TRANSPORTATION COMMITTEE REPORT relative to establishing the 2024-25 private ambulance service rates in the City of Los Angeles and a new methodology for future rate adjustments.

The Los Angeles City Council has adopted the Transportation Committee Report, establishing new 2024-25 private ambulance service rates and a new methodology for future adjustments. However, an amending motion (Lee-Rodriguez) was also referred to the Budget and Finance Committee and Transportation Committee, requesting the City Attorney to prepare an ordinance to adopt these rates as maximum allowable rates, a significant shift from the original intent for fixed, non-negotiable rates.

New Rates (effective 2024-25):

• Basic Life Support (BLS) base rate: $1,703.75
• Advanced Life Support (ALS) base rate: $2,417.00
• Mileage rate: $29.00 per mile
• Waiting time: $80.25 per 15 minutes after initial 15 minutes
• Standby time: $80.75 per 15 minutes after initial 15 minutes (in addition to base rate)
• Other special charges include night service ($29.00), oxygen ($111.00), emergency call with lights/siren ($176.50), Critical Care Nurse ($324.75/hr), and Respiratory Therapist ($1,092.75/3 hrs + $148.25/hr after 3 hrs).

New Methodology: Future rate adjustments will automatically align with the percentage change of Los Angeles County's annual ambulance rates, which consider minimum wage and the Consumer Price Index for Medical Care. This replaces LADOT's previous inefficient survey-based method. The new rates represent an average 29.3% increase since 2021, with some categories like mileage increasing by 52.63%.

Stakeholder Conflict:

• The ambulance industry (California Ambulance Association, United Steelworkers, Teamsters) strongly supports the rate increases and fixed rates, arguing they are crucial to cover rising operational costs (e.g., payroll, benefits, fuel, equipment) and ensure quality service, competitive wages, and personnel retention. They contend that fixed rates prevent large insurers and hospitals from driving down reimbursement rates, citing AMR's cessation of non-emergency services in LA County due to unsustainable rates.
• Conversely, hospitals (Cedars-Sinai, Mission Community Hospital) oppose the significant increases (over 30% in 2024, over 60% in two years for Mission Community Hospital) and the lack of their input. They argue that fixed City rates, unlike the County's maximum rates, hinder negotiation and disproportionately impact uninsured patients. Cedars-Sinai estimates an additional $120,000/month expense for BLS transfers. Public comment also highlighted Kaiser Permanente's $67 billion in cash reserves, questioning their claims of inability to pay fair market rates.

This item has no direct impact on the City's General Fund, as costs are borne by private ambulance service users, typically covered by insurance or government programs.