Item 2A: Approval of City Council Minutes

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Chief Murphy observed the Western Lane Ambulance District was funded by the district’s tax support, user fees, and a program that cooperated with FireMed called Life Care. Commissioner Fleenor thanked Mayor Piercy and Councilor Ortiz for arranging for the summit. He asked why the reasonable charge method was changed to a fee for service method. Chief Murphy said reasonable charge and fee for service were Medicare terms. Reasonable charge was equivalent to reduced Medicare reimbursement rates across the board. Medicare broke the bank. He suggested elected officials would need to compare all ALS ambulances in Lane County with ambulances that were BLS with a driver who was not even a basic Emergency Medical Technician (EMT) and response times not considered legal in Oregon on the east coast of the United States to determine if charges were reasonable. He opined Congress’ intent was not to pick on 9-1-1 services, but rather balance the entire Medicare system. Commissioner Fleenor asserted costs could be reduced by increasing response time. He asked who established minimum response time requirement standards. Chief Groves stated local jurisdictions set the standards by working with the local medical control boards. There were longer response times related to how far people lived from service providers. Outcomes for critical care cases were proportional to patients’ distance from service providers. Chief Murphy added the BCC through its ambulance service area designation established response time standards for urban, suburban, rural and frontier locations. Those standards were currently realistic and followed by the providers. In order to save a life, the agencies were heavily dependent on first responders in seventeen rural fire districts surrounding central Lane County that provided care prior to arrival of ambulances from the urban area. Inside the cities, by ordinance, the response times were set by the cities of Springfield and Eugene. Commissioner Fleenor asked theoretically if the budget could be balanced by increasing the response times. Chief Murphy said it was more than a theoretical concept, and the answer was yes, it could be done and it was a matter of public policy from a standpoint of resources. The cities and the county had set an expectation. He added it was also a matter of public policy on what should be done to save lives when it took longer to respond. Commissioner Fleenor asked how often policy makers met to consider the response time issue. Chief Murphy said the ambulance service area was initiated in compliance with state law in the early 1980’s. The system had been upgraded and response time standards for urban, suburban, rural and frontier locations had been reset twice since then. The Eugene City Council and Springfield City Council had met five times on the issue since 1981 and had made adjustments. Chief Groves said for Eugene’s ASA, and a population approaching 190,000 people, the City of Eugene had three ambulances. He said that capacity had been exceeded the previous night due to a critical incident, and that occurred frequently. He opined the department was already marginally staffed. Councilor Clark thanked fire personnel and staff and other providers for attending this evening’s meeting to help elected officials identify the issues. He averred ambulance transport was a core service. He asked MINUTES—Joint Elected Officials— January 27, 2009 Page 8 Lane Board of County Commissioners, Lane Rural Fire/Rescue Board of Directors and Eu- gene and Springfield City Councils