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Report of EMS Committee - Page 2 Of course, this organization will require articles of incorporation, bylaws, etc., which will provide greater detail relative to officers, meetings, and responsibilities. (A sample of such documents is included with this report). Cost of Operation. The committee attempted to review the cost of operation of the HMHEMS relative to other similar services. This comparison was difficult due to the lack of available data and the various organizational structures within which EMS services are provided. With most services being associated with hospitals or operated as part of another service like the fire department, we found no pure set of cost figures. This review was complicated by the various levels of service, including volunteer, basic and advanced life support programs. In general, the committee felt that the cost per capita of under $5.00 and cost per run of approximately $105.00 was well within reasonable cost standards compared with the sparse data available, especially due to the fact that the service is an advanced life support service. The current staffing provides one crew composed of two paramedics on duty at all times, and a second crew on backup call. The committee feels that the coverage provided by this system is adequate based upon the current population of San Marcos and Hays County. It is recommended that the backup call team be changed from two EMS paramedics to one paramedic and one fire department employee with EMT training. The backup ambulance would be located at the fire department and would be driven by the fireman/EMT to the emergency site, with the paramedic using his personal automobile to drive to the site. The value of the use of fire department staff for backup is approximately $485.00/month. At the current time, the fire department has four certified EMTs. Training of additional fire department employees would be provided by EMS personnel at the-fire station using available time based on service needs of both the 'fire department staff and EMS staff. The time to be invested in training additional personnel is valued at $2,000 - $3,000. The committee recommends that the governing board make an extensive review of the EMS service needs in three years to determine the need for two full crews to be on duty at all times. Along with the second crew, the board should review use of a second site for the new crew. The committee reviewed the base charge of the service, which ranges from $45.00 to $65.00 in the area, with the HMHEMS currently charging $65.00. An increase is recommended to meet inflationary costs of operating the EMS program for the current and future years. The current collection rate of approximately 71 percent of charges is well within acceptable guidelines, with the average of systems reviewed being around 66 percent. Collections for HMHEMS covers approximately 43 percent of total direct costs, with an average of about 33 percent of systems reviewed. Hays Memorial Hospital has indicated willingness to continue to provide EMS operating supplies at cost plus 10 percent.