2014-10-13 Reg - Laserfiche WebLink

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with the fire. She asked why additional turnout gear was needed when two employees will not be utilized to fight fires. Dr. Carr asked Ms. Pumm to provide Council with copies of the budget pages from FY04 and FY05. Dr. Carr stated that she had highlighted certain capital expenditures noting that the reason these expenditures do not appear in both budgets was because they are not purchased every year. She then asked the following questions: 1. Why were the projected savings from these capital expenditures lumped into one year rather than being prorated? 2. Has any consideration been given to the fact that the City may need to acquire a rescue vehicle if the selected EMS outsourcing model does not provide ALS services? 3. Why are the expenditures for medical supplies being eliminated if the City would still be required to carry these supplies on their fire trucks? Mr. Walker explained that staff had not gone that far in their analysis. 4. What is the real differential between annual expenditures and the cost? Dr. Carr stated that savings should not be the only determining factor involved in making a decision to change the policy on in-house EMS services. Other factors should include the effective outsourcing on EMS mutual agreements; the affect of eliminating twelve firefighter/paramedics; the affect on patient outcomes when EMS response times are extended; the affect on patient outcomes when utilizing a decreased number of licensed paramedics to staff private ambulances; whether or not the City can increase revenue by improved billing and collection procedures, and the affect on the image and perception of University City by decreasing the core services it provides to citizens based on its elevated tax rate. Dr. Carr stated that she would like to remind Council that it is the members of this body who establishes policies and the responsibility of the City Manager to carryout those policies. Before decisions are made, based on a rudimentary analysis for cost-savings, Council should be engaging with their constituents to determine what they want and what they are willing to pay for those services. Dr. Carr requested that all paperwork and documents associated with Mr. Walker’s analysis be provided to Council. Mr. Kraft provided several examples of the City’s previous experience related to outsourcing:  Solid waste collection; based on the final analysis; the decision was made not to outsource.  Repair of the City’s fleet of vehicles. Mr. Kraft stated that he was convinced, based on the consultant’s report, that there would be a huge savings to the City by outsourcing, but this savings was attained without the need for outsourcing.  Segments of the City’s IT and HR Departments are outsourced and has resulted in significant savings. Mr. Kraft stated that medical, hospital and patient care literature takes a completely different approach as it relates to emergency medical services, and the model by which EMS services are handled is now being looked at in a totally different way. What they have determined is that there are really acute patients who need this service, but there are also a large number of patients that frequently use EMS services because they have no other service to call, who don’t really need it. So what they have done is tried to develop an integrated approach that includes the assistance of home healthcare assistants and nurses to assist non-acute patients with their healthcare needs so that they no longer need the frequent use of EMS services. Mr. Kraft stated that a lot of the potential for savings can be realized by re- envisioning how the system works and this is the kind of creative thinking that he would like to see. At this point, Council has not seen a proposal and while all of the questions posed by Dr. Carr and Mr. Crow are very important, Council should wait until staff has put all of the information together and then decide if the amortization has been properly performed. 7