Loading...
SR 12-06-2016 3H Ci ty Council Report City Council Meeting : December 6, 2016 Agenda Item: 3.H 1 of 6 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 2 of 6 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 . 3 of 6 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. 4 of 6 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 5 of 6 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. 6 of 6 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)