private indiViduals, 13.83% from Medicaid, 37.72% from Medicare and 39.51% from private insurance. From the last two figures alone, they collected approximately 80% of the fees. Charges from Advanced Data Processing for the same period amounted to $39,647. West Palm Beach was left with a remaining balance of $361,614 net pro- fit after billing services. -7- RINUTES - SPECIAL CITY CO~414ISSION BOYNTON BEACH, FLORIDA PAY 18, 1992 With regard to administrative work, his personnel collects the billing infor- mation along with patient information. The billing information is completed before transporting or upon transport to the hospital. NO time is wasted gathering information. The EMS secretary spends approximately 40% to 50% of her time doing billing-type information. He stated a good deal of his secretary's time is spent doing cash receipts. Their checks and money orders go to their Fire Department and the secretary sends a report to the Finance Department. Processing the information takes much less time. He stated that West Palm Beach does double the amount of work Boynton Beach is planning to do. These duties were added to the job duties of a secretary who was already in place in West Palm Beach. Jim Ness asked Chief Boike to address the Commission's past concern about citi- zens complaining about double taxing. Chief Boike stated that to date, since June of 1987, he has received approximately fiften telephone calls in total from members of the public who were upset over the billing. The system was explained to everyone who called and after that, the majority understood. Mayor Weiner does not anticipate a tremendous outcry from the public. She also feels it is a matter of getting the information out to the public. Jim Ness reported that 55% of the ALS calls received by the Fire Department were for patients 65 years of age or older. That leads the Fire Department to believe that Boynton Beach's collections should be at least as good as West Palm Beach's collection. In response to Vice Mayor Matson's question, Mr. Ness sta~ed that no one would be denied service regardless of whether or not insurance exists. Care comes first. paul ~ranzela$~ President of Advanced Data Processing, Inc,, does the collection for Lake Worth and West Pa~Beach Fire as well as other municipalities. Mr. Franzelas stated that he has been providing services for West Palm Beach and Lake Worth for over four years. The cost for this service is $4.95 per indivi- dual transport. Additionally, a 20% incentive is collected for any money collected over 50% of the amount billed plus the cost of the telephones at cost. He provided an example of 1,500 patients at a base fee of $7,500 plus incentive. For the $7,500, the patient is billed up to six times. The patient incident report is put into his computer. If insurance information is available, he will immediately file with the insurance company, Medicaid, Medicare or set up monthly payment schedules if necessary. A history is maintained in the com- puters. No harsh techniques are used to obtain money from the individuals. An "800" telephone line is available to receive phone inquiries. City Manager Miller recognized the presence in the audience of the City's MediCal Director, Dr. James Godwin. Robert ~ President of Bethesda Healthcare Corporation and Bethesda Memorial H--O'~.~al, §ta~ed tha~ B~h'esda's Medi'ca~e pehcentages ar~ appr6'ximatei-y 30% to 40% ~f their total transports. He presented a review of Boynton Beach's ALS tran made qual In M resi. cost any sport proposal. Bethesda purchased AA Ambulance in 1985. The purchase was so that the service remained locally-owned and operated to insurance high ity service. The present two-tier system was not developed by Bethesda. '. Hill's opinion, it is the Commission's responsibility to make sure the lents of Boynton Beach receive high-quality service at the lowest possible He does not feel it is the responsibility of the Commission to protect )rivate company or preserve governmental employee jobs. Mr. Hill reviewed -8- RINUTE$ - SPECZAL CITY CONNI$SION BOYNTON BEACH, FLORIDA NAY 18, 1992 his proposal. In his opinion, some of the information provided by the Fire Department was incorrect because they are unaware of the actual transport num- bers. He referred to Page 2 of the report. Mr. Hill stated that the number of total calls reported by the Fire Department are not transports only. According to Mr. Hill, the average charge is $228.03 not $278.45 as proposed by the Fire Department. Regarding expenses, Mr. Hill stated that State-required radios are necessary and is not sure if the Fire Department has that equipment. He stated that Lines 13, 14 and 15 cannot be disputed, but suggested the Commission nego- tiate a contract with Dr. Godwin now before accepting the Fire Department's pro- posal. He further suggested renegotiating the Union contract. The profit- ability being demonstrated is questionable. Mr. Hill pointed out that the fees for emergency medical services in the City of West Palm Beach are expected to be $240,000 below budget and Mayor Graham may seek a tax boost. He stated that part of that tax boost would be to compensate for the medical services short- fall. Mayor Weiner questioned West Palm Beach's shortfalls. Bob Rehr, Fire Chief for the City of West Palm Beech~ stated that the figures quoted in ~ 'newsp~p~'~ a~"~'i'c~e ar~-'b~ on the anticipation of billing in the amount of $694,000 this year and anticipated the Medicare increases to be included. The Medicare increases did not kick in and will go into effect in January, 1993. This will not cause an increase in taxes. Mr. Hill stated that Medicare is lowering the reimbursement rate for all services. Page #5 of the Bethesda report shows that the difference between revenues and expenses is widening. Page #6 depicts a graph which illustrates that the billing fees have increased since 1990. Page #7 indicates the Boynton Beach Fire Department will charge a rate 20% higher than that which Bethesda Ambulance Service is now charging the residents of Boynton Beach. In his opinion, this is a hidden tax increase. Mr. Hill spoke of other options which he feels are more viable. The first of those options is new sources of revenue for the City. Since the paramedics are required to accompany the ALS patient in the back of the ambulance, they can offer an accompaniment fee to offset the time the paramedic is needed in the ambulance. They would offer the City $31,400 as an accompaniment fee. Since the Fire Department buys some supplies from the hospital, they would offer a preferential purchase agreement. This would result in the additional savings of $17,200 for a total cash flow increase of $48,600. Commissioner Harmening pointed out that this amounts to the payment of $20 per transport. A second option to be considered would be a public-private partnership of emergency medical services between the City and Bethesda Healthcare Corporation. Page #10 shows the cost of Fire Department EMS delivery at $1,273,628. Bethesda claims they can provide the same service for $788,111 for a savings of $485,517. Mayor Weiner pointed out that the City would have to layoff the three ALS transport operators and the one Paramedic Supervisor. Mr. Hill did not want to address this subject because he feels he will have to also layoff employees if the City takes over the transport of ALS patients. However, he pointed out that if this partnership agreement was arranged, he would require staffing for the units. He feels Bethesda can provide this service at a cheaper cost than the City, The remaining pages of the report detailed the staffing reductions, the existing budget and the details of how the figure of $788,111 was arrived at. ~. Hill stated that Beth~sd~ is willing to n gotiate a contract with the City. recommended that a future meeting be arranged to discuss the numbers stated at this meeting. -9- ~INUTES - SPECIAL CITY COI~4ISSION BOYNTON BEACH, FLORIDA HAY 18, 1992 MayOr Weiner feels that by discussing these proposals, the City has already come out ahead and feels this is a good start. Vice Mayor Matson asked Medical Director Godwin if there is a need for an addi- tional medical director fee. Dr. Godwin stated there woUld be no additional expenses from him. Vice Mayor Matson confirmed with Mr. Gulbrandsen that there would be no need for addi)tional employees. Vice Mayor Matson questioned the difference in Medicare reimbursements mentioned by Mr. Hill. Mr. Ness explained that the figure he stated was quoted by Medicare for an ALS call. Mr. Gulbrandsen stated that the $228 figure quoted by Mr. Hill is for Basic Life Support service, not for ALS. He explained that the Fire Department will continue to respond to EMS calls, but when the Medical Dispatcher determines that ALS is required, the City will not ask ,Bethesda to respond. The City will transport a minimal number of calls and feels Bethesda is the best agency to do the BLS service. Bethesda has provided good service and has expanded that service to other areas in the County. That expansion has caused some decrease in their availability to respond. Cityl Manager Miller referred to Page 8, the paramedic accompaniment fee. He mentlioned that there had been discussions about a $50 per ALS transport and won- dered if that figure would remain the same. Mr. Hill stated it would have to be analyzed to determine whether or not $50 per transport is financially feasible. Attorney Cherof stated that with respect to any issues which might impact the collective bargaining unit, there is no representation which can be made which could be considered binding either upon the City or the Union members. It is a separate set of discussions which would have to take place, be ratified and reduced to writing. Mayor Weiner suggested City Manager Miller investigate all of the information which was presented. Mr. Hill summarized his remarks: !. He feels the Fire Department proposal would do nothing to improve the service to the residents. He feels Bethesda Ambulance Service and the City have worked well over the years and provided high-quality service. He feels a hidden tax increase is present in the City's proposal. 2. Bethesda feels the City Commission should consider their proposal of a savings of approximately $500,000. He pointed out that if this proposal is considered, that savings would probably not go back to the taxpayers. Commissioner Harmening questioned how many years Bethesda would guarantee such a figure if the City does enter into such an agreement. Mr. Hill said it would be multi!-year, based on arrangement made With the City. 3. Bethesda feels the existing two-tierd system is the best for all parties concerned and recommends the City Commission keep the existing two- tiered system with the addition of the accompaniment fee from Bethesda Ambulance Service. M*INUTE$ - SPECIAL CITY COMHIS$ION BOYNTON BEACH, FLORIDA 1992 Commissioner Harmening suggested directing the City Manager to peruse the infor- mation contained in Bethesda's proposal and attempt to verify its authenticity and reliability and come back to the Commission and to discuss the renumeration aspect with the hospital with offering us approximately $20 per transport. He does not believe that figure is the bottom line. vice Mayor Matson stated that she is opposed to any system that will eliminate anyiof the transporters or supervisors and if there is any money to be made, she is in favor of the City of Boynton Beach making the bulk of the profit. Bob!Olenlk, ~ Executive Vice President, Greater Boynton Beach Chamber of COnmerce, stated the Chamber is concerned about the loss of any jobs in the City. He feels it is important to look at all the options so that jobs are not forgotten in the private sector at the expense of jobs in the public sector. Their money is spent in Boynton Beach. He is also concerned that ancillary reductions will be experienced in the local business. He urged caution when proceeding. Bill Gulbrandsen stated that the Fire Department never intended to eliminate any ~. The Fire Department wishes to give the best care to the patients based on the!agency most appropriate to deliver that care. The Fire Department figures only sPeak of 4.5 calls per day. He does not feel that 4.5 calls per day from Boynton Beach should cause Bethesda Ambulance much hardship. He pointed out that the Fire Department personnel are fire fighter EMTs. If replaced with pri- vate enterprise, the serviceability and cross-training will be lost. ADJOURNMENT There being no further business, the meeting properly adjourned at 6:10 p.m. THE CITY OF BOYNTON BEACH ATTEST: city~lerk ~e~cOrdi ng Secretary (Two Tapes) May o r Vi eXe Mayor Commissioner Commissioner - 11-