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MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS BUDGET WORK SESSION JUNE 12, 1989 The Orange County Board of Commissioners met on June 12, 1989 at 6:30 p.m. in Superior Courtroom, Hillsborough, N.C. for the purpose of holding a work session on the Manager's proposed 1989-1990 budget. BOARD MEMBERS PRESENT: Chairman Moses Carey, Jr. , and Commissioners Shirley E. Marshall, Stephen Halkiotis, John Hartwell and Don Willhoit. ATTORNEY PRESENT: Marilyn Tomei STAFF PRESENT: County Manager John Link, Assistant County Managers Ellen Liston and Albert Kittrell, Purchasing Director Pam Jones, Emergency Medical Services Director Nick Waters, Budget Analyst Donna Wagner, Health Director Dan Reimer, and Clerk to the Board Beverly Blythe. Chairman Carey called the meeting to order at 6:30 p.m. The specific topic of discussion for this meeting was EMS services and user fees for the coming year. Chief Ray DeFreiss of the South Orange Rescue Squad stated that he believed the outcome of this issue would determine the quality of EMS in Orange County. An equitable solution needs to be found to this problem. He stated that additional information needs to be gathered before a decision is made. Hopefully, volunteers could be included in the further study of this issue with a final decision being withheld until sometime next year. Mr. Dan Cowhig, an EMS volunteer, stated that the real issue is how to provide the best EMS service at the least cost to the taxpayer. He mentioned that voluntary contributions make up most of the squad's budget. They collected $145,000 last year. He pointed out that for two-thirds of the week EMS is covered by volunteer rescue squad members. He indicated he believed that charging a fee for the EMS services would reduce the amount of financial contributions, as well as the number of volunteer hours worked by EMS volunteers. He suggested as an alternative to the user fee proposal having a voluntary "check" box on a bill, such as the county water bills, where citizens could indicate if they want to make a voluntary contribution to EMS. He also mentioned a system in operation in Fairfax County, VA. , where subscriptions are sold to the citizens. Those that do not subscribe and need to use the service are billed in full for the cost of the service. He pointed out that the savings in labor costs for volunteer paramedics alone totals approximately 1.5 million dollars a year. Many of the cost savings are impossible to calculate. The volunteers are a diverse group and include many health care professionals in their ranks. Their contributions are varied and would be impossible to replace with paid professionals because of the cost. He suggested forming a committee consisting of paid EMS staff, volunteer EMS members, hospital employees, citizens, and County financial staff, to look at EMS as a whole and come up with a workable solution. Ms. Clara Heck, a paramedic with South Orange Rescue Squad, stated that she had researched the insurance issue. The average deduction on major medical is now approximately $250.00 for major medical. This trend will continue with deductibles of $500.00 in individual and group policies in the near future. It is a misconception to assume that an EMS charge would normally be paid by insurance companies. She pointed out