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"Fair, Stable and Adequate Financial Resources," which speaks of the need to prioritize available revenue and resource allocation to preserve and protect infrastructure and essential assets, including operations, maintenance and preservation. Financial and/or Resource Considerations The City's FY04 Proposed Budget document refers to the ongoing operating deficit facing the Ambulance Transport Fund (#592), by discussing the current implementation of a multi-phased plan which included the creation of a single-role ambulance resource, the formation of the "combination crew" deployment strategy, and the assumption of direct responsibility for performing all tasks associated with the ambulance service's accounts receivable functions. While these modifications have realized the projected annual savings, they have not provided a complete solution to the identified financial shortfalls. This proposal represents an additional strategy for developing further service refinements and cost efficiencies within the system. Other Background Information In addition to emergent and immediate ambulance response, Eugene also operates a non- emergency, pre-scheduled transfer service that regularly picks up and delivers patients for dialysis, cancer treatment, and other routine appointments for which they are too sick to travel by other modes of transportation. The call is handled first by a single-role paramedic ambulance or, if one is not available, a dual-role firefighter/paramedic staffed medic unit. The table below shows the significant volume these low level calls currently account for in the City's system. Call Type FY01 FY02 FY03 All Transports 8,387 8,565 9,231 Pre-Scheduled 806 1,329 470* Total 9,193 9,894 9,701 Daily Average 25 27 27 * The number shown is lower than actual activity as a result of a change in the way these pre-scheduled calls are now being coded and processed. Staff believes the provision to allow the potential for sub-contracting some low priority, non- emergency transport services can be successful in helping to lower the total aggregate unit costs of providing ambulance services here. Another potential benefit could be an augmentation to the area's overall ambulance inventory, and low priority transport service delivery without additional public cost. Currently, to preserve the limited ambulance capacity within the EMS system here, Eugene engine and truck companies are routinely dispatched to perform non-emergency patient evaluations. Upon arrival, the first response fire crew rapidly assesses the patient's condition and determines the most appropriate level of intervention. For incidents that require some form of non-emergency transportation, the options now available are very limited. In certain qualifying situations, the first responders can access the local CAHOOTS program, or a local industrial medic first aid service. However, because of the limited capacity of these programs, and their restricted scope of practice, these options are often either unavailable or inappropriate, leaving the use of a paramedic ambulance as the only other viable transport method available. L:\CMO\2004 Council Agendas\M040412\S0404124.doc