City of Lynden. Ambulance Cost of Service and Rate Study. February 2014

Transcription

1 City of Lynden Ambulance Cost of Service and Rate Study February 2014 FCS GROUP th Avenue NE, Suite D-215 Redmond, WA T: F:

2 FCS GROUP Solutions-Oriented Consulting Firm Headquarters Redmond Town Center th Ave NE Suite D-215 Redmond, Washington Serving the Western U.S. and Canada since 1988 Washington Oregon California February 10, 2014 Chief Gary Baar Lynden Fire Department 215 Fourth Street Lynden, WA Subject: Dear Chief Baar: The following is our final report on the results of our. We want to thank you and all the City staff for their assistance and participation in helping us gather information for the study. If you have any questions, please feel free to contact me at (425) extension 228. Sincerely, Peter Moy Principal

3 February, 2014 page i TABLE OF CONTENTS CHAPTER I: INTRODUCTION... 1 The City Fire Department... 2 CHAPTER II: COST OF SERVICE ANALYSIS... 3 Staffing... 4 Full Time Staff... 4 Volunteers... 4 Administrative Staff... 5 Support Services, Supplies, and Other Costs... 5 Ambulance Availability and Demand Costs... 6 CHAPTER III: RATE ANALYSIS... 8 Customer Classes... 8 Rate Calculations... 9 CHAPTER IV: IMPLEMENTATION ISSUES APPENDIX A:

4 February, 2014 page 1 CHAPTER I: INTRODUCTION Because of the growth in demand for emergency medical services (EMS) since 2005, the City of Lynden is considering establishing an ambulance utility to help support the staff necessary to continue its services. About 85% of the City s call volume is related to EMS, while 15% are related to fires and other responses including fire prevention activities, hazardous materials incidents, and auto accidents. In 2005 the City hired its first career firefighter/emt, added a second career position in 2006, and hired two additional staff in The call volume in 2005 was 983 calls, and by 2009 the call volume was over 1,100 calls. In 2009 the Department was awarded a five year SAFER federal grant to hire two additional full time responders, and the City has been able to sustain these positions through its General Fund tax revenues. In 2012, the call volume reached 1,260, and again the Department was awarded another federal grant to hire three additional full time firefighter/emts. With the added staff, the Department s career staffing reached nine staff members that work three rotating 24 hour shifts that are augmented by volunteers. However, the City estimates that its projected tax revenues will not be able to support the three recently hired firefighter/emts once the grant funding ends. As a result, the City is reviewing its options for creating an ambulance utility. The Revised Code of Washington (RCW) Section gives all cities and towns the authority to establish an ambulance service to be operated as a public utility. This includes the authority for a City Council to set and collect rates and charges for regulating, operating and maintaining an ambulance utility. It also identifies the policies with regard to classifying costs and setting rates for an ambulance utility. In July 2011 the Washington State Legislature amended RCW by eliminating the requirement that the General Fund continue to provide support to ambulance utilities at 70% of the May 2004 funding level. As a result, cities now have more freedom to decide how much support their General Fund will provide to their ambulance utility. According to RCW , a cost of service study is required to identify the total cost necessary to regulate, operate, and maintain the ambulance utility. FCS GROUP was engaged by the City to develop a cost of service study and the related ambulance utility rates. FCS GROUP s scope of work included: Reviewing and analyzing fire department and ambulance costs and workload data, Developing the cost of service framework and establishing the cost of service for fire and emergency medical services, Establishing and identifying customer classes and cost allocation methods for the ambulance utility, and Calculating availability and demand rates for each customer class, consistent with RCW To accomplish the scope of work, FCS GROUP worked with City staff members in analyzing the cost of service, EMS response data, and customer class data. We would like to especially thank Sandra Dalessandro, Teresa Camfield, and Chief Baar for their support and assistance with this study.

5 February, 2014 page 2 THE CITY FIRE DEPARTMENT The City s Fire Department provides both fire and emergency medical services (EMS) to the City s residents, businesses, and visitors. The Department operates from its downtown station and has 12 FTEs that include the fire chief, an assistant fire chief, one administrative staff (i.e. the support services manager), three lieutenants, and six firefighters. There are currently 15 volunteers who are available to assist full-time staff in responding to fire or EMS emergency calls. Four staff are on duty at the Department s station 365 days a year 24 hours a day. About 90% of the time there are three full-time staff and one volunteer on duty, and the rest of the time there are two full-time staff and two volunteers on duty. All full-time staff respond to both fire and EMS incidents. Volunteers also respond to both fire and EMS incidents. Additional volunteers are also called in to assist during major fire events. The City currently budgets for its Fire Department costs in the General Fund. The 2014 total combined budget for fire and emergency medical services is $1,886,423, but did not include any revenues or costs associated with an ambulance utility. If the City establishes an ambulance utility, the City identified an additional $15,250 in ongoing costs for utility billing services that will be provided by the Finance Department. More information about these ongoing costs for utility billing services can be found in Chapter II. The 2014 budget for the Fire Department is displayed below in Exhibit 1. If the City establishes an ambulance utility, the total cost of providing fire and EMS services will be $1,901,673. Exhibit Fire Department Budget Plus Ambulance Utility Billing Costs General Budget Category Fund Personnel $1,333,069 Supplies & Services 144,500 Intergovernmental Services 318,854 Capital 90,000 Subtotal: 2014 Budget $1,886,423 Ambulance Utility Billing 15,250 Grand Total $1,901,673 In 2012, (i.e. the most recently completed calendar year at the time of this study) the Fire Department responded to 1,257 emergency incidents. Exhibit 2 displays a breakdown of these emergency responses for this period. Exhibit City Emergency Responses Type of Response Emergency Responses % of Total EMS 1,098 87% Fire and Other calls % Total Calls 1, % To provide more data for the cost of service study and to determine if 2012 was a representative year, the emergency responses for a 24 month period from September 2011 through August 2013 were analyzed. The percentage breakdown between EMS and fire related responses for this period was the same as 2012, at 87% and 13%, respectively.

6 Calculate Total Costs City of Lynden, Washington February, 2014 page 3 CHAPTER II: COST OF SERVICE ANALYSIS As noted in Chapter I, the City s Fire Department operates as an integrated fire and EMS department, and the Department s station personnel respond to both types of incidents. As a result, the Department s costs must be divided appropriately between fire and EMS activities. To establish the cost of service for both fire and EMS/ambulance services, several cost allocation steps were used. The allocation process consisted of the following steps. Allocating the costs within the Fire Department s budget between those related to fire services and those related to emergency medical/ambulance services, and Dividing the ambulance costs between availability and demand costs. Exhibit 3 shows the framework for the overall allocation process to determine the cost of service for ambulance services. The amounts shown at each step are the allocated costs. Exhibit 3 Cost of Service Framework Total Fire Department Costs $1,901,673 Fire/EMS Allocation Fire $612,684 EMS $1,288,989 Availability/ Demand Allocation Availability $1,104,821 Demand $184,169 The first step in the process allocated the 2014 budget for the Fire Department as well any related costs not included in the Fire Department s budget, such as the new utility billing costs, to determine the total costs of providing fire and EMS/ambulance services. To establish the costs for these categories, the following sections discuss the assumptions and allocation factors that were used to allocate costs between fire and ambulance services and between availability and demand costs.

7 February, 2014 page 4 STAFFING Full Time Staff The costs for full-time line staff (i.e. firefighters, lieutenants, and overtime) were allocated based on an analysis of staff time. The analysis involved estimating the total time spent responding to calls, participating in various administrative, training, and maintenance activities, and on standby (i.e. waiting for an emergency call to occur). The City currently has four staff on duty 24/7 at the fire station, using a combination of full-time staff and volunteers. It was assumed that on average there are 2.9 full-time staff on duty 24/7 at the fire station. In estimating the time spent responding to calls, it was assumed that on average 2.9 fulltime staff responded to both fire calls and EMS calls. For ambulance transports, it was assumed that only 1.0 full-time staff was involved. The average staffing levels for these three different types of calls (i.e. fire, EMS, and ambulance transports) were multiplied by the overall time spent responding to those calls in 2012 to estimate the total staff time spent on each type of call. It should be noted that ambulance transports were assumed to take an average of 81 minutes plus an additional 25 minutes of travel time for a total of 106 minutes. The additional 25 minutes of travel time was added to account for time when the unit was technically available to respond to another call but had not yet returned to the fire station. The City also provided a breakdown of various EMS and fire related activities performed regularly by full time staff. These activities included tasks such as daily apparatus inspections, equipment maintenance, training, reporting, etc. The average daily time spent on these activities was combined with the typical number of staff involved in each activity to estimate the total time spent each year. The remaining unidentified time was designated as standby time (i.e. time spent waiting to respond to a call). This time was divided between EMS and fire based on the percentage of staff time spent responding to EMS or fire calls. Based on this analysis, we found that 76% of the time spent by full time line staff can be attributed to EMS/ambulance related activities and 24% of their time to fire related activities. Volunteers The costs for volunteer staff were also allocated based on an analysis of their time. The City relies on volunteers to fill shifts to maintain a staffing level of four staff on duty at all times. It was initially assumed that there are on average 1.1 volunteers on duty 24/7 at the fire station. In estimating the time spent responding to calls, it was assumed that on average 1.1 volunteer staff were involved with EMS calls and 1.0 involved with ambulance transports. For fire calls, it was assumed that the 1.1 on duty volunteers were involved plus an average of 0.57 volunteers responding to calls for additional assistance for an average total of 1.67 volunteers for all fire calls. To arrive at the 0.57 average for additional assistance, it was assumed that: Calls for additional assistance from volunteers usually occur only for actual fires, Typically two volunteers respond to these calls for additional assistance, and Actual fires made up 28% of the overall fire calls in The 0.57 was calculated by multiplying the two volunteers by the ratio of actual fire to overall fire calls (i.e. 2 times 28% = 0.57). Similar to full time staff, the City also provided a breakdown of various EMS and fire -related activates performed regularly by volunteers. These tasks included EMS and fire training (including weekly training meetings and on-line medical training), daily station cleaning, and other fire safety activities such as station tours. The average time spent on these activities was combined with the

8 February, 2014 page 5 typical number of volunteers involved in each activity to estimate the total time spent each year. The remaining, unidentified time for the 1.1 on duty volunteers was designated to be standby time (i.e. time spent waiting to respond to a call). This time was divided between EMS and fire related services using the percentage of on duty volunteer time spent responding to EMS or fire calls. Based on this analysis, we found that 70% of the time spent by volunteers can be attributed to EMS/ambulance related activities and 30% of their time to fire related activities. Administrative Staff In most cases, the costs for administrative staff (i.e. Fire Chief, Assistant Fire Chief, and Support Services Manager) were allocated using the total line staff and volunteer hours assigned to EMS and fire. The exception was for the Fire Chief, who according to City staff spends about four hours a week doing fire plan review and inspections, or about 10% of his overall time. This portion of the Fire Chief's cost was assigned entirely to fire. SUPPORT SERVICES, SUPPLIES, AND OTHER COSTS The following explains how the budgeted supplies, services, and other costs were distributed between EMS and fire. Unless otherwise noted, all cost splits are based on information provided by City staff. For the Fire Suppression/EMS division budget: EMS and fire supplies, including EMS medical supplies, were split 60/40 between EMS and fire. Fuel was split 33/67 between EMS and fire. Small tools were split with $7,857 to EMS and $47,143 to fire. Professional services such as insurance billing, biohazard waste disposal, station fire alarm testing, SCBA air testing, etc. were split 90/10 between EMS and fire. Communications costs, such as fees for emergency reporting, cell phone bills, radio repair, postage, etc. were split between EMS and fire based on total calls for service. Travel related to training and miscellaneous costs for registrations at conferences and academy classes were split 50/50 between EMS and fire. Operating rentals & leases for a storage unit housing fire and EMS equipment was split 50/50 between EMS and fire. Insurance for operations (excluding facilities) was split between EMS and fire using total staff and volunteer hours. Dispatch services provided by the Prospect Fire Dispatch Center are associated with BLS transports to Bellingham and were assigned entirely to EMS. Dispatch services provided by What-Comm 911 and Whatcom County Fire Agencies Radio System (FARS) were distributed between EMS and fire based on total calls for service. The Whatcom County Specialized Emergency Response Program Hazardous Materials Unit (SERP) was assigned entirely to fire. The capital purchase of SCBA equipment was assigned entirely to fire. The EMS 1/10th of 1% sales tax pass through to the County was assigned entirely to EMS. For the Administration division budget, supplies and service were split between EMS and fire using the total time of both full-time staff and volunteers, except for ambulance billing services which were assigned entirely to EMS/ambulance services.

9 February, 2014 page 6 All budgeted costs for the Training Division were split 50/50 between EMS and fire, respectively, except for supplies and professional services. Supplies and professional services were split with two-thirds going to fire and one-third going to EMS, reflecting the assumption that two Wednesday night training sessions are held on fire topics for every one held on EMS topics. The costs of the Fire Prevention Division budget were assigned entirely to fire. For the Vehicles & Equipment Maintenance Division budget, 44% of repairs and maintenance was assigned to EMS ($22,537) with the remaining 56% ($28,358) assigned to fire. The Facilities Division budget was allocated between EMS and fire based on the share of space used by EMS and fire vehicles. It was assumed that three garage bays are occupied by various fire apparatuses, and two by EMS aid cars, resulting in a 40/60 split between EMS and fire, respectively. An additional $15,250 was also identified for ambulance utility billing services that will be provided by the Finance Department. This included $11,250 for utility billing supplies and a $4,000 one-time cost for setting up the software for the utility billing system. Because the City does not yet know how much staff time will be required to do the billing for the ambulance utility, labor costs were not included at this time. After 2014, the $4,000 for utility billing software will serve as a placeholder for ambulance utility billing labor costs until they can be more accurately estimated. Based on the above assumptions, the allocated cost for fire related services was $612,684, and the allocated cost for EMS/ambulance services was $1,288,989. A table showing how the 2014 line items for the Fire Department were allocated to fire and EMS can be found in Appendix A. AMBULANCE AVAILABILITY AND DEMAND COSTS The costs listed in the EMS category represent the costs to the City for providing ambulance services both inside City limits and outside City limits through automatic/mutual aid arrangements. Once these ambulance costs were identified, the costs were then divided between availability and demand costs. According to RCW , availability costs are attributable to the basic infrastructure needed to respond to a single call for service and may include dispatch, labor, training, equipment, patient care supplies, and equipment maintenance costs, while demand costs are attributable to the burden placed on the ambulance service by individual calls, such as those associated with the frequency of calls or the distance from hospitals. To determine availability and demand costs, the following assumptions and allocation factors were used. The costs for full time line staff and volunteers were allocated between availability and demand using the results of our staff time analysis. The time spent responding to EMS calls or providing ambulance transports were attributed to demand, with all remaining time attributed to availability. Using the results of this analysis, availability to demand ratios were developed for both full-time line staff and volunteers. For full-time line staff, 15% of their costs were allocated to demand, and 85% to availability. For volunteers, 22% of their costs allocated to demand and 78% to availability. The costs of administrative staff (i.e. Fire Chief, Assistant Fire Chief, and Support Services Manager) were assigned to availability. Ambulance billing services, EMS supplies, fuel, and Prospect Fire Dispatch Center were assigned to demand.

10 February, 2014 page 7 Professional services such as insurance costs and biohazard waste disposal were distributed between availability and demand using the availability to demand ratio for full time line staff. All other costs were assigned to availability.

11 February, 2014 page 8 CHAPTER III: RATE ANALYSIS Once the availability and demand costs were identified, the next step was to determine the availability and demand rates. RCW establishes the following rate policies. Availability costs must be uniformly applied across user classifications, Demand costs must be based on each user classification s burden on the utility, The costs for exemptions or reductions are a general expense of the utility and are designated as an availability cost to be spread uniformly across the utility user classifications, Medicaid eligible persons who reside in a nursing home, boarding home, or adult family home, or who receive in-home services are exempt, and Designated classes consistent with Article VIII, section 7 of the state Constitution may be exempt from or have reduced rates. CUSTOMER CLASSES To calculate the rates, the City first established several different customer classes and identified the number of billing units in each class. The City established the following customer classes: Single family residential, Multi-Family residential, Commercial businesses Nursing homes and assisted living facilities, Public Exhibit 4 shows the customer classes and the type of regular and Medicaid billing units. The ambulance utility billing units are based on the City's water utility accounts. All water utility accounts located outside of the City's boundaries were excluded as well as those accounts solely for stormwater or irrigation. Accounts with shared water meters were adjusted so that every tenant or living unit served by a shared meter was counted as a separate ambulance utility billing unit. For example, a multi-family water account with 15 apartments would be counted as a single billing unit for the water utility but 15 billing units for the ambulance utility. Trailer parks and commercial customers with multiple units (such as strip malls) were also adjusted in this manner. On the other hand, there were a few commercial and public customers who had multiple accounts at the same facility due to their having multiple water meters, (such as the NW Washington Fairgrounds, Darigold, etc.). These accounts were adjusted so that they were counted as a single ambulance billing unit. For example, Darigold has three billing units for the water utility but would be counted as one billing unit for the ambulance utility.

12 February, 2014 page 9 Exhibit 4 Number of Billing Units by Customer Class and Type of Unit Customer Class Regular Medicaid Total % Regular % Medicaid % Total Residential 4,133 4, % 0.0% 72% Multi-Family * % 0.0% 16% Commercial % 0.0% 7% Nursing Home/Assisted Living ** % 1.0% 4% Public % 0.0% 1% Total 5, , % 1.0% 100% *Includes 72 independent living units at Meadow Greens. **Includes 85 rooms at Christian Health Care Center, 107 rooms at Lynden Manor, and 32 rooms at Meadow Greens. The ambulance utility billing unit count for nursing homes and assisted living facilities was based on the number of rooms in each facility as provided by City staff. One facility, Meadow Greens, also has 72 independent living units, and these have been included as part of the Multi-Family residential customer category. The City obtained the number of Medicaid-eligible billing residents by contacting the nursing homes located within City limits. This ratio of Medicaid-eligible residents to total residents was then used to estimate the number of Medicaid-eligible rooms at each facility. Excluding Medicaid-eligible rooms, the ambulance utility billing units for the nursing homes/assisted living facilities at Christian Health Care Center, Lynden Manor, and Meadow Greens was 36, 98, and 32, respectively, with a combined total of 166. RATE CALCULATIONS As a result of the July, 2011 changes to the law discussed above, cities that establish ambulance utilities after May, 2004 are no longer required to contribute at least 70% from their General Fund and/or EMS levy funds to the costs of operating and maintaining their ambulance utilities. The law still requires that revenues from ambulance fees be subtracted from the revenue required by the utility. In addition, we have subtracted a portion of the grant funds as well as a pass-through of EMS sales tax revenue to the County. The total 2014 revenue budgets for ambulance fees, grant funds, and the sales tax pass-through were $197,000, $184,801, and $95,000, respectively. To calculate the cost that can be recovered from rates, the ambulance fee, grant funds, and sales tax pass-through revenues were subtracted from the availability and demand costs, as shown below in Exhibit 5. The law requires that ambulance fee revenues be applied only to the demand related costs. Because the budgeted ambulance fees were greater than the demand costs, the remaining $12,831 in ambulance fee revenues was used along with the grant fund revenues and sales tax pass-through to offset some of the availability costs. As a result, the net availability costs that can be supported by rates totals $812,189.

13 February, 2014 page 10 Exhibit 5 Adjusted Availability and Demand Costs Availability Demand Total Ambulance Utility Costs $ 1,104,821 $ 184,169 $ 1,288,989 Adjustments (Less Revenues) Net Ambulance Utility Costs $ 825,020 $ (12,831) $ 812,189 *The $241,743 in budgeted 2014 SAFER Grant revenue has been allocated between fire and EMS based on the results of the cost of service study. Based on the distribution of full-time staff hours, 76% ($182,801) was attributed to EMS, and 24% ($58,942) to fire. The law requires that availability costs be spread uniformly, and because the Medicaid billing units are exempt from the rates, the costs for each class include a share of the amount that would be owed by Medicaid patients. Based on the regular billing units in each class, Exhibit 6 shows how these costs were allocated to each customer class. Exhibit 6 Adjusted Availability Costs by Customer Class If the City were to collect all the revenue necessary to support the net ambulance utility costs shown in Exhibit 6, each customer billing unit would pay an ambulance utility rate of $ a year or $11.99 a month as shown in Exhibit 7. Exhibit 7 Adjusted Availability Rates by Customer Total Ambulance & Emergency Aid Fees $ (190,000) $ (190,000) Reimbursement for Fair/Rodeo $ (7,000) $ (7,000) DOH Trauma Care Grant $ (2,000) $ (2,000) SAFER Grant* $ (182,801) $ (182,801) Intrgov't - EMS 1/10th of 1% sales tax pass-through $ (95,000) $ (95,000) Customer Class Availability Demand Total Residential $ 594,857 $ - $ 594,857 Multi-Family $ 132,558 $ - $ 132,558 Commercial $ 56,564 $ - $ 56,564 Nursing Home/Assisted Living $ 23,892 $ - $ 23,892 Public $ 4,318 $ - $ 4,318 Total $ 812,189 $ - $ 812,189 Customer Class Availability Demand 2014 Annual Rate/Acct 2014 Monthly Rate/Acct Residential $ $ - $ $ Multi-Family $ $ - $ $ Commercial $ $ - $ $ Nursing Home/Assisted Living $ $ - $ $ Public $ $ - $ $ If the City wishes to continue providing General Fund support for ambulance services, Exhibit 8 shows several alternative rate and revenue scenarios. These include 1) 50% of the costs, 2) the replacement of only the SAFER grant revenues attributed to EMS, and the 3) full cost alternative. Because 2014 rates might not become effective until at least March, total revenue has been estimated for 2014 based on 10 months of billing. An adjusted rate has also been calculated so that the total revenue target for 2014 can be met after only 10 months of billing.

14 February, 2014 page 11 Exhibit 8 Alternative Rate Scenarios Using the 50% of Cost rate alternative as an example, the estimated total revenue from 12 months of billing at $6.00 per month is $406,296. If the rate is not charged until March, 10 months of billing at $6.00 per month only results in $338,580. To achieve the full $406,296 in revenue over 10 months, the monthly rate needs to be raised to $7.20 per month.

15 February, 2014 page 12 CHAPTER IV: IMPLEMENTATION ISSUES As part of the process of conducting the cost of service and rate study, several implementation issues were identified during data gathering and cost analysis. Based on the legislative guidelines and the process required to calculate ambulance utility rates, there are some steps that the City might take to assure that the necessary data are collected and are used in subsequent ambulance cost of service and rate studies: Because the cost of Medicaid patients must be identified separately and then absorbed as an availability cost, the City needs to establish a process to identify the number of Medicaid responses and Medicaid billing units in each customer class, especially in the nursing home/assisted living customer class. Medicaid billing units represent Medicaid eligible persons who reside in a nursing home, boarding home, or adult family home, or who receive in-home services. To help identify the non-nursing home/assisted living customers belonging to this group, the City might want to consider sending out a questionnaire with its utility bills so those who receive in-home services have an opportunity to notify the City that they should be exempt. The law also requires that a separate fund be used to account for the rates and charges and the costs of regulating, maintaining, and operating the ambulance utility.

16 February, 2014 Appendix A APPENDIX A:

17 February, 2014 Appendix A-1 City of Lynden, WA EMS & Fire Cost Allocation - Step 1 Fire EMS Total Description 2014 Budget Allocation Combined Staff Cost for All Divisions $ - $ - $ - Firefighters 499,916 Staff Time - Full-Time Staff 121, , ,916 Lieutenants 313,984 Staff Time - Full-Time Staff 76, , ,984 Assistant Fire Chief 108,287 Staff Time - Full Time & Volunteers 28,016 80, ,287 Fire Chief 108,270 Staff Time - Full Time & Volunteers 28,011 80, ,270 Fire Chief - Fire Prevention Activities 12,030 All to Fire 12,030-12,030 Support Srvcs Manager II 65,582 Staff Time - Full Time & Volunteers 16,967 48,615 65,582 Overtime 70,000 Staff Time - Full-Time Staff 17,068 52,932 70,000 Out of Class Pay 5,000 Staff Time - Full-Time Staff 1,219 3,781 5,000 Volunteers 150,000 Staff Time - Volunteers 44, , ,000 Subtotal - Personnel $ 1,333,069 $ 346,379 $ 986,691 $ 1,333,069 Fire EMS Total Description 2014 Budget Allocation Administration $ - $ - $ - s Supplies 12,000 Staff Time - Full Time & Volunteers 3,105 8,895 12,000 s Professional Services 3,150 Staff Time - Full Time & Volunteers 815 2,335 3,150 s Professional Services - Ambulance Billing Services 8,000 All to EMS - 8,000 8,000 s Travel 3,650 Staff Time - Full Time & Volunteers 944 2,706 3,650 s Miscellaneous 3,562 Staff Time - Full Time & Volunteers 922 2,640 3,562 Fire Suppression/EMS s Supplies 28,000 60/40 EMS Fire 11,200 16,800 28,000 s Fuel 15,000 33/67 EMS Fire 10,000 5,000 15,000 s Small Tools - Fire 30,000 All to Fire 30,000-30,000 s Small Tools - EMS 5,000 All to EMS - 5,000 5,000 s Professional Services 12,255 90/10 EMS Fire 1,226 11,030 12,255 s Communications 5,000 Emergency Responses 632 4,368 5,000 s Travel 6,000 50/50 EMS Fire 3,000 3,000 6,000 s Operating Rentals & Leases 2,000 50/50 EMS Fire 1,000 1,000 2,000 s Insurance (operations) 11,275 Staff Time - Full Time & Volunteers 2,917 8,358 11,275 s Repairs & Maintenance - s Miscellaneous 4,000 50/50 EMS Fire 2,000 2,000 4,000 i Intrgov't - Prosepect (Dispatch for BLS trnsprts) 26,000 All to EMS - 26,000 26,000 i Intrgov't - What-Comm (911 Fire & EMS) 18,500 Emergency Responses 2,340 16,160 18,500 i Intrgov't - FARS (Fire Agency Radio System) 3,000 Emergency Responses 379 2,621 3,000 i Intrgov't - EMS 1/10th of 1% sales tax passthrough 95,000 All to EMS - 95,000 95,000 Intrgov't - SERP Hazmat 1,500 All to Fire 1,500-1,500 i Capital Outlay - SCBAs 70,000 All to Fire 70,000-70,000 Fire Prevention & Investigation s Supplies 1,000 All to Fire 1,000-1,000 s Small Tools 1,000 All to Fire 1,000-1,000 s Professional Services 900 All to Fire s Travel 500 All to Fire s Public Utility Services 200 All to Fire s Miscellaneous 500 All to Fire

18 February, 2014 Appendix A-2 City of Lynden, WA EMS & Fire Cost Allocation - Step 1 (cont.) Fire EMS Total Description 2014 Budget Allocation Training (Provided to Employees) s Supplies 8,000 33/67 EMS Fire 5,333 2,667 8,000 s Fuel 1,000 50/50 EMS Fire ,000 s Small Tools 1,000 50/50 EMS Fire ,000 s Professional Services 5,000 33/67 EMS Fire 3,333 1,667 5,000 s Travel 4,000 50/50 EMS Fire 2,000 2,000 4,000 s Public Utility Services - 50/50 EMS Fire s Miscellaneous 11,000 50/50 EMS Fire 5,500 5,500 11,000 Facilities s Supplies 6,000 Facilities 40/60 EMS Fire 3,600 2,400 6,000 s Professional Services 2,600 Facilities 40/60 EMS Fire 1,560 1,040 2,600 s Communications 6,000 Facilities 40/60 EMS Fire 3,600 2,400 6,000 s Insurance 11,790 Facilities 40/60 EMS Fire 7,074 4,716 11,790 s Public Utility Services 12,000 Facilities 40/60 EMS Fire 7,200 4,800 12,000 s Repairs & Maintenance 6,000 Facilities 40/60 EMS Fire 3,600 2,400 6,000 s Miscellaneous 300 Facilities 40/60 EMS Fire i Intergov't 500 Facilities 40/60 EMS Fire Vehicles & Equipment Maintenance s Supplies - s Repairs & Maintenance - Fire 20,000 All to Fire 20,000-20,000 s Repairs & Maintenance - EMS 15,895 All to EMS - 15,895 15,895 Additional Budget Adds s Vehicle Equipment Maintenance 15,000 Bdgt Add - Vehcl Maint 8,358 6,642 15,000 c Capital 20,000 All to Fire 20,000-20,000 s Small Tools & Equipment 20,000 Bdgt Add - Smll Tls & Eqpt 17,143 2,857 20,000 s Training (EMT/Firefighter School) 10,000 50/50 EMS Fire 5,000 5,000 10,000 s Fuel 5,000 33/67 EMS Fire 3,333 1,667 5,000 s Operating Supplies 5,277 60/40 EMS Fire 2,111 3,166 5,277 Utility Billing Estimated cost for utility billing provided by Finance 15,250 All to EMS - 15,250 15,250 Subtotal - Non Personnel $ 568,604 $ 266,305 $ 302,299 $ 568,604 Total Costs $ 1,901,673 $ 612,684 $ 1,288,989 $ 1,901,673 Fire EMS Staff Time - Full-Time Staff 24% 76% Check O.K. Staff Time - Volunteers 30% 70% Check O.K. Emergency Responses 13% 87% Check O.K. 50/50 EMS Fire 50% 50% Check O.K. 60/40 EMS Fire 40% 60% Check O.K. 90/10 EMS Fire 10% 90% Check O.K. 33/67 EMS Fire 67% 33% Check O.K. Facilities 40/60 EMS Fire 60% 40% Check O.K. Staff Time - Full Time & Volunteers 26% 74% Check O.K. Bdgt Add - Vehcl Maint 56% 44% Check O.K. Bdgt Add - Smll Tls & Eqpt 86% 14% Check O.K. All to Fire 100% Check O.K. All to EMS 100% Check O.K.

19 February, 2014 Appendix A-3 City of Lynden, WA EMS Cost Allocation - Step 2 Availability Demand Description EMS Allocation Combined Staff Cost for All Divisions $ - $ - $ - $ - Firefighters 378,025 Availability Demand Ratio 322,588 55, ,025 Lieutenants 237,427 Availability Demand Ratio 202,609 34, ,427 Assistant Fire Chief 80,272 All to Availability 80,272-80,272 Fire Chief 80,259 All to Availability 80,259-80,259 Fire Chief - Fire Prevention Activities - Support Srvcs Manager II 48,615 All to Availability 48,615-48,615 Overtime 52,932 Availability Demand Ratio 45,170 7,763 52,932 Out of Class Pay 3,781 Availability Demand Ratio 3, ,781 Volunteers 105,379 Vol. Availability Demand Ratio 82,034 23, ,379 - Subtotal - Personnel $ 986,691 $ 864,772 $ 121,918 $ 986,691 Total Availability Demand Total Description EMS Allocation Administration $ - $ - $ - $ - Supplies 8,895 All to Availability 8,895-8,895 Professional Services 2,335 All to Availability 2,335-2,335 Professional Services - Ambulance Billing S 8,000 All to Demand - 8,000 8,000 Travel 2,706 All to Availability 2,706-2,706 Miscellaneous 2,640 All to Availability 2,640-2,640 - Fire Suppression/EMS - Supplies 16,800 All to Demand - 16,800 16,800 Fuel 5,000 All to Demand - 5,000 5,000 Small Tools - Fire - Small Tools - EMS 5,000 All to Availability 5,000-5,000 Professional Services 11,030 Availability Demand Ratio 9,412 1,617 11,030 Communications 4,368 All to Availability 4,368-4,368 Travel 3,000 All to Availability 3,000-3,000 Operating Rentals & Leases 1,000 All to Availability 1,000-1,000 Insurance (operations) 8,358 All to Availability 8,358-8,358 Repairs & Maintenance - Miscellaneous 2,000 All to Availability 2,000-2,000 Intrgov't - Prosepect (Dispatch for BLS trnsp 26,000 All to Demand - 26,000 26,000 Intrgov't - What-Comm (911 Fire & EMS) 16,160 All to Availability 16,160-16,160 Intrgov't - FARS (Fire Agency Radio System 2,621 All to Availability 2,621-2,621 Intrgov't - EMS 1/10th of 1% sales tax passt 95,000 All to Availability 95,000-95,000 Intrgov't - SERP Hazmat - All to Availability Capital Outlay - SCBAs - - Fire Prevention & Investigation - Supplies - Small Tools - Professional Services - Travel - Public Utility Services - Miscellaneous - -

20 February, 2014 Appendix A-4 City of Lynden, WA EMS Cost Allocation - Step 2 (cont.) Availability Demand Total Description EMS Allocation Training (Provided to Employees) - Supplies 2,667 All to Availability 2,667-2,667 Fuel 500 All to Availability Small Tools 500 All to Availability Professional Services 1,667 All to Availability 1,667-1,667 Travel 2,000 All to Availability 2,000-2,000 Public Utility Services - All to Availability Miscellaneous 5,500 All to Availability 5,500-5,500 - Facilities - Supplies 2,400 All to Availability 2,400-2,400 Professional Services 1,040 All to Availability 1,040-1,040 Communications 2,400 All to Availability 2,400-2,400 Insurance 4,716 All to Availability 4,716-4,716 Public Utility Services 4,800 All to Availability 4,800-4,800 Repairs & Maintenance 2,400 All to Availability 2,400-2,400 Miscellaneous 120 All to Availability Intergov't 200 All to Availability Vehicles & Equipment Maintenance - Supplies - Repairs & Maintenance - Fire - Repairs & Maintenance - EMS 15,895 All to Availability 15,895-15,895 - Additional Budget Adds - Vehicle Equipment Maintenance 6,642 All to Availability 6,642-6,642 Capital - Small Tools & Equipment 2,857 All to Availability 2,857-2,857 Training (EMT/Firefighter School) 5,000 All to Availability 5,000-5,000 Fuel 1,667 All to Demand - 1,667 1,667 Operating Supplies 3,166 All to Demand - 3,166 3,166 - Utility Billing - Estimated cost for utility billing provided by F 15,250 All to Availability 15,250-15,250 - Subtotal - Non Personnel $ 302,299 $ 240,048 $ 62,250 $ 302,299 Total Costs $ 1,288,989 $ 1,104,821 $ 184,169 $ 1,288,989 Availability Demand Availability Demand Ratio 85% 15% Check O.K. Vol. Availability Demand Ratio 78% 22% Check O.K. All to Availability 100% Check O.K. All to Demand 100% Check O.K. Check O.K. Check O.K. Check O.K. Check O.K. Check O.K. Check O.K. Check O.K. Check O.K.