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? <br /> Tax payments: 57 percent. <br />? <br /> Ambulance Revenue: 45 percent. <br /> <br />Chief Borland reviewed trends and solutions for regional ambulance transport service: <br /> <br />Trends: <br />? <br /> Calls for service were increasing. <br />? <br /> Operating and administrative costs were increasing. <br />? <br /> Medicare age population was growing. <br />? <br /> Number of uninsured and under-insured patients was growing. Increased on-scene triage resulting <br />in fewer transports. <br /> <br />Potential Short-Term Solutions: <br />? <br /> Increase ambulance transport fees. <br />? <br /> Tax support (General Fund). <br />? <br /> First response fees. <br />? <br /> Sub-contracting inter-facility, non-emergent transports freeing up fire based resources. <br /> <br />Potential Long-Term Solutions: <br />? <br /> Higher ambulance transport fees. <br />? <br /> Consolidate/merge department functions. <br />? <br /> Create ambulance service taxing district. <br />? <br /> Create a fire district or authority that incorporates ambulance transport into its base budget. <br />? <br /> Continue Congressional lobbying efforts to increase Medicare/Medicaid payments. <br />? <br /> Reconfigure ASA boundaries (urban/rural split). <br />? <br /> Develop an alternative service delivery model. <br />? <br /> New membership initiatives/programs. <br /> <br />V. SCHEDULED SPEAKERS <br />Mr. LeDuc introduced the evening’s scheduled speakers: <br /> <br />Robert Leopold, EMS Director, Oregon Department of Health and Human Services, said when someone in <br />Oregon called 9-1-1, they expected to have a competent, trustworthy person show up with correct <br />equipment. That person also needed to be able to communicate with the hospital emergency department to <br />ensure care initiated in the field continued at the hospital. It was extremely important to maintain these <br />systems which the citizens relied on 24 hours a day. Funding health care was a challenge nationally, even <br />before the current economic crisis. Rural communities that provided care entirely through volunteer <br />systems in Oregon were finding the systems were not sustainable and urban areas were facing funding <br />crises. The Oregon EMS and Trauma Systems Program were committed to working with chiefs and <br />community leaders to find a way to make a sustainable EMS system. <br /> <br />Tim Herrmann, Hospital Administrator, Sacred Heart Medical Center (SHMC) University District, stated <br />SHMC was experiencing many of the same challenges expressed by the chiefs. He offered a PowerPoint <br />presentation which illustrated those challenges. SHMC was also on a capitated payment schedule for <br />Medicare and Medicaid resulting in reimbursements that were below costs, which was not a sustainable <br /> <br /> <br />MINUTES—Joint Elected Officials— January 27, 2009 Page 5 <br /> Lane Board of County Commissioners, Lane Rural Fire/Rescue Board of Directors and Eu- <br />gene and Springfield City Councils <br /> <br />