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.~ ~.~ i.-.- :i;e4 Mr. Link stated that the EMS Advisory Council could do a great deal to help clarify everyone's roles in this. They will be able to focus on how the system is operating., . What we can do to improve it. We use paid staff and volunteer staff and they all _ .- respond.to one Medical Director of the hospital who is the one in charge of protocol. We need to start with the basics of who is in charge of the EMS system in Orange County. The county has a statutory responsibility for emergency services. We need to talk about the protocol. Chairman Carey asked if we were contracting with EMS, giving them a grant, or are we paying them to let us use their equipment. He agreed that having a position dedicated to learning the intricacies of medicare and medicaid would probably pay for itself. Mr. Link indicated that at present we have a franchise which is fairly loose it its content. We need a more structured contract. Mr. Willhoit proposed that this position be left out of the budget. He also mentioned that there is a real problem with non-emergency transport which needs to be addressed. An example of this is when someone is transported to the hospital because of an accident. They are taken care of at the hospital and occasionally have no way home because at that point the emergency is over. We need a mechanism to provide non- emergency transport and we need to know what this will involve in terms of funds and manpower. Mr. Link stated that the position, or the funding, could be left in the budget. Then the administration will come to the Board with a recommendation on the implementation of collection for non-emergency EMS by August 1st. ~'; Chairman Carey indicated that he believed that this 1/2 time position needed to be <, left in the budget so that we could begin to generate the expertise needed to start the cashflow for providing the service. In response to a question for Commissioner Halkiotis, Mr. Link indicated that we will be charging $110.00 for every non-emergency trip. That money will go into the general fund. In the budget recommendation the amounts suggested for both rescue squads included their picking up the non-emergency transport. It was also recommended that any amount above $25,000 that we collect in non-emergency fees go toward the operation or capital reserve, for the rescue squads needs. Commissioner Halkiotis stated that the average cost of a ride in an emergency vehicle in North Carolina is $135.00. Because of the insurance deductible, it is quite likely that the ihdividual will be paying for this. The average cost of airlift services is $875.00. Beginning July lst we will be charging $925.00. He also asked who pays for the airlift service if the helicopter.is called unnecessarily? He mentioned that this information came from an employee of Blue Cross/Blue Shield and that this individual would be willing to service on any group that would like to get some first hand information. Mr. Link indicated that the individual who is the "responsible party" is the one who is billed, however, Mr. Waters stated that the charge is made only if someone is transported. Chairman Carey stated that the EMS Council needs to be reactivated and we need to address the problem with non-emergency transport before this issue is settled. Someone