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90-2126 ORI � . � � Council Fi��- /? � . b � ,��� � � _ , . : Green Sheet# � I RESOLUTION CITY OF SAINT PAUL, MINNESOTA , /� � '��� ,, Presented By: � �, � .�,._,�_ ' : ;-. v Referred Ta �,l�t��--�.-c� Committee: Date /�- (,��. ��j 1 WHEREAS,the Emefgency edical Services Institute(EMSI)has been formed by communities of the East Metro Region to 2 ensure that residents�receivq'the best ambulance and emergency medical services possible within their resources,and 3 WHEREAS,EMSI is�collab�ration of local ambutance services,hospitals,public safety agencies and other institutions with a 4 purpose of providing�raining technology and other resources to ambulance crews,emergency room staff and other emergency 5 service providers,an�i 6 WHEREAS, EMSI intlends to iraise private and public funds to support new educational efforts and research,enhancing(not 7 replacing)local effortls,and I 8 WHEREAS,the mayQr has ef�dorsed and recommends a multi year commitment of support to the Institute,and 9 WHEREAS,The May{or,purs�uant to Section 10.07.4 of the City Charter recommends the following transfers for the 1990 General 10 Fund budget: I, 11 CURRENT BUDGET CHANGES AMENDED BUDGET 12 TRANSFER FROM: 13 General Government Accounts 14 Contingent Reserve�eneralj 15 09060-0548 Contingiency,C�uncil Action 31,850 (11,000) 20,850 16 , i 17 TRANSFER TO: 18 Department of Fire and Safety Services 19 05001 Fire Administ�ation 20 05001-0255 Membership 1,185 11,000 12,185 21 05001 All Other Spemding 826,063 0 826,063 22 All Other Fund Spenping �i 132,162,540 0 132,162,540 23 24 Total Fund , 133,021,638 0 133,021,638 25 ' NE7 CHANGE 0 26 27 RESOLVED,That thie City Cpuncit approves these changes to the 1990 budget. Yeas n►ays Absent Requested by Department of: Dimond Goswitz Long Maccabee Rettman By: . Thune � Wilson Approval Recommended by Budget Director: Adopted by Council: qate ' By: Adoption Certified by Council Secretary: Form App o by City Attorney: By: By: Approved by Mayor. Date ' Appr e a r f r Submi ion to Council: B B ' . �.y'd� -��� Y• Y• \� /�`� �`L� a Prepared by Saint Paul Budget Office (Kline ZENITMEMSTRANS 11/73J90) � `�/ . . � � ��qa-ai�l� DEPARTM[NTIOFFIf�/OOUNpL DATE INITIATED Fire and Saiety S rvic s 11/13/90 GREEN SHEET NO. ���� OONTACT PER80N i PFIONE �NITtAU DATE 1 A DATE John Colonna 222 0477 ���P��T aRECTOR � �CITV OOUNdL DNlAA�ER FOR �CITY ATTORIYEY n CITV CLERK MUST BE ON COUNGI ACaENDA BY( T� �BUOOET D119ECTOR �Q_ u FIN.8 MGT.$ERVICEB OIR. fianl approval by 12/3 /90 �MAYORjOqA8818TANT) � TOTAL N OF SKiNATUHE P �iES (CLIP ALL LOCATIONS FOR SIGNATUR� ACTION REOUESTED: adoption of the at ache resolution that� allows for a budget transfer from the contingent reserve to the Fir bud et within the Z990 General Fund budget REOOMMENDATIONS:App�as(ly ar (R) f�IJNpL i�PORT OPTfONAL _PLANMIPI(i COMAMSSION CIVIL RVIC:COMMISSIWr �Y� n��� � �E�. _(�B OO�AMI7TEE —�� ���5: ;�� �g��, _aerRicr cou� r �oeQ�� SUPPWiTB NMK:FI OOUNpL OBJE 9 INITIATINO PROBLEM.18�1E. PNTY .What.Whsn�1MMre.Why): The Emergency Medi al S rvices Institute (EMSI) was established to address common needs and concerns in the E t Me ro emergency medical services community. EMSI is an opportunity for Saint Paul to ack wled e by sharing in training, .technology, research and resouz�ces. Sharing efforts in a coo inat d, combined approach' will benefit the community. The Mayor has agreed to support EMSI's 'nten and recommend a multi year finarlc�.al.:;c�2�e�nent. �uwwr�ea���: Saint Paul's EMS fort will be coordinated with the balance of the East Metro area. The City will sha�'e i adva cements in EMS, perhaps not possible within the confines of our own financial li.m�t$t' ns. he City's commitment will likely leverage additional public/private dollars. The �ost f pr viding an essential city need will be shared with others. Saint Paul will partake of a new knowledge, methods or techniques that would improve the delivery of EMS to its reside s. ois�v�wr,�c�s��ovEO: • $20,000 cost comm'tmerit (for 1990 - $11,000 from the Contingnet Reserve and $9,000 from existing Fire Dep rtmen resources) . Long term support will require financial commitments in future budgets. OIBAOVANTAQES IF NOT APPROVEO missed opportunit to are EMS research costs with surrounding communities loss of the lates EMS raining, technoTogy -and equipment �c�unci� f'����rch Cente� �ECEIVE� N d V l � ly�u � . �IdV2919A0 TOT�►L AMOUNT oF TRANSA 11 000 CpgT/REyENUE�IJppETEp(C�pNE� YEg (�� _��r.� ���p� Gene al F d Conti ent Reserve ��p�p 090 60 / 05001 �"is��r°ans�e�o�'� 11,0 0, when added to $5,000 that the Fire Departmen,t has earmarked within i its own resources will provide the total support of $20,000. . • � . . Z 5� : , . � . �✓�-yd-a� � . � An Overview Of � - ' EMSI � �Emergency Medical Services tnstitute � . , . tiYtt rr iS. EMSI is a n�ew ublic ri��vate consortium. It is bein _,,,_ ' ��,,..m� �.��m,� eawfr<x3*rt't�s,�t,'::ri�'.:-� ast metro re 'on td ensure that their residents continue to re ' �� ' and emer en me ical s rvices possible within their resour�ces.�,,ry�,� , 1,,.., �,���: .�'., , �. �<�.:,, . The Institute is a col�abor tion of local ambulance services, hospitals, public saEety agencies, 'nstitutio . Its� u ose is to provide training, technology, and other resources to and other t �s ,P rP ambulance crews, emerg ncy room staff, and other emergency services providers, and to conduct research th'rat lea�s to advances in emergency services. . EMSI will not replrace ttle current system or its funding sources. It will be aimed at the . acquisition of add�tiona funding -to aid in the acquisition of new knowledge and the evaluation of new n�hetho s and technologies. , BENEFITS: 1. Education and�jesear¢h to ensure unifoim high qualiry emergency care and coordination � across the regian in the years to come. 2. Additional needed.swpport for emergency medical secvices in a time of public funding crisis. 3. .Evaluation oE �ew �mergency medical technologies and procedures under quali�ied � supervision to �elp guarantee continued highly trained ambulance personneL ation on and auccess to the latest emergency response technotogy, equipment, and � 4. Inform , training. ' ' � � 1 �nr.r�,�o/v/esl ' . .. ' I . , . , , . � �-yo-���� • Emcrgcncy Mcdical Seryicu Lus�itate ' . I • WIiY 1TS NEEDED. _ , � . i. Increasing sopltistica�ion of emergency care. In the last 15 years, emerghocy`m�idic�a` , services have �ecorc�e much more than a rapid ambulance nde to the p the resent tirne, th rapies such as cardiac defibrillation and medications previously P � available only in hos�itals are given routinely at home or wherever the patient has need. New technologles an procedures such as pacemakers and clot dissolving drugs for heart � attacks are be�ing odified to be given in the prehospital setting. These lifesaving therapies requiire tr ining of ambulance personnel as well as evaluatio lieseerelcu e Effective med�cal s pervision and control must also be provided. All t q coordination, accou tability, know how, and money beyond the reach of individual local emergen�y res�onse agencies. � 2. Pressure on pucblic ,�'unding. Local government is assuming more responsibilitie n without more resourc�s to support them If emergency medical services are left on their ow to compete for'resou�rces,manY communides may be unable to mauntain and improve their emergency r�s�onse pability. If this were to happen, the East metro emergency medical . system could biecom a hodge podge of inconsistent local capabilities. ', �Yt1AT EMSI DOES.I I ' 1. Raises public �nd p�ivate funds to support new educational efforts and research. 2. Contracts with other� to provide training in new areas of clinical relevance to regional ambulance se�vices. ' . . 3, Identifies syst�m prmblems and develops methods of solving them. � 4. Contracts wichiothers to provide reseazch and evaluation of new emergency medical services capab�ilities. 5. �. Contracts wit}� corpprations to evaluate relevant emergency medical services products. 6. Ensures that$ast metro communides have access to current proven techno(ogies and skills. r 7.� Provides publid educ�.tion in relevant areas such as CPR training and how to properly access I the 911 systecrn. .. 2 (Dnft, 10/13/89J I � . .� � , � . . � ��`ys�a��� • Ernugcnry Medical Skrvices!litscituct � � BACKGROUND. � i Def'cnition Eme�genc�r medical services include all emergency.care from the time a person calls for help until he r she is admitted to a hospital. The two principal components are ambulance and bospit 1 emergency room services. en medical s rvices are a covrrlinated sYstenz of emergency care provided under Emerg cy physician supervis�oa mergenry ambulance seivices ai'e primarily operated by communitles (for example, St. Pa�I Fir Department, Maplewood Police Department.) Medical control is P rovided by St.Pl�ul-R�msey Medical Center and consists of training ambulance Peho ceel a�nd supervising med�cal c�are. Patients are transported to the h�ed cal s stem. C community emengenc}+� departments are part af the emergency Y Hrstory. St. Paul h I been among the nation's leaders in ambulance service since the early 1960's. In the ea y'70's ambulance attendants in the East metro region were e Wh ch has � first in the U.S.tr�.ined o the more advanced paramedic level and have provided car .led to a decreased dea�th and disability rate from trauma and heart attack. � I vanced Li e Support services and 17 Basic Life Support services There are currently 7� Ad f in the region,provriding�emergency response and receiving medical control from Ramsey 'Ihese � senrices respond to 23,m00 emergencies annually In 1990,emergency medical services aitional to expand with new �echnologies and methods of providing care demand�ng ad education and r�searc;h. din . Emergency medical services have been funded by a combination of Hcstoncal Fun g . ' community Publi�servi�es(1oca18rn+ernment),S�Paul-Ramsey Medical Center,Ramsey Counry, and patient chaxges• �In addition to salaries and equipment costs, local co a�nt charges. costs are artially offset by p nominal fees for'medi�al direction. Co��from Ramsey County,S�Paul-Ramsey Medical In adclition to medical director fees and$ , Center supports khe e�ergency medical services system in the amount of$400,000 annually. diffic lt i�, that the system's ability to provide new and better services requires ' p current u Y . more cducation pf pro�viders and the general p�btic as well as cvaluation of new technologies at •{ 3 (Draft, 10/23/89J � � . ,. . � , . . . ��yo a�� � . . . Ei:urgenry Medical Ser�vica Ir�stiart� � � � _ • , , li , . a time of increasin fiscal constraints for both hospitals and communities. There is a concern . . that important ne serv�ces will not be available to the public in the near future. � , STRUCTURE�F1NA1�10E A�ID BUDGET. prgunization EN�SI is �community resource open to all hospitals and ambuland a servarate It will be associate�i with�the Ramsey Foundation,but will have its own Duector p oard of directors ' led,a Council. This relationship will minimize admitistrative costs and b I� provide a logical li to�St.Paul-Rainsey Medical Center and its extensive research expert�se in a. Rarnse 'Foun ation will bear fiduciary responsibility but will not direct programs or th►s are y � fund raising. � • . itals will be asked to join EMSI as Membership. Al1�East�inetro ambu lance services and hosp , members. Memb�cship�will entitle organizations to participate in organizational direction and program decisions. I . � Governance. Govern�nce will be the responsibility of a part-time Director�appointed by the Council (boa�d of�irectors). The Council will be self perpetuating, no b�e Eor dec d ng � role v��hll be to direct t he a f fai r s o f E M S I a n d t o b e r e s p o n s , replacements. Its, , policy direction a�d tb� awarding of grants. . ' '11 nsis�oE 15 members representing three categories with up to f�ve Council The Council wi �o seats in each cat�gory:�' � � 1) Large sust�iain�contributors. � 2) CommuniCy em�rgency services organizations. 3) Influential�community leaders who are willing to help in fund raising. hoc Im leme tation Committee which is overseeing formation oE EMSI will An •ad A � nominate the fi�st Council. The Director and Council membership will be ratiEied by the President oE the Ramsey Foundation. ' • � �' 4 (Draft,10/2�/89� . . . . :., ' � ����i�� Emergcncy Medical Suviccs ln�hcute _ . Opera�ing Budge�: , �250,000. . Half will be raised throu h public sector grants of monies raised for EMSI through �OO�m nt � ' ' activities S�e bel�w.) The balance will be generated from interest on an end ra�s�ng � ° orate and of $3,000,000. The en owment will be raised by 1996. Until that time, corp ts will b�sought to satisfy this half of the operating budget. foundation gran . . $300,000. Education and Resiearch�udget: �. 000 a year in interest �An additional endqwmerlt of$2,000,000 will be raised to generate S 100, . for education and�resea�ch. The balance oE the education and research bu agen�'ln ome is through annual pri?vate �iving and through earned income. An example of e ntractin to erfvrm upervised field evaluadons for medical equipment manufacturers. co g P � et fi es assl me that a successful capital campaign can be conducted to raise total These budg g�' � endowments of SS Imillio by 1996,and that operating,educadon, and research support can be g enerated during the int�rim from corporate and foundation sources in the form of gr�ne�of • product evaluatiod cont�acts. The latter are expected to generate $40,000 in the irs y operation. (See pt'elimi�ary futancial sta�emen�) an has not been developed, but early help will be sought nd raisin 1 , . Fund Ra�scng. A� fu . � g P a local ertj to de�elop a plan. However,tl�e organizers of EMSI believe that pubLc fund from �p , . raising by local m�nicip�lities will be the most effective means of generat�ng peo lle have had � Everyone bene6ts�rom�strong Emergency Medical Sernces system, and.most p p direct or indirect� expe�ience with emergency services. As presently envisioned, this fund � � �dvi will be ttae responsibility oE EMSI member orgatizations,with guidance from a raismg a ty . fund raising professional. PROGRAMS . I$MSI Vvill sponsor educational programs for the public and for emergen a services providecls. and will conduct research directed at evaluation of nea d emhhasis wi1� � � technologies. Re�earch will in.the main be focused on the prehospttal settmg P � be on new�programs npt covered by current educational offerings. �� 5 ���n,to/v/s�i . , . � . . �qa ar� � F.��urgenry McdicaJ Scn�ices Luficute . . Examples. - - . � o Hazardous mat�rials�curriculum for basic ambulance personnel. . o CPR training fdr Fire�Cadets who in turn train their high school classmates. o Evaluation of n�w dri�gs given early in heart attacks to limit damage. o Fstablishment olf a daqa base for all ambulance runs in ihe East metro region so that quality oE care can be monitaired closely. � . o� Disaster plannit�g and coordination. . o Stress debriefin�for e�nergency personnel and the general public following a major public trauma. . otentiall useful in the prehospital setting. o Evaluation oE n�ew eq�ipment p y , . EMSI HOPES TO SERYE Tf�E FOLLOVYING COhIMUN1TY SERViCES: r ve Polic� ' o Gladstone Fire o Cottage G o � o District Memo�'ial Hbspital o Lower St. Croix Ambulance o Interstate EMS � o Mahtomedi Fire o Lakeview EMS � o Marine on the St. Croix Ambulance o Life Link III I'� o North St. P aul Fire � o pakdale Fire � o Maplewood Po�ice I _ o St. Paul Fire ' o Park Side Fire o White Bear Lake Fir�e o Vadnais Heights Fire o East County Li�e Fir�e , o Woodbury Ambulance o Falcon Heights Fite � . ' ; , i � �� 6 �o�a. to/�/e�� . � TO CITY COUNCIL COMMITTEE: �� � �FINANCE,MANAGEMENT&PERSONNEL ❑ HOUSING 8 ECONOMIC DEVELOPMENT ❑ HOUSING&REDEVELOPMENT AUTHORITY ❑ HUMAN SERVICES,REGULATED INDUSTRIES, AND RULES AND POLICY ❑ INTERGOVERNMENTAL RELATIONS ❑ NEIGHBORHOODSERVICES ❑ PUBLIC WORKS,UTILITIES 8 TRANSPORTATION ❑ ACTION ❑ OTHER DATE << FROM . , , , . . . .��ya-ai°?� . ' ' . � . � - Emugency Medical Seavicu Ir�3rituct . ; . . ' I �'RELIMINARY FINANCIAL STATEMENT . (000's) , , . 11�4 1221 �? � � � � ' REYENUES ', �perations: �'� Public Grants: 5125 $150 5185 �185 $185 $185 $185 Private Grant�s i ', 20 � �p 105 105 123 140 140 & Fund Raisi�g: Education & Research 60 Private Grants: t 30 45 45 52 60 (dedicated) '� 60 4� �0 40 60 60 60 Contracts:3 � ' • � 2 5 11 19 . 21 Interest: � � � Endowments: . _. ' � . Operating:S I ,' S0 75 125 150 Education , � SO 100 100 & Research: 6 ' � ' 72 �4. � � Net from Prior ear: II • � � Total Revenlues• 185 300 407 547 710 961 1,017 I . EXPENSES 135 200 250 263 276 290 290 Operations: � ' n ' 2 7 4� Educat►o � � � �Q � � & Research: 4 ' . ; ' Total Ex e�lses: 175 . 270 335 393 438 660 690 P ._ . 30 72 �� 154 272 301 327 , NET � 10 . .° 7 �n�n,io/�s/av� � , . . �. � � � � � yo_a,�� . � � Entergenry Medical$trvicu'�,Lts�ihret . NOTES TO PRELIMINARY FINANCIAL STATEMENT . � 1. Private granits assume 30% designated and listed under Education & Research, and 70%a undesi�natec� and listed under Operations. Designated funds are expensed below. : . 2. Interest on IKet fr�m Prior Year. Calculated at 7%. 3. Contracts a�e dir�ctly with vending companies to test equipment. I . 4. Education 8�Reselarch expense is derived from Designated Private Grants + Contrac1996 Educadon dd Rese ch endowment income. In addition,expense forecast f�in 9a ounts: � includes revienuesl�rom undesignated grants and fund raising in the follo g . . 1995: $150, 0 � . � 200�0 1996. $ , , 'ncome frlom O erating Endowment of�3.0 million. Assumes 5%yield, earning S. Interesti , P 5150,000/ydar byi 1996. • 6. Interest inciome fJrom Edu�ation & Research Endowment of�2.0 million. Assumes 5% yield, earnipg$100,000/year by 1995. 7. Net incomt is applied to the subsequent year's expenses, and is necessary to make ' funding co�mitirrtents. � . � . i � � � ., 8 (Draft�l0/27/89� ' . j • . . � � � � , � � � � � -- 90�ia� The fo�.lowi;ng potential needs were identified at a recent planning meeting of the EMS staff. • • I . Ed�cati:on will be directed toward the following audiences : A. EI�S Personnel: This training will be necessary in ac�dition to basic and continuing education. It is not c rrently offered but estimates are that it will be � r�levant within the next 3-5 years. I � 1� ALS and BLS Medical Director training 2 ! Training EMS personnel in new techniques � a . Home defibrillatars '�, b. Training in new procedures, ie lytic agents I c. Disaster techniques I d. Aids updates and new techniques ' 3 EMS trainer training. �� 9 Hazardous materials in non-fire hazards �' 5 Ambulance driver training 6 Critical incident stress debriefing 7 Dispatch training 8 t EMS �cecruitment 9 � �First responder training for police 10 Working with the state to develop standards of EMS education . B. I dustry: EMS within the workplace is becoming i creasingly necessary in the following areas: 1 First responder EMS training •with 'businesses , 2 Training for small businesses to meet hazardous ' materials requirements. . . _ 3 Course development and presentation for "Keep them Alive" courses for workers. C. C mmunity Education: working with others to develop c�urses to present within the community • ... 1� . When should a community upqrade their ambulance system . . 2, When and how to use 911 3, Focused community education . ', a. SE Asians delivering babies at home b. Communicable disease control c. New cardiac treatments for heart attack d. CPR traininq - health care professionals & public e. Resuscitation of the newborn 4 . Pediatric BLS � . , . ��'Q'/a �° Committee Report Finance Comm;ittee December 17, i1990 Page 4 17. Resolut�on 90-2128 - amending the 1990 Budget by adding $4, 500. 0 to the Financing and Spending Plans for Community Service� - Parks & Recreation - Crosby Farm Park (Referred from Co�incil 12/06/90) Approve�l 3-0. 18. Resolut�ion 90-2146 - amending the 1990 Budget by tra�sfe�ring $11, 075.75 from Special Services Enterprise Fund to Japanese Garden Fund. (Referred from Council 12/11/9p) App�rove 3-0. . Res lut on 90-2126 - amending the 1990 Budget by tra sfe ring $11, 000 from Contingent Reserve to Departmen of ire & Safety Services. (Referred from Council 12/06/9 ) Dea�ed �endinq further information. 20. Resolut�on 90-1926 - amending the 1990 Budget and transfe ring $101,930 from Contingency to General Fund Fire - Code �nforcement - Salaries. (Referred from Council 11/01/9�) To �e wilthdrawn by author. 21. Green Sheet 9423 - Resolution from Department of Fire and Saf�ty Services for $10, 253 .25. Approved 3-0. 22. Gre�n Shjeet 11260 - Resolution amending the Spending Plan for ,the �Public Works Engineering fund for $34, 000 to go to PED, App�ovec� 3-0. � 23 . Green Sheet 8483 - Resolution amending the 1990 Budget for Fund 127, PED Printing Services. App�ovedl3-0 with cost projections and savings to be subalitte�d to the Council prior to adoption. 24. Green Sh�eet 8125 - Resolution eliminating arbitrage concerns on Newe11 park and Linwood Park projects. 1s,pproved 3-0.