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City Council - 2 - February 26, 1997 The District has increased this charge to an annual assessment of $21.14 per benefit unit in 1996- 97. The $21.14 is broken into two components: $10.00 funds the current paramedic delivery system and the operation of the EMS District, and $11.14 provides a subsidy to ambulance service providers, and funds the three County trauma centers (Highland Hospital in Oakland, Children's Hospital in Oakland, and Eden Hospital in Castro Valley). II. History of City's EMS Supplemental Assessment The County Board of Supervisors made an administrative determination to allow cities in the County Service Area to levy a supplemental assessment to fund EMS related services, including paramedic services, within their jurisdictions. Using the same weighted land use classification system as the County, the City of San Leandro has been levying a supplemental assessment of $9.90, through action of the City Council, since FY1988-89. III. Impact of Prop. 218 Proposition 218, called the "Right to Vote on Taxes Act" was approved by voters in the November 1996 general election. The City Attorney has determined that the City's assessment, which currently funds the Engine Company paramedic program, does not qualify as a benefit assessment under the provisions of Prop. 218 and should be authorized by the voters as a special tax to comply with Prop. 218. IV. Future of EMS in Alameda County In order to evaluate the alternatives, it is important to review what EMS is likely to be in the future within Alameda County. First, it is expected that the Paramedic Engine will become the standard of EMS delivery. Second, funding issues will require a reconfiguration of ambulance response standards within the County. The recent changes to ambulance response times within the County are evidence of this trend. Third, managed health care is driving changes in the system, by dictating under what circumstances ambulance services will be covered. Finally, to maintain a stable emergency response capability, a strong Advanced Life Support First Responder Program is considered a necessity. DISCUSSION I. Services Provided by EMS Supplemental Funding Our dispatch center receives approximately 11,000 to 12,000 calls annually requesting emergency medical services. Of those, approximately 1,800 to 2,000 calls require Advanced Life Support procedures, and approximately 360 to 500 represent immediate life threatening condition leading to death without rapid intervention. The City's current emergency medical services program, provided via the Alameda County Fire District contract, consists of 168 Emergency Medical Technicians with 110+ hours of training