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Chief Groves emphasized the importance of the three fire and EMS agencies working collaboratively and <br />why it was important to deal with the problems together. Current issues facing the agencies included: <br />? <br /> Medicare and Medicaid reduced reimbursements accounted for more than 65 percent of all trans- <br />ports. <br />? <br /> Unfunded mandates: <br /> Decreasing federal money to pay for federal programs. <br />o <br /> Increasing state requirements for EMT recertification. <br />o <br /> County designated metro/rural ASA, one level of service. <br />o <br /> Medical Control Board established protocols/procedures. <br />o <br />? <br /> Calls for ambulance transport services had increased over 40 percent since 2003. <br />? <br /> Effects of under-insured/uninsured/indigent patients. <br />? <br /> Costs of increased technical sophistication and equipment. <br /> <br />Chief Groves noted the region’s ambulance transport system had evolved over time and was completely <br />integrated with the community’s fire, rescue, hazardous materials, and emergency medical response <br />programs, thus enhancing the entire system’s response capabilities. <br /> <br />Chief Groves reviewed the emergency tiered response that consisted of: <br /> <br />? <br /> Advanced Life Support (ALS)/Basic Life Support (BLS) First Response—provided by a fire <br />suppression company. <br />? <br /> ALS Medic Unit (ambulance)—provided treatment and transport. <br />? <br /> Air Ambulance—provided patient transport via helicopter. <br /> <br />Chief Groves said emergency medical calls were resource intensive, adding patients received critical care in <br />the field which had proven to decrease morbidity and mortality. He said there were eight Ambulance <br />Service Areas (ASA) in Lane County designated by the BCC under the authority of the State of Oregon. <br />The areas under discussion tonight included ASA 4—Eugene; ASA 5—Springfield; and, ASA 8—Lane <br />Rural Fire and Rescue. <br /> <br />Chief Groves provided a review of Lane County ASA 4. ASA 4 covered 432 square miles, and responded <br />to 17,213 calls for service in FY08. System issues facing Eugene, similar to Springfield and Lane County, <br />included: <br /> <br />? <br /> Eugene’s current fee-supported Ambulance Transport System (ATS) was not sustainable long <br />term, with operating costs outpacing revenues. <br />? <br /> Eugene’s existing resource-based ambulance service had inadequate capacity to keep pace with the <br />current call volume and workload. <br />? <br /> Calls for service were increasing. <br />? <br /> Ambulance transports were decreasing due to a state requirement that patients be advised of the <br />cost of transport, better scene triage, and some transports to Sacred Heart Hospital previously pro- <br />vided by Eugene were now provided to the new RiverBend campus by Springfield. <br /> <br />Chief Groves reviewed the three types of units used by Eugene Fire and EMS: three dual-role medic units, <br />two single-role medic units, and one overload company. Approximately 44 percent of dollars billed were <br /> <br /> <br />MINUTES—Joint Elected Officials— January 27, 2009 Page 3 <br /> Lane Board of County Commissioners, Lane Rural Fire/Rescue Board of Directors and Eu- <br />gene and Springfield City Councils <br /> <br />