Item 1: Future Ambulance Transport Funding

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ATTACHMENT A governments have had some limited success in pushing for increases in the fee sche- dule (an example being the Medicare Prescription Drug, Improvement, and Moderni- zation Act (MMA) of 2003, which unfortunately is due to sunset on December 31 of this year). This lobbying should continue. OTHER OPTIONS CONSIDERED Continue to Raise Rates: Although this approach has been used in the past to forestall revenue deficits, our Task Force rejected it for simple mathematical reasons. Because the majority of pa- tients transported are covered by Medicare with its capitated reimbursement schedule, and be- cause a large percentage of the remaining patients are unable to pay, the full fee is seldom col- lected. Even an astronomical rate increase would result in only a minimal revenue gain, and would in all likelihood result in a negative patient care impact if cost became a deterrent to ac- cepting transport. Privatize the Service: The elected bodies to which we belong have identified ambulance trans- port as a core public service that should continue to be publicly administered. Therefore the op- tion of privatization was not studied by our group, and was not identified to the public as a viable option. Eugene Fire & EMS has contracted with a private provider to handle some non- emergency transports, but assignment of emergency prehospital care to this or any other private provider is not being considered. Under full privatization, the public would not only relinquish quality control, but also the emergency response versatility afforded by the firefighter/para- medics now staffing local ambulances. Market FireMed as an Alternative to Additional Taxation: This was suggested at one of the community forums. It is correct that, if a sufficient number of FireMed memberships were sold, that enhanced revenue stream could take the place of General Fund support. However, FireMed and fire service professionals have countered, and we as your Task Force believe, that this type of marketing would probably result in unfortunate public perceptions and could lead to a back- lash. Further, continued service would become dependent on adequate FireMed sales from one year to the next. Having said that, we are recommending enhanced marketing of FireMed, but with a positive approach. PUBLIC PARTICIPATION During our process, we directed staff to engage the public regarding this issue. We published an op-ed column in The Register-Guard explaining our charge, and nine community forums were organized within the three jurisdictions. The forums were announced via paid advertising, earned (unpaid) media (newspaper, television, and radio), and online. There were also presenta- tions made to the Eugene City Club, Eugene Chamber of Commerce, and Springfield Chamber of Commerce. In addition to the community forums, we set up an online survey providing the same information and options as were provided at the public forums. Documentation can be found in Appendices A through F, including a full transcript of written public comments received. In summary, the combined responses from the community forums and the online survey showed the most support for the formation of a general fire service district, while General Fund support 8