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ECC UGENE ITY OUNCIL AIS GENDA TEM UMMARY Work Session: Non-Emergency Stretcher Car Transports by Private Providers Meeting Date: February 13, 2008 Agenda Item Number: A Department: Fire & EMS Department Staff Contact: Denise Giard www.eugene-or.gov Contact Telephone Number: (541) 682-7111 ISSUE STATEMENT The work session was initiated by Councilor Andrea Ortiz to discuss private provider requests to deliver non-emergency stretcher car service within the city of Eugene. In discussing this issue, staff asks that the council consider the entire ambulance transport system with regard to service delivery, funding stability, system capacity and workload. Eugene’s fee-supported ambulance system is no longer self- supporting and the resource base has inadequate capacity to keep pace with today’s call volume and workload. BACKGROUND The City currently operates its ambulance transport system within an Ambulance Service Area (ASA), assigned by Lane County, under the authority of the State of Oregon. This mandate is to ensure that no portion of the state is left without ambulance service. Eugene’s ASA encompasses 438 square miles and serves a population approaching 180,000. In fiscal year 2007, the Fire & EMS Department responded to 16,976 medical calls for service that resulted in the transport of 11,167 patients. Eugene staffs three 24-hour, dual-role (firefighter/paramedic) transport ambulances, one 24-hour swing crew (fire company that can be shut down to staff an additional ambulance when needed), and up to two single-role (paramedic only) transport ambulances during peak periods. For emergency medical calls within the city, the closest advanced life support fire suppression company and ambulance are dispatched concurrently. Eugene and Springfield both staff their fire suppression units with firefighter/paramedics and equip them with advanced life support equipment and medications. The City is currently operating its ambulance transport system at a financial deficit and without adequate resources. Without any intervention, the ability to sustain the Ambulance Transport Fund (ATF) into FY10 is in jeopardy. At present, the fiscal deficit is being covered by ATF fund (592) reserves. System Financial Deficit: Although there are a number of contributing factors to the current financial situation, the deficit is primarily attributed to the reduced levels of reimbursement the City receives from Medicare (federal) and Medicaid (state) for qualifying patient transports. These decreases have been phased in by the federal government since the passage of the Balanced Budget Act of 1997, which shifted much of the financial burden for covered patient transports from the federal government to local providers. In 2003, Congress passed the Medicare Modernization Act (MMA), which introduced several temporary payment provisions, including a regional fee schedule that overlapped with the F:\CMO\2008 Council Agendas\M080213\S080213A.doc