HomeMy WebLinkAbout2016-0517 Documents Submitted at Mtg
CITY OF
^AS H LA N D
Council Communication
0511712016, Business Meeting
Ambulance Operator's License Renewal
FROM:
John Karns, Fire Chief, Ashland Fire & Rescue k ms', ashiarY ®on s
SUMMARY
The Ashland Municipal Code requires that all ambulance service providers in the City obtain an
ambulance operator's license. This is the Fire Department's request for the renewal by Council of the
Fire Department's Ambulance Operator's License per AMC 6.40.110.
BACKGROUND AND POLICY IMPLICATIONS:
Ashland Municipal Code (AMC) Chapter 6.40.110 requires ambulance service providers operating
within the City of Ashland to apply annually for an ambulance operator's license. The Fire Department
has provided emergency services in Ashland since 1885. From 1926 to 1936, the fire department
operated the ambulance service in Ashland, and in 1936 the ambulance service was sold to Litwiller
Funeral Home. The fire department obtained its first medical response vehicle (Rescue 9) through
community donations in 1973, and began providing first response emergency medical services to the
community. In January 1996, the City of Ashland purchased the Ashland Life Support Ambulance
Company and Ashland Fire & Rescue began providing ambulance services within a 650 sq mile
ambulance service area in south Jackson County, known as ASA III. Ambulance services in Oregon
are regulated by county governments, and within the City of Ashland they are required to obtain an
ambulance operator's license. This license is renewed on an annual basis.
FISCAL IMPLICATIONS:
The license fee is $300 plus $100 per ambulance, for a total of $800. This is provided for by a line item
in the department's emergency medical services budget (604160).
STAFF RECOMMENDATION AND REOUESTED ACTION:
Staff recommends renewal of the Ambulance Operator's License for Ashland Fire & Rescue.
SUGGESTED MOTION:
I move approval of the application for an Ambulance Operator's License for Ashland Fire & Rescue.
ATTACHMENTS:
Ambulance license renewal application.
Page 1 of 1
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Ashlars Fire & Rescue
Ashland', O
This report was generated on 5/10/2016 4:22:48 PM M
I
State o®s per Personnel
i®_ NAME STATE EMS to EMS CERT. LEVEL STATE TRAINING ID
o~
1144 Beck [P], Todd 124333 EMT Paramedic 9119 ati
089170 Boyersmith [P], Steve 120378 EMT Paramedic 5901
089667 Burns [P], Andrew 139879 EMT Paramedic 27749
9472 Burns [P], Kelly 120248 EMT Paramedic 12147
089437 Foss [P], Justin 131705 EMT Paramedic 20624
25664 Freiheit [P], Matt 121237 EMT Paramedic 9854
089466 Garfas-Knowles [P], Ron 132871 EMT Paramedic 25087
1126 Hadden [P], Jennifer 124336 EMT Paramedic 13281
33984 Hanstein [P], David 111814 EMT Paramedic 7088
089515 Hegdahl [P], Tim 135298 EMT Paramedic 25030
089289 Hickman [EMT], Margueritte 128889 EMT 13324
36864 Hollingsworth [P], Scott 113607 EMT Paramedic 3629
089399 Knutson [P], Brent 130961 EMT Paramedic 19472
089163 Lacoste [P], Rod 127119 EMT Paramedic 13893
089465 Manning [P], Ashley 132690 EMT Paramedic 22552
089625 Mekkers [P], Mike 135069 EMT Paramedic 5585
089277 Menold [P], Lance 125954 EMT Paramedic 17566
089565 Palmesano [P], Nick 134776 EMT Paramedic 25485
089255 Rasor [P], Marshall 126969 EMT Paramedic 13980
089436 Roselip [P], David 130561 EMT Paramedic 17793
69056 Rosenlund [P], Derek 121067 EMT Paramedic 12485
089666 Safko [P], Kyle 143902 EMT Paramedic 31523
69248 Sallee [P], Dana 116336 EMT Paramedic 12486
-
1052 Shepherd [P], David 123197 EMT Paramedic 9766
1053 Stephens [P], Robert 123787 EMT Paramedic 12148
77560 Stoy [P], Trent 118911 EMT Paramedic 12483
089295 Stubbs [P], Todd 130277 EMT Paramedic 16319
089665 Thomason [P], Jim 139172 EMT Paramedic 28470
089428 Trask [P], Robert 130008 EMT Paramedic 16743
089394 Turner [P], Shannon 126208 EMT Paramedic 12628
089630 Winwood [P], Brandon 136263 EMT Paramedic 25223
emergencyreporting. com
Doc Id: 1255
All active personnel Page # 1
CITY OF ASHLAND
APPLICATION FOR AMBULANCE OPERATOR LICENSE
AMC Ch. 6. 6.40
2016
Applicant's Name: CITY OF ASHLAND
Trade Name, if any: ASHLAND FIRE & RESCUE
Address: 455 Siskiyou Boulevard
Ashland OR 97520
Telephone number: (541) 482-2770
Ambulance descriptions Manufacturer Vin # License #
1. 2002 Ford LIFELINE 1 FDXF47F63EA10341 EXEMPT
2. 2016 Ford HORTON 1 FDUF4HTXGEA67381 EXEMPT
3. 2011 Ford LIFELINE 1 FDUF4HTOBEC53861 EXEMPT
4. 2006 FORD LIFELINE 1 FDXF47F06ED06467 EXEMPT
5. 2008 FORD LIFELINE 1 FDXF47R48ED90832 EXEMPT
â Attach information showing that every proposed driver, attendant and driver-
attendant is qualified as required in Ashland Municipal Code Chapter 6.40 and as
required by the laws of the State of Oregon.
o Enclose with the application, the initial license fee of $300 plus $100 per ambulance.
â Enclose a performance bond in the amount of $500,000.
â Enclose an insurance policy meeting the requirements of AMC §6.40.110.7. Attach
additional pages as necessary. Explain any box not checked.
Submit your application and required enclosures to Barbara Christensen, City Recorder,
City Hall, 20 East Main Street, Ashland, Oregon 97520.
1 certify that each ambulance listed above is adequate and safe for the purposes for
which it is to be used and that it is equipped as required by Ashland Municipal Code
Chapter 6.40 and the laws of the State of Oregon.
J
Signature
Print name: Kimberley Summers
Title: Administrative Assistant
Date: 05-17-2016
R\Ambulance License Fee12015 Lic. renewal.doc
April 10, 2009
ROSTYKUS, PAUL S MD
ASHLAND FIRE DEPARTMENT
MED DIRECTOR: DR PAUL ROSTYKUS
N 455 SISKIYOU BLVD
ASHLAND, OR 97520-0000-000
C?
J
DEA REGISTRATION THIS REGISTRATION FEE I CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE
NUMBER EXPIRES PAID I UNITED STATES DEPARTMENT OF JUSTICE
BA3050692 04-30-2018 FEE EXEMPT I DRUG ENFORCEMENT ADMINISTRATION
I WASHINGTON D.C. 20537
SCHEDULES BUSINESS ACTIVITY ISSUE DATE I Restricted to Government personnel for official dutles only.
F 2,2N, PRACTITIONER 03-19-2015 1
3,3N,4;5, 1
ROSTYKUS, PAUL S MD 1 Sections 304 and 1008 (21 USC 824 and 958) of the Controlled
LIMITED TO OFFICIAL GOVERNMENT DUTIES ONLY ( Substances Act of 1970, as amended, provide that the Attomey
ASHLAND FIRE DEPARTMENT ( General may revoke or suspend a registration to manufacture,
distribute, dispense, import or export a controlled substance.
455 SISKIYOU BLVD I
ASHLAND, OR 97520-0000 I THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF
1 OWNERSHIP, CONTROL, LOCATION, OR BUSINESS ACTIVITY,
I AND IT IS NOT VALID AFTER THE EXPIRATION DATE.
CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE
UNITED STATES DEPARTMENT OF JUSTICE
DRUG ENFORCEMENT ADMINISTRATION
WASHINGTON D.C. 20537
DEA REGISTRATION THIS REGISTRATION FEE
NUMBER EXPIRES PAID
BA3050692 04-30-2018 FEE EXEMPT Restricted to Government personnel for
official duties only.
SCHEDULES BUSINESS ACTIVITY ISSUE DATE
2,2N, PRACTITIONER 03-19-2015
3,3N,4,5,
CD ROSTYKUS, PAUL S MD Sections 304 and 1008 (21 USC 824 and 958) of the
LIMITED TO OFFICIAL GOVERNMENT DUTIES ONLY Controlled SubstancesAct of 1970, as amended,
N ASHLAND FIRE DEPARTMENT provide that the Attorney General may revoke or
455 SISKIYOU BLVD suspend a registration to manufacture, distribute,
o ASHLAND, OR 97520-0000 dispense, import or export a controlled substanoe.
0 THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF OWNERSHIP, CONTROL, LOCATION, OR BUSINESS ACTIVITY,
AND IT IS NOT VALID AFTER THE EXPIRATION DATE.
DEA REGISTRATION THIS REGISTRATION FEE CONTROLLED SUBSTANCEIREGULATED CHEMICAL
NUMBER EXPIRES PAID REGISTRATION CERTIFICATE
BA3050692 04-30-2018 FEE EXEMPT UNITED STATES DEPARTMENT OF JUSTICE
DRUG ENFORCEMENT ADMINISTRATION
SCHEDULES BUSINESS ACTIVITY ISSUE DATE WASHINGTON D.C. 20537
2,2N, PRACTITIONER 03-19-2015 Restricted to Government personnel for official duties only.
3.3N.4.5. Sections 304 and 1008 t21 USC 824 and 958) of the
ROSTYKUS, PAUL S MD Controlled Substances Act of 1970, as amended, provide
LIMITED TO OFFICIAL GOVERNMENT DUTIES ONLY that the Attomey General may revoke or suspend a
ASHLAND FIRE DEPARTMENT registration to manufacture, distribute, dispense, import or-
55 SISKIYOU BLVD export a controlled substance.
ASHLAND, OR 97520-0000 THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF
OWNERSHIP, CONTROL, LOCATION, OR BUSINESS ACTIVITY,
AND IT IS NOT VALID AFTER THE EXPIRATION DATE.
i
I REQUESTING MODIFICATIONS TO YOUR
I REGISTRATION CERTIFICATE
: I To request a change to your registered name, address, the drug
REPORT , schedule or the drug codes you handle, please
v
1. visit our web site at deadiversion.usdoj.gov -or
CHANGES I 2. call our customer Servioe Center at 1-(800) 882-9539 - or
ch I 3. submit your change(s) in writing to:
N PROMPTLY Drug. Box 2808 errtAdministratlon
0 I Washington, DC 20083
1
See Title 21 Code of Federal Regulations, Section 1301.51
I for complete instructions.
You have been registered to handle the following chemical/drub codes_____
CERTIFICATE OF COVERAGE
Agent This certificate is issued as a matter of information only
and confers no rights upon the certificate holder other
DIRECT than those provided in the coverage document. This
certificate does not amend, extend or alter the coverage
afforded by the coverage documents listed herein.
I cifycounty insurance services
Named Member or Participant Companies Affording Coverage
City of Ashland COMPANY A - CIS ;
20 East Main Street COMPANY B - National Union Fire Insurance Company of Pitts, PA
Ashland, OR 97520 COMPANY C - RSUI Indemnity
LINES OF COVERAGE
This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Not withstanding any
requirement, term or condition of any contract or other document with respect to which the certificate may be issued or may pertain, the coverage afforded by the coverage
documents listed herein is subject to all the terms, conditions and exclusions of such coverage documents.
Type of Coverage Company Certificate Effective Termination Date Coverage Limit
Letter Number Date
General Liability A 14LASH 7/1/2014 711/2015 General Aggregate: $15,000,000
X Commercial General Liability Each Occurrence: $5,000,000
X Public Officials Liability
X Employment Practices
X Occurrence
Auto Liability A 14LASH 7/1/2014 7/1/2015 General Aggregate: None
X Scheduled Autos Each Occurrence: $5,000,000
X Hired Autos
X Non-Owned Autos
Auto Physical Damage A 14APDASH 7/1/2014 7/112015
X Scheduled Autos
X Hired Autos
X Non-Owned Autos
X Property A/C 14PASH 7/112014 7/1/2015 Per Filed Values
X Boiler and Machinery A 14BASH 711/2014 711/2015 Per Filed Values
X Excess Crime B 14ECASH 711/2014 711/2015 Per Loss: $250,000
Excess Earthquake
Excess Flood
Excess Cyber Liability
Workers' Compensation
Description:
Jackson County is named as additional insured per the agreement made between Jackson County and the City of Ashland giving Ashland
Fire & Rescue the exclusive right to provide ambulance service in ASA #3.
Certificate Holder: CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date
Jackson County thereof, CIS will provide 30 days written notice to the certificate holder named herein, but failure to mail
1005 East Main Street such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the
Medford, OR 97504 issuer of this certificate.
".V,,._j Date: August 25, 2014
AtialT Na
F SOON. HEALT(- / UTI-fO l '1( .
PUBLLC HEALTH L IVIS1EV
60906
MERGEICY/IEDICL :SERVICES & `TRAUMA 5YSTEl1S°RGARIVI
AGENCY NUMBER -
1501
OPrtmi 0 D TES
MO DAY YF# THRU MD DAY YR
f S
c 053E12f'1 Q3E~/20'I 6
STATE âŽM OFFICE DOPY
. .
City of Ashland #1501
455 Sisl~tyotBlvd
Ashland, OR 97520 . PAYMENT-DATE
MO DAY YRs
.05/05/2015-,
CITY OF
ASHLAND
May 27, 2015
Director Mark Orndoff,
Jackson County Health & Human Services
1005 E. Main Street
Medford, Oregon 97504
Dear Director Orndoff,
Please accept this letter as evidence of Ashland Fire & Rescue's intent to reapply for assignment of
Jackson County Ambulance Service Area #3 pursuant to Jackson County Ordinance Chapter 1075,
Exhibit A, Five year assignment per Section 73A. Reassignment of Ambulance Service Area 3
(South County-Ashland/Talent) to Ashland Fire & Rescue will serve to ensure the continued
integration of emergency medical services within Jackson County. Since 1996, Ashland Fire &
Rescue has been providing high quality ambulance services to the resident of south Jackson County
as the primary ambulance services provider.
We continue to receive above average approval ratings from our patients regarding the ambulance
services provided, as evidenced by their many notes, letters and e-mail comments to both the Fire
Department and our billing service. In addition to receiving high approval ratings from our patients,
we enjoy a strong cooperative working relationship with all other EMS providers within the county,
and also with adjacent service providers outside. of Jackson County.
Ashland Fire & Rescue has consistently operated well within all Jackson County ASA response time
standards, and met or exceeded all other standards and requirements of our ASA agreement. We
continue to be a major participant in decisions and activities directed toward the ongoing
improvement of county-wide EMS services, and-we have faithfully executed our assigned
stewardships within the EMS community.
We are looking forward to the potential renewal of our ASA service contract with Jackson County
and the continued and uninterrupted provision of quality ambulance services to the citizens of south
Jackson County.
Respectfully,
John Karns
Fire Chief
ASHLAND FIRE & RESCUE
455 Siskiyou Boulevard
Ashland, OR 97520
(541) 482-2770 - Fax (541) 488-5318
TTY: 800-735-2900
PRINTED ON RECYCLED PAPER
City of Ashland, Oregon - Municipal Code http://www.ashland.or.us/CodePrint.asp?CodelD=2353
A. Any person desiring to obtain an ambulance operator license shall apply upon
forms available from the city recorder. Each application shall be accompanied by a
surety bond in the amount provided in this chapter. The application shall include the
following information:
1. The name of the applicant and trade name, if any, under which the applicant
intends to conduct the business; or if it is a corporation, its name, date and place of
incorporation, address of its principal place of business and the names of its principal
officers, together with their respective residence addresses; or if a partnership,
association or unincorporated company, the names of the partners, or of the persons
comprising such association or company, and the business and residence address of
each partner or person.
2. A description of each ambulance or other vehicle used, or proposed to be used, by
the applicant, with the name of the manufacturer, engine and serial numbers, state
motor vehicle license number, together with a certification that each ambulance is
adequate and safe for the purposes for which it is to be used and that it is equipped
as required by this chapter and the laws of the state of Oregon.
3. The address and description of the premises at and from which it is proposed to
maintain and operate such ambulances.
4. Information showing that every proposed driver, attendant, and driver-attendant is
qualified as required in this chapter and as required by the laws of the state of
Oregon.
5. The applicant shall furnish such additional information as the city may require.
6. Upon application for an ambulance operator's license, applicant shall furnish the
city with a good and sufficient cash bond or surety bond in the sum of $500,000.00
which shall be continued in effect during the period that such ambulance operator
shall do business in the city. The bond shall be given as a guarantee that the
ambulance operator will furnish and maintain ambulance service from the date of
obtaining a city license without interruption of service, except that by giving 180 days'
notice to the city, such ambulance operator shall be authorized to discontinue service
without penalty. If, for any reason, the licensed ambulance operator shall cease
operations or discontinue business for any reason whatsoever, voluntarily or
involuntarily, without giving the notice herein required, such cash bond or surety bond
shall be forfeited to the city.
7. No ambulance operator's license shall be issued unless there is also on file with
the city an insurance policy approved by the city administrator, whereby the owner
and driver of each of the vehicles described in this license are insured against liability
for damage to property and for injury to, or death of, any person resulting from the
ownership, operation, or other use thereof. This policy shall be in the sum of not less
1 of 2 5/10/2016 4:02 PM
City` ci AAsW,and, Oregon - Municipal Code http://www.ashland.or.us/CodePrint.asp?CodefI}=2353
than $500,000.00 for property damages, personal injuries to, or death of persons in
any single accident.
a. The insurance policy shall contain an endorsement providing that this policy of
insurance will not be canceled until notice in writing shall have been received by the
city administrator at least thirty days prior to the time such cancellation shall become
effective.
b. The insurance policy must be issued by a company authorized to do business in
the State of Oregon. This policy shall further provide that there shall be a continuing
liability thereon, notwithstanding any recovery on this policy. If, at any time, this
insurance policy shall be canceled by the company issuing the same, or the authority
of the company to do business in the state of Oregon shall be revoked, the certificate
holder shall replace the policy with another policy approved by the city administrator.
B. The initial license fee and each yearly renewal thereafter shall be $300 for an
Ambulance Operator's License plus $100 per ambulance providing emergency
medical services to the city. Changes in the amount of these fees may be made by
resolution of the council.
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2 of 2 5/10/2016 4:02 PM
CITY OF
ASHLAND
Memo
DATE: May 10, 2016
TO: Lee Tuneberg
Cindy Hanks
FROM: Kimberley Summers
RE: Renewal of City of Ashland Ambulance Operators License Fee
Lee,
Our ambulance license is due to expire on June 30, 2016 and we need to renew our ambulance operator's
license for July 1, 2016 to June 30, 2017. Would you please do an inner-departmental transfer or check for the
ambulance licensing fees in the amount of $800.00. It will need to be transferred from EMS account #
110.07.13.00.604160 and put into the City of Ashland Accounts Receivable.
This will need to be included in the renewal application for ambulance operator's license that includes the
required certifications and documentation required by the AMC 6.40 a memo will be sent to Dave Kanner and a
Council Communications requesting ambulance license renewal. I have contacted Diana Shiplet to have this
placed on the next council meetings consent items agenda.
As in the past the fees and bond have just been charged to our budget please let me know if this is still the
correct procedure. I would like to know if we can streamline the process to obtain our annual business license.
Thank you for your time
Kimberley Summers
1
OREGON HEALTH AUTHORITY AUDIT NO.
PUBLIC HEALTH DIVISION
EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS PROGARM
AGENCY NUMBER:
OPERATION DATES
MO. DAY YR. THRU MO. DAY YR.
1501
05/12/2016 6/30/2017
AMBULANCE AGENCY LICENSE - POST IN AGENCY
City of Ashland #1501 PAYMENT DATE
455 Siskiyou Blvd MO. DAY YR.
Ashland, OR 97520 05/12/2016
MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERABLE
r~ j !
To: Ashland City Council
From: Sandra Coyner:
Member, HCAO-Rogue Valley Chapter
Member, Legislative Committee for HCAO
May 17, 2016
Thanks for the opportunity to speak on this request for a ballot initiative referral.
I'll follow up on Paul's comments with two additional general points
First is some more background on why we are asking for this specific resolution at
this time.
Second is a question that has come up often here in Ashland-if the study points to
universal, single-payer, Medicare-type financing for health care in Oregon, how
will it be paid for?
With regard to my first point, how we got here now, I think Ashlanders (and you
on the Council) will want to know that HCAO - the state organization that has
been working super-diligently on this issue for years-- has done a lot of listening.
Members statewide contacted and engaged many stakeholders hospitals, doctors,
nurses, employers, unions, legislators, regular people. We listened to their
concerns and to their responses to our ideas. We found broad support for
improvement in health care financing. We have talked, many times, with
legislators, learning their views and asking their advice on how to proceed. We
locally have talked with many Ashland citizens, too, and are heartened by their
enthusiasm for improving the health care system.
Last year, in 2015, the state legislature voted to spend actual money to fund the
study that is due in 2015, because they think it is a good investment to find out
what will be best for Oregon. The Oregon Health Authority, which supervises
such studies, among many health-related matters for Oregon, added more money.
They are committed. The resolution we are asking you to put on the November
ballot gives Ashland citizens a chance to express our support for what the
legislature has been doing, conveying to them that we have noticed, and
encouraging them to keep on keepin' on. Our timing-asking for this resolution
on this November ballot - is optimal for conveying Ashland citizens' support to
the legislature for the next full legislative session, in 2017. Other cities are doing
the same thing, as local resolutions are coming from Eugene and Corvallis and
perhaps other locales as well.
So, in sum, the request we make today comes from a lot of consulting, a lot of
listening, a lot of Ashland values, and a lot of good will in Oregon to keep moving
on what, as Paul has pointed out, remains an important problem for Oregonians.
Finally, I would like to respond briefly to a question that has been asked a number
of times recently in conversations about this issue. The Health Care Study for
Oregon asks for the optimal system to achieve health care goals universal
access, choice of providers, transparency and accountability, affordability,
minimizing administrative costs and medical efforts, financing that is sufficient,
fair and sustainable, adequately compensating providers, and including
community-based systems.
It is not pre-ordained that this study will recommend a single-payer, Medicare-
style system. But every other such study has done so. So why did we ask for an
Oregon study? To learn more specifically what would work in Oregon, and how
Oregonians would pay for it. Other states have done such studies and drafted bills
for a single-payer system, and their ideas help us figure out our solutions. Oregon
is not alone in seeking improvements in our health care system, and we all learn
from each other.
So if it is recommended, how could single-payer be paid for? A lot of fear has
been generated around this issue, but a solution is not impossible. The most likely
model uses familiar revenue streams but tweaks and renames them. Many
Americans get health care insurance through their jobs, with employers paying part
and the employees paying part. These revenues can be directed to the single-payer
plan through payroll taxes. Unearned income can also be taxed, providing revenue
analogous to what people pay for health care through private policies. It's really
unfortunate that we can't call such taxes a "health care premium," which is what
they will be, but we have to use that dreaded word "taxes," so the payments can be
deductible on your 1040. But we're not looking to balloon everybody's income
taxes to unheard-of levels.
We're glad to be in Ashland where people care about things like supportive,
consultative processes to improve our society, and where people (some at least)
always want to know how things will be paid for.
Thanks for your time. Paul and I would be happy to answer any questions you
might have.
Comments in support of: W
RESOLUTION OF THE CITY OF ASHLAND, JACKSON COUNTY, OREGON, TO SUBMIT TO ASHLAND
ELECTORS AT THE NOVEMBER 8, 2016 GENERAL ELECTION AN ADVISORY QUESTION ON
ENCOURAGING THE 2017 OREGON LEGISLATURE TO CREATE A PUBLIC PROCESS TO DESIGN A SYSTEM
THAT PROVIDES TIMELY ACCESS TO AFFORDABLE COMPREHENSIVE HEALTH CARE FOR ALL OREGON
RESIDENTS, ENSURES CHOICE OF PROVIDER, HAS EFFECTIVE COST CONTROLS, AND FOCUSES ON
PREVENTATIVE CARE.
We are here to ask the Council to support placing an advisory resolution on the November 8, 2016 ballot. I want to
review some of the ideas about the Legislative intent; renew our focus on the problem of healthcare access; and
finally ask you to support placing the resolution on the ballot for the voters of Ashland to judge for themselves.
This advisory resolution for the citizens of Ashland lends support and encouragement to the Oregon State
Legislature to continue their work in finding affordable and comprehensive healthcare access to all Oregon
residents. The Legislature started this work with a multi-year study to find a system that ensures provider choice;
that has effective cost controls; and that focuses on preventive care. The purpose of the resolution before you is to
bring attention to Legislature's work; provide an informed citizenry conversation around the healthcare issue; and
open up new paths of dialogue to assist in resolving the lingering problems our current healthcare system does not
address.
We have improved healthcare access with the passage of the Affordable Care Act (ACA). It has brought attention
and created discussions which resolved many issues that faced our citizens. However, we still do not have universal
healthcare access. We still leave substantial numbers of families without adequate medical attention. We continue
to depend on employers, individuals, and the government to provide the patchwork of coverage that is too
expensive for many of us. Competing insurance companies escalate premium costs to small businesses more and
more each year; the increase in premiums buys less coverage each year. These small businesses cannot make their
budgets from year to year. This causes them to make very hard and difficult human resource decisions. Our
citizens are left with partial or non-existent coverage insufficient to prevent economic chaos in their lives. Our
medical providers are spending more and more each year on non-productive costs to simply be compensated for
the services they provide. Each insurance company has its own rules and will pay only its own rates. It is a very
complex but irrational system. But most of all, it is inefficient and expensive. It hurts our business expansions, our
governmental stability, and our citizens well-being.
The Legislature has recognized that this crisis has gone beyond political ideology or preference. It impacts both
employees and employers. It threatens all of us regardless of our political, social, religious, or philosophical tenets.
We all are subject to insurance limits that one major accident or illness can over-spend. The costs are then made
up from other sources or extracted through the legal system of bankruptcy. Either way it is harmful to both the
medical facility and to the patient.
All of our citizens are not given medical access in an equitable manner. This can lead to higher costs and less
successful treatments for some. Our businesses are threatened by unpredictable costs. Even the enterprise of the
City of Ashland has its own struggles with the insurance coverage and the ratcheting of insurance costs. The State
Legislature study investigates these components and will determine a system that will be the most cost effective,
have the most equitable access, and focus on preventive care.
We are asking the Council to support our effort to include the citizens of Ashland in this discussion by authorizing
this resolution to be placed on the fall ballot.
Thank you in advance for attention to this matter.
Sincerely submitted,
Paul Fisher, PhD
505 Ashland Street
Ashland, OR 97520
541-261-7315
f
For Ashland City Council Meeting Tuesday, May 17, 2016
Words of Dr. Patrick Honsinger
Under the current system, my payers (people who pay me, a primary care doctor) are the insurers of the
patients who are paying monthly premiums in the form of cash/income, social security or whatever funds
they can come up with to "cover" themselves.
I only get paid to deliver a service (sew-up a wound, open an abscess) or spend face-to-face time with the
patient evaluating and managing their health (the so-called "E&M"). This is in the form Relative Value
Units. The more RVUs a provider can generate, the more money will be reimbursed. If the provider is
delivering a procedure (surgery, draining abscesses, doing colonoscopies etc.) the RVU generation is
relatively higher and more money is generated for income and business expenses.
Currently, this country is emphasizing "preventative care", trying to implement a cultural change by getting
people to change lifestyles, make better choices and live with fewer medical expenses over the course of
their lives. That task is being laid on primary care providers nationwide.
But with insurance companies paying primary care providers in RVUs, the only way primary care practices
(small and large hospital-based practices alike) is to turnover as many RVUs as possible on a given
day. Some practices are seeing patients in 10-15 minute slots or less per visit to generate enough RVUs to
run the business of medicine. One cannot blame insurers for being reluctant to pay providers: naturally,
that cuts into profit. So the RVU-generating machine is kicked into higher gear and patient time is cut
more. Patients are dissatisfied. Providers are dissatisfied.
It fosters me, the provider, to give the patient Prozac instead of taking the time to listen to the patient, ask
what her stressors are, address and acknowledge difficulties and fully assess his depression. It fosters me
to give an opioid to a patient rather than to ask why he hurts, explore what led to the injury and devise an
alternative plan to help him manage chronic pain. It hastily pushes me to write a prescription for blood
pressure pills and cholesterol pills rather than taking the time to suggest an exercise plan, discuss diet,
smoking cessation and weight loss.
Primary care has accepted the challenge of changing the healthcare in this country. However, the American
system is driven by a machine that pushes its providers to hastily generate as many RVUs in as short a time
as possible. This is how insurance- my payers- promotes the culture. It will never change as long as it's in
the equation. There is no such thing as cheap insurance: we get what we pay for. I dream of the day there
will be one payer for all.
Sincerely,
Ashland Resident Patrick Honsinger, MD, Southern Oregon physician