SR 12-06-2016 3H
Ci ty Council
Report
City Council Meeting : December 6, 2016
Agenda Item: 3.H
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To: Mayor and City Council
From: Jacqueline Seabrooks, Police Chief , Police Department
Subject: Medical Services for Arrestees
Recommended Action
Staff recommends that the City Council:
1) Authorize the City Manager to negotiate and execute a three -year pr ofessional
service s agreement with Vital Medical Services, LLC, a California -based
company, for in -house medical service provisions for arrestees. This
recommended award is made as an exception to the competitive bidding proce ss
pursuant to Section 2.24.08 0 (d) and is for a total amount not to exceed $500,000
(includes a 7.5% annual contingency), with future year funding contin gent on
Council budget approval; and
2) Authorize the City Manager to negotiate and execute a three -year professional
service agreement with UCLA Santa Monica Hospital and Palm Drive Medical
Group , a California -based company, to provide emergency room medical
services to arrestees. This recommended award is made as an exception to the
competitive bidding proce ss pursuant to Section 2.24.080 (d) and is for a total
amount not to exceed $150,000 with future year funding contingent on Council
budget approval .
Executive Summary
The Santa Monica Police Department (SMPD) is required by state and federal law to
provide medical services to arreste es known to have or declaring medical issues or
injuries prior to booking and housing in the SMPD Jail. Currently, Vital Medical Services,
LLC (Vital) provides on -site medical services for SMPD arrestees and inmates. For
medical needs requiring emergency r oom treatment, SMPD utilizes UCLA Medical
Center, Santa Monica (UCLA SM).
SMPD is seeking authorization to enter into a Professional Services Agreement with
Vital which would enable Vital to continue to provide on -site medical services for Santa
Monica P olice Department (SMPD) arrestees and inmates . The total cost of these
services would not exceed $150,000 during the first year, and not exceed $500,000
over the term of the agreement
Secondly, SMPD is seeking authorization to enter into a Professiona l Services
Agreement with UCLA Medical Center, Santa Monica (UCLA SM) and Palm Drive
Emergency Physicians Medical Group (Palm Drive ). The total cost of these services
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would not exceed $50,000 in the first year, and not exceed $150,000 over the term of
the agreement.
Background
The S anta M onica P olice D epartment (SMPD) ran a pilot program with Vital Medical in
2015. Based on the success of the pilot, SMPD contracted with Vital beginning in March
2016 for one year of service.
Prior to the on -site services provided by Vital, arrestees requiring pre -booking medical
clearance, medical care, or blood draws were transported by police officers to local
hospitals. The cost of the emergency room visits, physician services and any ancillary
tests or medical services were borne by the Police Department. Additionally, every
medical clearance required one or two sworn police officers to transport the arrestee to
the medical facility, wait for available medical personnel, standby during the necessary
treatment and tests, and transport the arrestee back to the SMPD Jail Facility. Arrestees
who required follow -up medical treatments for wound care or the dispersal of medicine
required additional police transports. These activities place an additional burden on the
Police Dep artment's patrol personnel who then a re unable to be in the field responding
to the community's public safety needs , creating potential public safety risks, in addition
to the risks posed by having arrestees waiting in the emergency room with the general
p ublic. The usage of Vital in the SMPD Jail throughout 2016 has provided a more
secure environment to conduct medical exams and has significantly reduced the
amount of time police officers are removed from patrol duties to obtain medical
clearances .
Prio r to contracting with Vital in 2016, SMPD analyzed data from FY 2008 to FY 2014 to
assess costs . T he average number of patients requiring medical treatment was 287 per
year, with the lowest year’s treatment numbers being 199 arrestees and the highest
being 437. Costs paid for those medical services averaged $71,643 per year, with the
span of costs ranging from $38,000 to $110,000. These averages do not include the
costs associated with the amount of time officer(s) spent in the emergency room and
the cost i mpacts of the resulting patrol shortages .
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The Police Department and UCLA SM/Palm Drive have had an ongoing relationship for
more than twenty years. The contract was renewed simultaneously to the contract with Vital
in February 2016. The most recent Counc il action prior to 2016 dates back to a February
10, 1998 Council meeting regarding the use of UCLA -Santa Monica Hospital/Palm Drive
(under their previous name “Janzen, Johnston, and Rockwell”) for Emergency Room
Treatment of Prisoners.
Discussion
Vital Medical Services, LLC
Currently, Vital provides pre -booking medical clearances to arrestees who exhibit or
complain of non -emergent medical conditions that police personnel are unable or
unqualified to administer treatment for, and blood draws taken from persons arrested for
driving under the influence (DUI).
The proposed three -year agreement with Vital would allow medical treatment for up to
600 arrestees annually (a n average of 50 per month) on -site in the Jail Facility. The
agreement would enable SMPD to exceed this annual estimation by 20% (for a total of
720 arrestees) at no additional charge. Vital w ould notify the Department when 75% of
the agreed upon services have been delivered.
Vital's personnel currently provide pre -booking medical clearan ce evaluations and
select minor medical treatments to the Police Department's arrestees utilizing
appropriately vetted and licensed PAs and/or NPs. Examples of m edical services
performed include minor wound care and treatment of nausea. Absent specific
evi dentiary kits required by County of Los Angeles crime laboratories, Vital provides the
necessary equipment and supplies to perform the medical services in a private room
located within the SMPD Jail Facility. The medical exam room meets all medical,
Count y Health Department and Board of State and Community Corrections
requirements for these types of services. Providing such medical services in the Jail
complies with current standards set forth in Title 15 of the California Code of
Regulations.
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The usage of Vital for medical treatment has significantly reduced the need for police
officers to be removed from patrol duties to obtain medical clearances from local
emergency rooms (ER). Not having arrestees in the ER limits the exposure of the
general public to uncooperative, potentially combative arrestees and potentially thwarts
a mechanism for escape. It also enhances officer safety by not having to transport an
uncooperative or combative arrestee to and from the SMPD Jail Facility.
The propose d agreement would commit Vital to provide 16 hours of on -site medical
services per week , on predetermined dates , and provide medically certified personnel
on an on -call basis 24 -hours a day, 365 days per year . Currently, Jailers are
responsible for identif ying arrestees that require medical clearance, notifying Vital to
respond to the jail, and escorting the arrestee to the secure medical exam room located
in the confines of the Jail. The estimated time for jail staff to conduct a medical
clearance averages 30 minutes in comparison to a police officer which averaged over
two hours in an ER.
Based on a recent 90 -day analysis (March 7 – June 4, 2016), Vital provided 153
medical clearances and 21 DUI blood draws. This equates to an approximate savings of
27 6 hours that police officers would otherwise have been removed from patrol duties for
arrestee medical clearances with an estimated salary savings of $25,000. Jail staff
performed the medical clearances utilizing approximately 77 hours at a significantly
lower pay rate. Vital has proven to be an effective and cost efficient means of providing
medical treatment to arrestees.
UCLA Medical Center, Santa Monica Hospital and Palm Drive
In the event an arrestee requires emergency room services, he/she would be
transported to the UCLA Medical Center, Santa Monica Emergency Room for treatment.
The proposed three -year agreement with UCLA SM/Palm Drive, at a cost of $300 per
visit, would meet the medical needs of those arrestees who require ongoing, emergent
c are and cannot be treated in the SMPD Jail Facility b y Vital. In the event that an
arrestee requires emergency room treatment, one or two sworn police officers (based
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on the nature of the arrest) will transport the arrestee to the UCLA SM Hospital
Emergenc y Room, wait with the arrestee for available medical personnel, standby
during the necessary treatment and tests, and then transport the arrestee back to the
SMPD Jail Facility. Examples of situations requiring emergency room treatment include
any injury needing an x -ray or an MRI since that equipment is not available to Vital
Medical in the SMPD Jail Facility .
Vendor/Consultant Selection
Staff recommends Vital Medical Services to furnish and provide on -site medical
services in the SMPD Jail Facility as an exception to the competitive process basis .
Competition does not exist, since Vital is currently the only service in existence
delivering facility -based medical support to municipal law enforcement agencies. The
alternatives to providing on -site medica l services would require SMPD to hire medical
staff as City employees at a significantly higher cost or to return to the previous practice
of having police officers transport all arrestees requiring medical services to the hospital
emergency room and wait with them for treatment .
In terms of those arrestees who require immediate, emergency medical care, staff
recommends UCLA SM/Palm Drive to provide emergency room services to the Police
Department’s arrestees. Staff has confirmed that there are no simil ar emergency room
and billing services pairing provided at local hospitals.
Financial Impacts and Budget Actions
The agreement to be awarded to Vital Medical Services, LLC is for an amount not to
exceed $500,000 . Funds of $150,000 are available in the FY 2016 -17 budget in the
Police Department. The agreement will be charged to account 01306.555250. Future
year funding is contingent on Council budget approval.
The agreement to be awarded to Palm Drive Emergency Physicians Medical Group is
for an amount n ot to exceed $1 50,000. Funds of $50,000 are available in the FY 2016 -
17 budget in the Police Department. The agreement would be charged to account
01306.555250 . Future year funding is contingent on Council budget approval.
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Prepared By: Jennifer Estrada, Jail Manager
Approved
Forwarded to Council
Attachments:
A. Staff Report - January 26, 2016 (Weblink)
B. Staff Report - February 10, 1998 (Weblink)
Reference:
Agreement No. 10400
(CCS)
&
Agreement No. 10401
(CCS)