HomeMy WebLinkAbout68-08 RESOLUTION4
RESOLUTION NO. 68-08
A RESOLUTION TO APPROVE AN INTERLOCAL AGREEMENT
FOR AMBULANCE SERVICE BY AND WITH THE CITY OF
FAYETTEVILLE, WASHINGTON COUNTY, ELKINS,
FARMINGTON, GOSHEN, GREENLAND, LINCOLN, PRAIRIE
GROVE, WEST FORK, WINSLOW AND JOHNSON, AND TO
ESTABLISH THE AMBULANCE AUTHORITY AND CENTRAL
EMERGENCY MEDICAL SERVICES AS THE EXCLUSIVE
EMERGENCY AND NON -EMERGENCY AMBULANCE SERVICE
WITHIN THE CITIES
WHEREAS, A.C.A. § 14-14-910, and § 14-266-102 and § 25-20-101 authorize cities and
counties to enter into interlocal contracts to provide services such as emergency and non -emergency
ambulance services; and
WHEREAS, the above cities and Washington County have determined that the continued
provision of ambulance service is necessary for the health; safety and welfare of the residents of said
cities and Washington County; and
WHEREAS, Washington County, the City of Fayetteville and all other cities listed in the
Resolution's title agree that the creation of an Ambulance Authority or similar entity as provided for in
A.C.A. § 14-266-100 et seq. is in the best interests of all parties and their citizens; and
WHEREAS, the Ambulance Authority should be established pursuant to the Agreement For
Ambulance Services interlocal agreement attached as Exhibit A to this Resolution; and
WHEREAS, in order to save taxpayer money and to reduce the need for taxpayer revenue to
subsidize the furnishingof emergency ambulance service to our citizens, the Ambulance Authority and
CEMS should be designated the exclusive provider of emergency and non -emergency ambulance service
within all cities that are parties to this agreement.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves the
Interlocal Agreement For Ambulance Services attached as Exhibit A, authorizes Mayor Coody to sign
this agreement, and designates the Ambulance Authority created by this agreement to operate Central
Emergency Medical Services as the exclusive emergency and non -emergency ambulance services
provider throughout Fayetteville and every other city which is a party to this agreement as broadly as
authorized in A.C.A. § 14-266-102 and 105. ""'O
PASSED and APPROVED this the 18'" day of March, 2008.
APPROVED.
By:
ATTEST:
By
DAN COODY, Mayor 4 SONDRA E SMITH, City Clerk/Treasurer
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AGREEMENT
FOR AMBULANCE SERVICES
THIS INTERLOCAL AGREEMENT FOR AMBULANCE SERVICES
("Agreement") is made and entered into by and between WASHINGTON COUNTY,
ARKANSAS, ("County") and the cities of ELKINS, FARMINGTON, FAYETTEVILLE,
GOSHEN, GREENLAND, LINCOLN, PRAIRIE GROVE, WEST FORK, WINSLOW and
JOHNSON ("Cities").
WHEREAS, A.C.A. § 14-14-910, A.C.A. § 25-20-101, and A.C.A. § 14-266-102
authorize cities and counties to enter into contracts to co-operate or join with each other to
provide emergency and non -emergency medical services and to specify the responsibilities of all
parties; and,
WHEREAS, all parties acknowledge that the continued provision of ambulance service
is crucial for the continued health and safety of the residents of the named Cities and the County;
and,
WHEREAS, the County and Cities mutually agree that the creation of an Ambulance
Authority or similar entity as provided for in A.C.A. § 14-14-910, A.C.A. § 25-20-101 and
A.C.A. § 14-266-101 et seq. is in the best long-term interests of the parties; and,
WHEREAS, said Authority should consist of representatives of the above named Cities
and the County; and,
WHEREAS, all parties acknowledge that the formation of such an Authority will
demand close and continued cooperation of all parties.
NOW, THEREFORE, IT IS AGREED:
ARTICLE 1. AUTHORITY ORGANIZATION.
(a) One individual selected by each entity shall represent said entity on the Board of
Directors of the Authority to be known as the Washington County Regional Ambulance
Authority.
(1) Each Board member shall serve a term of three (3) years and be
eligible to serve two (2) consecutive terms.
(2) The initial term of each Board member shall be determined by the
drawing of lots or similar method so as to provide staggered terms.
(b) The Board shall meet on no less than on a quarterly basis to transact all business
associated with the powers and responsibilities conferred upon it. However, the Board shall
reserve to itself the right to meet on whatever basis it determines is appropriate.
(c) The Board shall employ an executive director to manage a regional ambulance
system.
(d) In order to ensure maximum efficiency and effectiveness of the operation, an
executive committee shall be formed to be charged with the oversight of the day-to-day
operation of the system. The members of said executive committee shall be as follows:
(1) The County board appointee who shall reside in the unincorporated
service area.
(2) The Fayetteville City Council appointee;
(3)
A second Fayetteville appointee (Both City Council appointees shall
serve at the pleasure of the City Council and can be removed and
replaced by different representatives by City Council Resolution.);
(4) A small city appointee to be chosen by the aforestated cities, excluding
the City of Fayetteville;
(5)
A Nursing Home or medical profession representative who shall reside
in the City of Fayetteville to be chosen by the County appointee; the
Fayetteville appointees, and the small city appointee.
(6) A Hospital representative who shall reside in the City of Fayetteville to
be chosen by the County appointee; the Fayetteville appointees, and the
small city appointee.
(7)
A representative of the financial community residing in the service area to be
chosen by the County appointee, the Fayetteville appointees and the small city
appointee.
ARTICLE 2. PURPOSES, POWERS, RIGHTS, OBLIGATIONS AND
RESPONSIBILITIES OF THE CREATED ENTITY.
(a) All parties acknowledge that the need to create an entity to own, operate and
manage an ambulance service is necessary and appropriate.
(b) The Authority created herein shall have the following powers:
(1) To provide advanced life support emergency ambulance service in the
designated area;
(2) To provide emergency medical dispatch including pre -arrival
instructions in accordance with approved dispatch protocols;
(3) To set ambulance user fees;
2
(4) To own system revenues;
(5)
To provide exclusive emergency and non -emergency (within the cities
only) ambulance service;
(6) To enter into mutual aid and automatic aid agreements with
neighboring ambulance services for emergency services;
(7)
Comprehensive regulatory powers over the ambulance system
performance;
(8) Ownership of or access to key components of the system infrastructure;
(9)
Centralize medical direction and clinical oversight of the ambulance
system to the extent deemed necessary;
(10) To promulgate rules and regulations to further effectuate the purposes
of this agreement,
(11) To own and dispose of real and personal property;
(12) To adopt and oversee comprehensive system performance on an annual
basis to include periodic revisions to comply with emerging
technologies and changes in clinical and operational standards.
(c) Washington County Regional Ambulance Authority's Specific Duties.
The Authority created herein shall have the following specific duties and responsibilities
in addition to the statutory and administrative requirements of § 14-266-109, the Arkansas
Medical Practices Act, and any other government or professional standards.
(1) Minimum Standards Continue. The Authority shall continue to meet all
existing minimum performance standards within Fayetteville as stated in
the current City of Fayetteville Contract For Emergency Medical
Transport Services with CEMS except as to quarterly reports to the City
of Fayetteville. (A copy of this contract is attached as Exhibit A.)
(2) Reporting Requirements.
A) Fayetteville On the third Tuesday of July each year, the
Washington County Regional Ambulance Authority by the two
Fayetteville representatives on the Executive Committee shall
appear before the Fayetteville City Council to present:
(i) The written annual, audited report of the previous
year's financial and response data reports;
3
(ii) A written report of the financial and response data
for the first half of the current year;
(iii) Plans and projections to replace or enlarge capital
property and equipment within the next 18 months;
(iv) Plans and justifications for any personnel increases
within the next 18 months; and
(v) Revenue/expense projections for the next 18
months.
(B) Any Other Member Of This Authority. Upon written request by
any other member of this authonty, the Board Member
representing that entity shall provide the full written and oral report
referred to in (A) to that City or to the County during its regular
July or August meeting.
ARTICLE 3. FINANCING; TRAINING; COMPLIANCE WITH A C A $ 20-13-
301 ET SEO.
(a) All parties acknowledge that the need for a guaranteed revenue source independent
of and in addition to fees for service is necessary in order to ensure the continued viability of said
service.
(b) The annual regional ambulance service -funding source for all parties of this
Agreement shall be based upon the most recent Federal Census including any special Census.
(1) All Cities shall pay $4.00 per capita except that only those citizens of
Johnson within CEMS's territory shall be counted for the per capita
fees. The City of Fayetteville shall maintain at least its minimum
annual contribution of $270,000.00 through the end of 2011.
(2) Washington County shall pay $15.50 per capital for the unincorporated
population served by CEMS with at least a minimum annual
contribution of $550,000.00 through the end of 2011.
(c) The Authority shall continue to seek a sustainable funding source with the goal of
reducing subsidies proportionately across the board.
(d) Except as stated above, no party to this Agreement may be financially obligated
without the approval of its governing body.
(e) All governing bodies party to this agreement must approve any increases in subsidy.
(1) A percentage of these funds shall be set aside for replacement of capital items.
4
(g) The ambulance service owned or under contract with the Authority shall be required
to provide, at no additional charge, the Arkansas Department of Health 24 hour basic
refresher course to all EMT certified firefighters that act as first responders with said
ambulance service.
(h) The financing provided by the parties hereto shall be from general revenues;
furthermore, the financing and this agreement are contingent upon compliance with
A.C.A. §20-13-301 et. seq. by the County and all the parties will cooperate to the
extent necessary in complying with such. The parties shall receive credit for
payments already made to CEMS in 2008 for this year's annual subsidy
commitment
ARTICLE 4. TERM.
This initial term of this agreement shall be from the date that all parties have agreed to
this interlocal agreement through December 31, 2011. This agreement shall be automatically
renewed with possible changes to Article 3 Financing for an additional five year term unless
any party notifies the Authority in writing of its refusal to participate in the Authority and this
Agreement by September 1, 2011. All parties agree to consider the effects of the 2010 Decennial
Federal Census upon the division of the County Sales Tax between the County and the Cities and
the proportional changes of the populations of the Cities and the unincorporated portions of
Washington County and make any adjustment or amendments advisable and necessary to Article
3 to ensure financial viability of the Authority and faimess for all parties. A second automatic
renewal shall occur on December 31, 2016 unless any party notifies the Authority in writing of
its refusal to participate in the Authority and this Agreement by September 1, 2016. A
substantial review of the financial status of the Authority and all parties should occur in 2021
after the 2020 Federal Decennial Census and prior to further renewals of this Agreement.
Not withstanding the above terms, all parties to this Agreement may withdraw from this
agreement upon six months' written notice to the Authority and shall only be responsible to pay
its per capita fee for that portion of the year.
ARTICLE 5. TRANSFER OF OWNERSHIP OF EQUIPMENT TO
WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY
Property currently owned by any party that is transferred to the Washington County
Regional Ambulance Authority shall be returned to that party or purchased from that party at its
fair market value if such party terminates its membership from the Authority and withdraws from
this Agreement by July 1, 2011, after giving its six month notice All property and resources of
the Washington County Regional Ambulance Authority purchased during its existence or owned
by it on July 2, 2011, or thereafter shall remain the Authority's exclusive property throughout the
Authority's existence.
ARTICLE 6. SEVERABILITY.
The provisions of this Agreement are declared to be severable If any provision hereof
shall be held to be invalid or to be inapplicable to any person or circumstance, such holdings
shall not affect the ability or the applicability of the remainder hereof.
5
ARTICLE 7. EFFECTIVE DATE.
This Agreement shall not be effective until approved and signed by all parties in
accordance with the law.
APPENDIX TO AGREEMENT
APPENDIX DEFINITION OF TERMS WHEN AND IF USED.
Ambulance Authority: Quasi -governmental entity created to oversee and deliver ambulance
service in a specified geographical service area.
Ambulance Service: Means emergency and non -emergency transport services offered by the
Authority, including management, supervision, mass gathering and community events.
Exclusivity: Sole provider emergency and non -emergency ambulance rights granted by
ordinance or resolution by each party to the extent allowed by State Law.
Per Capita: Funding structure set forth by this Agreement based on population. Cities
contribute at $4.00 per capita due to the increased number of calls generated within their city
limits. The County contributes at $15.50 per capita due to the increased coverage area and
decreased density of call volume in the unincorporated areas of the County. No reduction of any
entity's gross subsidy shall occur during first term of this agreement.
Subsidy: Government funds requested by the Authority to provide ambulance service.
User Fees: Fees charged to patients treated or transported by the ambulance service, or fees
charged to an individual or an organization for ambulance standby coverage.
6
Signed this day of , 2008.
CITY OF
FAYETTEVILLE, ARKANSAS
ATTEST:
By:�OVt t&A/
Sondra E. Smith, City Clerk/Treasurer
7
1
Tony Johnson
Submitted By
1
City of Fayetteville Staff Review Form
City Council Agenda Items
and
Contracts, Leases or Agreements
March 4, 2008
City Council Meeting Date
Agenda Items Only
Fire
Division
Action Required:
Res
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Fire
Department
Council approval of the proposed Inter -local ambulance agreement between the City of Fayetteville and Washington
County. There is no cost associated to the approval of this agreement.
Cost of this request
Account Number
Project Number
Category! Project Budget
Program Category / Project Name
Funds Used to Date Program / Project Category Name
Remaining Balance Fund Name
Budgeted Item Budget Adjustment Attached
Department Director r
Cit
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Date
ZS d�
Date
Tam Q• 2 -26-6Y
Finance and Internal Service Director Date
ayor
-2,12.042"?
Date
Previous Ordinance or Resolution #
Original Contract Date:
Original Contract Number:
Comments:
Revised April 16, 2007
ird,/ed 4 eared 7,!,,,as y yfC_
City of Fayetteville Fire Department
303 W. Center St. Fayetteville, AR. 72701
Phone (479) 575-8365 Fax (479) 575-0471
February 20, 2008
To: MayorCoody
Fayetteville City Council
From: Tony Johnson, Fire Chief 19..
Subject: Proposed Inter -local Ambulance Agreement
F
Attached, is the proposed inter -local Ambulance Agreement between the City of
Fayetteville and Washington County. After the many discussions, amendments, and
reviews, I believe the proposal to be favorable to the City of Fayetteville as well as
Washington County. The proposal, if accepted will -provide for the continuation of a
service that the residents of our community have become accustom to. In addition, it
will place an emphasis in the delivery of a service that is home grown and not driven by
the need to show a profit I encourage your careful consideration and passage of the
proposed inter -local ambulance agreement.
RESOLUTION NO.
A RESOLUTION TO APPROVE AN INTERLOCAL AGREEMENT
FOR AMBULANCE SERVICE BY AND WITH THE CITY OF
FAYETTEVILLE, WASHINGTON COUNTY, ELKINS, FARMINGTON,
GOSHEN, GREENLAND, LINCOLN, PRAIRIE GROVE, WEST FORK,
WINSLOW AND JOHNSON, AND TO ESTABLISH THE AMBULANCE
AUTHORITY AND CENTRAL EMERGENCY MEDICAL SERVICES
AS THE EXCLUSIVE EMERGENCY AND NON -EMERGENCY
AMBULANCE SERVICE WITHIN THE CITIES
WHEREAS, A.C.A. §14-14-910, and §14-266-102 and §25-20-101 authorize cities and counties
to enter into interlocal contracts to provide services such as emergency and non -emergency ambulance
services; and
WHEREAS, the above cities and Washington County have determined that the continued
provision of' ambulance service is necessary for the health, safety and welfare of the residents of said
cities and Washington County; and
WHEREAS, Washington County, the City of Fayetteville and all other cities listed in the
Resolution's title agree that the creation of an Ambulance Authority or similar entity as provided for in
A.C.A. § 14-266-100 et, seq. is in the best interests of all parties and their citizens; and
WHEREAS, the Ambulance Authority should be established pursuant to the Agreement For
Ambulance Services interlocal agreement attached as Exhibit A to this Resolution; and
WHEREAS, in order to save taxpayer money and to reduce the need for taxpayer revenue to
subsidize the furnishing of emergency ambulance service to our citizens, the Ambulance Authority and
CEMS should be designated the exclusive provider of emergency and non -emergency ambulance service
within all cities that are parties to this agreement.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves the
interlocal Agreement For Ambulance Services attached as Exhibit A, authorizes Mayor Coody to sign this
agreement, and designates the Ambulance Authority created by this agreement to operate Central
Emergency Medical Services as the exclusive emergency and non -emergency ambulance services
provider throughout Fayetteville and every other city which is a party to this agreement as broadly as
authorized in A.C.A. §14-266-102 and 105.
PASSED and APPROVED this the 4th day of March, 2008.
APPROVED: ATTEST:
By: By:
DAN COODY, Mayor SONDRA E. SMITH, City Clerk/Treasurer
•
AGREEMENT
FOR AMBULANCE SERVICES
THIS INTERLOCAL AGREEMENT FOR AMBULANCE SERVICES ("Agreement")
is made and entered into by and between WASHINGTON COUNTY, ARKANSAS
("County") and the cities of ELKINS, FARMINGTON, FAYETTEVILLE, GOSHEN,
GREENLAND, LINCOLN, PRAIRIE GROVE, WEST FORK, WINSLOW and
JOHNSON ("Cities")
WHEREAS, A.C.A. §14-14-910 and A.C.A. §25-20-101 authorizes Cities and
Counties to enter into contracts to co-operate or join with each other to provide services;
such to specify the responsibilities of all parties, and,
WHEREAS, all parties acknowledge that the continued provision of ambulance
service is crucial for the continued health and safety of the residents of the named Cities
and the County; and,
WHEREAS, County and Cities mutually agree that the creation of an Ambulance
Authority or similar entity as provided for in A.C.A. § 14-14-910; A.C.A. §25-20-101
and A.C.A. §14-266-101 et. seq is in the best long-term interests of the parties; and,
WHEREAS, said Authority should consist of representatives of the above named
Cities and the County; and,
WHEREAS, All parties acknowledge that the formation of such an Authority will
demand close and continued cooperation of all parties
NOW, THEREFORE, IT IS AGREED:
ARTICLE 1. AUTHORITY ORGANIZATION.
(a) One individual selected by each entity shall represent said entity on the
Board of Directors of the Authority to be known as the Washington
County Regional Ambulance Authority.
(1) Each Board member shall serve a term of three (3) years and be
eligible to serve two (2) consecutive terms.
(2) The initial term of each Board member shall be determined by
the drawing of lots or similar method so as to provide staggered
terms.
(b) The Board shall meet on no less than on a quarterly basis to transact all
business associated with the powers and responsibilities conferred upon it
However, the Board shall reserve to itself the right to meet on whatever
basis it determines is appropriate.
(c) The Board shall employ an executive director to manage a regional
ambulance system.
(d) In order to insure maximum efficiency and effectiveness of the operation
an executive committee shall be formed to be charged with the oversight
of the day-to-day operation of the system. The members of said executive
committee shall be as follows:
(1) The County board appointee who shall reside in the
unincorporated service area.
(2) The Fayetteville board appointee
(3) A second Fayetteville appointee
(4) A small city appointee to be chosen by the aforestated cities
excluding the City of Fayetteville.
(5) A Nursing Home or medical profession representative, who shall
reside in the city of Fayetteville to be chosen by the County
appointee; the Fayetteville appointees and the small city
appointee.
(6) A Hospital representative who shall reside in the City of
Fayetteville to be chosen by the County appointee; the
Fayetteville appointees and the small city appointee.
(7) A representative of the financial community residing in the
service area to be chosen by the County appointee, the
Fayetteville appointees and the small city appointee.
ARTICLE 2. PURPOSES, POWERS, RIGHTS, OBLIGATIONS AND
RESPONSIBILITIES OF THE CREATED ENTITY.
(a) All parties acknowledge that the need to create an entity to own, operate and
manage an ambulance service is necessary and appropriate.
(b) The Authority created herein shall have the following powers.
(1) To provide advanced life support emergency ambulance service in a
designated area
(2) To provide emergency medical dispatch including pre -arrival instructions
in accordance with approved dispatch protocols
(3) To set ambulance user fees.
(4) To own system revenues
(5) To provide exclusive emergency and non -emergency (within the cities
only) ambulance service.
(6) To enter into mutual aid and automatic aid agreements with neighboring
ambulance services for emergency services.
(7) Comprehensive regulatory powers over the ambulance system
performance
(8) Ownership of or access to key components of the system infrastructure
(9) Centralize medical direction and clinical oversight of the ambulance
system to the extent deemed necessary
(10) To promulgate rules and regulations to further effectuate the purposes of
this agreement
(11) To own and dispose of real and personal property
(12) To adopt and oversee comprehensive system performance on an annual
basis to include periodic revisions to comply with emerging technologies and
changes in clinical and operational standards
ARTICLE13. FINANCINGNTRAINING;TCOMPLIANCEIWITHWOAN§2013'-30117
se .
(a) All parties acknowledge that the need for a guaranteed revenue source
independent of and in addition to fees for service is necessary in order to ensure
the continued viability of said service.
(b) The regional ambulance service funding source for all parties of this Agreement
shall be based upon the most current Northwest Arkansas Regional Planning
Commission population estimates or most recent Census.
(1) Cities at $4.00 per capita*.
(2) County at $15.50 per capita (unincorporated population).
(c) The Authority shall continue to seek a sustainable funding source with the goal
of reducing subsidy proportionately across the board.
(d) Except as stated above, no party to this Agreement may be financially obligated
without the approval of its governing body.
(e) All governing bodies party to this agreement must approve any increases in
subsidy.
(f) A percentage of these funds shall be set aside for replacement of capital items.
*City of Johnson assessed at $4 per capita for that portion of
the City now served by Central Emergency Medical Service.
(g) The ambulance service owned or under contract with the Authority shall be
required to provide, at no additional charge, the Arkansas Department of Health
24 hour basic refresher course to all EMT certified firefighters that act as first
response with said ambulance service.
(h) The financing provided by the parties hereto shall be from general revenues;
hfwthe theifinanc n ndrttiis agreement are contingent upo npliar
with7A!C!AR§20!13*301ret . by�the County andralrthe parties willcoon` Aerate
to the extent necessary in co�mplymg.with such'
ARTICLE 4. DURATION. This authority will exist in perpetuity, however, any party
may terminate and withdraw from this Agreement in whole or in part upon six (6) months
written notice; any property, real or personal purchased with funds from such party shall
either be returned to the terminating party or purchased by the remaining parties at its fair
market value.
ARTICLE 5. SEVERABILITY. The provisions of this Agreement are declared to be
severable. If any provision hereof shall be held to be invalid or to be inapplicable to any
person or circumstance, such holdings shall not affect the ability or the applicability of
the remainder hereof.
ARTICLE 6. EFFECTIVE DATE. This Agreement shall not be effective until
approved and signed by all parties in accordance with the law.
APPENDIX TO AGREEMENT
APPENDIX DEFINITION OF TERMS WHEN AND IF USED
Ambulance Authonty: quasi -governmental entity created to oversee and deliver
ambulance service a specified geographical service area.
Ambulance Service: means emergency and non -emergency transport services offered by
the Authority, including management, supervision, mass gathering and community
events.
Exclusivity: sole provider emergency and non -emergency (cities only) ambulance rights
granted by ordinance by each party to the extent allowed by state law; exclusivity of non-
emergency service does not include the unincorporated areas of Washington County as
such power is not granted to counties by state law.
Per Capita: funding structure set forth by this Agreement based on population. Cities
contribute at $4.00 per capita due to the increased number of calls generated within their
city limits. The County contributes at $15.50 per capita due to the increased coverage
area and decreased density of call volume in the unincorporated areas of the County.
Subsidy: government funds requested by the Authority to provide ambulance service.
User Fees: fees charged to patients treated or transported by the ambulance service, or
fees charged to an individual or an organization for ambulance standby coverage.
W-row Aua &-
' WashingtonRegional c� "`'
3N-fog
March 3, 2008
The Honorable Jerry Hunton
Washington County Judge
280 North College
210 Court House
Fayetteville, AR 72701
The Honorable Dan Coody
Mayor, City of Fayetteville
Administration Building
113 W. Mountain St
Fayetteville, AR 72701
Gentlemen.
As the predominant healthcare provider for the City of Fayetteville and Washington
County, Washington Regional Medical Center believes it importantto offer its
perspective on the discussion occurring between the City and County with regard to the
merits of having an exclusive provider service the emergency transport needs for the
entire County or the County and City having separate arrangements for such services.
Our perspective on this issue derives from our daily operation of the largest acute care
hospital in the region and one of the state's busiest emergency departments: That „
perspective is further influenced by our charitable mission to serve the healthcareneeds
of all of Washington County's citizens and the surrounding area.
Any resolution of this issue must keep two important considerations in mind. First,
healthcare services do not follow typical free market economic tenets. Healthcare is for
the most part a technological and capital -intensive endeavor where competition often
produces expensive duplication of services with no measurable qualitative benefit —
either in the realm of improved patient care or reduction in overall healthcare costs.
Indeed, it has been my experience that where duplication of services occur higher prices
for consumers generally follow.
Second, ambulance services are considered a low to no margin business as there is a
continual need to maintain, upgrade and replace equipment and train personnel while
operating in a reimbursement environment that is heavily regulated, and therefore
unpredictable, and where a large number of the consumers of the service are uninsured or
unable to pay for the service.
3215 NORTH HILLS BOULEVARD • FAYETTEVILLE, AR 72703 • (479) 713-1000 • wregional.com
rye fayow
Ambulance Service
Page 2
Washington Regional Medical Center, therefore, believes that the concept of a single
ambulance provider for emergency services remains the only prudent and logical means
of ensuring that the overall emergency transport needs of all citizens are adequately met,
whether they live in the City or elsewhere. While it remains unclear as to whether an
exclusive provider would enjoy the prerogative of serving both the emergent and non-
emergent transport needs for all citizens, such course may be necessary to ensure the
economic viability of the overall service. Washington Regional would be concerned that
multiple emergent transport providers servicing Fayetteville, Springdale, and the Larger
County would have a deleterious effect on the overall delivery of healthcare in our
County.
While establishment of an exclusive emergent transport arrangement requires attention to
detail and the development of adequate safeguards to ensure that the County, each
municipality and the overall citizenry receive the highest quality of service at the most
effective cost, benefits that are not traditionally associated with a monopoly, Washington
Regional Medical Center believes that the single emergent transport provider ensures the
most effective emergency care for all citizens of the County.
Sincerely,
Williai L. Bradley
President and Chief Executive Officer
Mar 04 2008 9:11PM HP LASERJET FAX
WashingtonRegional
March 4, 2008
The Honorable Jerry Hunton
Washington County Judge
280 N. College Ave.
210 Court House
Fayetteville, AR 72701
Dear Judge Hunton:
1 14_ p.2
6-41 aguAn� �I e-b%/lam.
Nvoe
As our earlier correspondence indicates, we endorse the concept of an exclusive,
centralized ambulance service for the county's emergency transport needs. While we did
not specifically address a vendor for this critical service, our experience with Central
EMS has been positive.
With that in mind, we do not see any rationale for a change in this regard unless
necessary to meet regulatory or fiduciary requirements unknown to us
Sincerely,
William L. Bradley
President & Chief Executive Officer
3215 NORTH HILLS BOULEVARD • FAYETTEVILLE, AR 72703 • (479) 713-1000. vneg'lonoI.com
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EMS SYSTEM RE=DESIGN
Washington County, Arkansas
September 2005
Report for:
WASHINGTON COUNTY, ARKANSAS
CITY OF FAYETTEVILLE
Prepared by:
• HEALTH CARE VISIONS
201 Moming Dove Court
Argyle, Texas 76226