Council PKT 03-05-2013 SpecialCITY OF
� Federal Way
AGENDA
FEDERAL WAY CITY COUNCIL
SPECIAL MEETING
Council Chambers - City Hall
March 5, 2013
6:30 p.m.
www. cityoffederalway. com
1. CALL MEETING TO ORDER
2. COUNTY-WIDE 2014-2019 MEDIC ONE / EMERGENCY MEDICAL SERVICES
LEVY PRESENTATION
3. ADJOURNMENT
COUNCIL MEETING DATE: March 5, 2013
CITY OF FEDERAL WAY
CITY COUNCIL
AGENDA BILL
ITEM #:
SUBJECT: PRESENTATION REGARDING COUNTYWIDE LEVY FOR MEDIC ONE/EMS SERVICES
PURPOSE: T'he purpose of this briefing is to provide an update on the King County Medic One/EMS Strategic
Plan and proposed county-wide ballot proposition for funding EMS services for 2014-2019.
COMMITTEE: N/A
MEETING DATE: N/A
CATEGORY:
❑ Consent ❑ Ordinance ❑ Public Hearing
❑ City Council Business ' ❑ Resolution � Other
STAFF REPORT BY: Pat Richardson City Attorne ___ _____ DEr'r: LAW
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Attachments: Presentation materials prepared by King County Emergency Services
Background: Since 1979, the Medic One/ Emergency Medical Services (EMS) system has been funded through
a series of voter approved levies. The current six-year 30-cent Medic One/EMS levy will expire December 31,
2013. To ensure continued emergency medical services, a new levy must be approved by voters.
RCW 84.52.069 allows for a property ta� levy of up to $.50/$1,000 assessed valuation (AV) for the purpose of
funding emergency medical services. This property tax levy may be for six years, 10 years, or permanent. RCW
84.52.069 also requires that any Countywide proposal secure the approval of those cities 50,040+ in population
prior to it being placed on the ballot. In King County, there are nine such cities: Federal Way, Auburn,
Bellevue, Kent, Kirkland, Redmond, Renton, Shoreline and Seattle.
The EMS Advisory Task Force was created to develop inter jurisdictional agreement on an updated EMS
strategic plan and financing package for the 2014-2019 levy funding period. T'he Task Farce worked
collaboratively with regional stakeholders to develop programmatic and financial recommendations. These
recommendations were adopted by the Task Force and transmitted to the King County Council by the King
County Executive in the form of the Medic One/EMS 2014-2019 Strategic Plan.
The Task Foree recommended to: 1) Reauthorize a 6-year EMS levy to fund the system, and 2) Enact a levy rate
of 33.5 cents/$1,000 AV to.fund projected expenditures of _$695_million for the 2014-2019 s�an_______ _______ __ __
MAYOR'S RECOMMENDATION: N/A
MAYOR APPROVAL: N/A i����� DIRECTOR APPROVALZ
Committee Counci
COMMITTEE RECOMMENDATION: N/A
Committee Chair Committee Member Committee Member
PROPOSED COUNCIL MOTION: N/A
(BELOW TD BE COMPLETED BY C7TY CLERKS OFFICE)
COUNCIL ACTION:
❑ APPROVED COUNCIL BILL #
❑ DENIED 1ST reading
❑ TABLED/DEFERRED/NO ACI'ION Enactment reading
❑ MOVED TO SECOND READING (ordinances only) ORDINANCE #
REVISED— 08/12/2010 RESOLUTION #
King County Medic One/EMS 2014-2019 levy package
SUBJECT
A briefing on the King County Medic One/Emergency Medical Services (EMS) 2014-2019 levy
package (Strategic Plan and county-wide ballot proposition)
POLICY ISSUE
The current six-year 30-cent Medic One/EMS lew will expire December 31, 2013. To ensure
continued emergency medical services in 2014 and beyond, a new levy must be approved by voters.
RCW 84.52.069:
Allows for a property tax levy of up to $.50/$1,000 assessed valuation (AV) for the purpose of
funding emergency medical services;
May be a six year, 10 year or permanent levy; and
Requires that any county-wide proposal secure the approval of those cities 50,000+ in
population prior to it being placed on the ballot. In King County, there are nine such cities:
Federal Way, Auburn, Bellevue, Kent, Kirkland, Redmond, Renton, Shoreline and Seattle.
BACKGROUND
The King County Medic One/EMS system provides essential life-saving services to the residents of
King County, regardless of location, incident circumstance, day of the week, or time of day. It is a
tiered system that relies upon coordinated partnerships with fire departments, paramedic agencies,
dispatch centers and hospitals to ensure patients receive the most appropriate level of care.
Founded on medicine, its services are derived from the highest standards of inedical training,
practices and care, scientific evidence, and close supervision by EMS physicians. Programmatic
leadership, state of the art science-based strategies, continuous improvements and its focus on
efficiencies have allowed the system to obtain superior medical outcomes, and manage the growth
and costs of the system.
Access to EMS System:
Bystander Calls 9-1-1
�
Triage by Dispatcher:
Use of Medical Response
Assessment Criteria
�
First Tier of Response:
Basic Life Support (BLS)
by Firefighter/EMTs (30 agencies)
�
Second Tier of Response:
Advanced Life Support (ALS)
by Paramedics (6 agencies)
�
Additional Medical Care:
Transport to Hospital
Universal Access: Any person regardless of location or circumstances
can access the Medic One/EMS system by calling 9-1-1 for medical
assistance. This immediate and continuous access provides all areas of
King County equitable access to this lifesaving service.
Dispatcher Triaqe: Calls to 9-1-1 are received and triaged by
professional dispatchers who determine the most appropriate level of
care needed. Dispatchers are trained to provide pre-arrival instructions
for most medical emergencies and guide the caller through life-saving
steps, CPR and AED instructions.
Basic Life Support (BLS): BLS personnel are the "first responders" to an
incident, providing immediate basic life support medical care that
includes advanced first aid and CPR/AED to stabilize the patient. BLS
units arrive at the scene in under 5 minutes (on average) and contribute
significantly to the success of the Medic One/EMS system.
Advanced Life Support (ALS): Paramedics provide out-of-hospital
emergency medical care for critical or life-threatening injuries and
illnesses. As the second on scene and used only for the most serious
injuries and illnesses, they provide airway control, heart pacing, the
dispensing of inedicine and other life-saving procedures.
Once a patient is stabilized, it is determined whether transport to a
hospital or clinic for further medical attention is needed. Transport is
most often provided by an ALS agency, BLS agency or private
ambulance.
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In addition to these components of the system, King County EMS also oversees Strateqic Initiatives
and Reaional Services. These core programs and services further provide for regional coordination
and consistent quality across all jurisdictions in King Counry. These services include program
supervision, BLS EMT staff training, E-911 dispatch training, medical data collection and analysis,
financial oversight, contract administration, and division management. EMS regularly integrates
initiatives that are aimed at preventing/reducing emergency calls and improving the quality of the
services.
2014-2019 MEDIC ONE/ EMS LEVY PLANNING PROCESS
The EMS Advisory Task Force was established by King County Ordinance 15862 to develop inter-
jurisdictional agreement on an updated EMS strategic plan and financing package for the 2014-2019
levy funding period. Comprised of leaders and decision makers from throughout the region, the 19-
member Task Force worked collectively with EMS Stakeholders for over nine months to assess the
needs of the system and develop recommendations to direct the system into the future. The City of
Federal Way was represented by Councilmember Linda Kochmar.
The Task Force used a subcommittee format to concentrate efforts in four areas: ALS, BLS, Strategic
Initiatives and Regional Services, and Financial model. The four subcommittees developed
recommendations that were then brought to the full Task Force for consideration.
The Task Force adopted its recommendations on July 26, 2012. The King County Executive
transmitted these recommendations to the King County Council in December 2012, as the Medic
One/EMS 2014-2019 Strategic Plan.
TASK FORCE RECOMMENDATION/2014-2019 STRATEGIC PLAN
■ Reauthorize a six-year EMS levy to fund the system, per RCW 84.52.069;
■ Enact a levy rate of 33.5�ents/$1,000 AV to fund projected expenditures of $695 million for
the 20142019 span;
■ Renew the EMS levy in 2013;
• Continue funding ALS (paramedic) services, and a portion of first responder (BLS) services for
local fire and eme�gency response departments;
� Maintain a responsible level of reserves;
■ Continue programs and initiatives that provide essential support for the system and encourage
efficiencies, innovation and leadership;
■ Use conservative financial policies and procedures; and
■ Meet future demands with services that include collaborating on programs that reduce impacts
on BLS agencies, and "rescoping" programs to meet emerging community needs.
The proposed levy rate does not raise funding levels to add services, but provides resources to
maintain existing services, incorporate efficiencies and offer improvements where appropriate. The
proposal costs less than if 2008-2013 operations were continued into the 20142019 levy period.
Impact on the Federal Wav Rate Paver
2008 2014*
Average Federal Way residence value $298,900 $194,063
EMS levy rate $0.300 $0.335
Levy amount for average Federal Way residence $89.67 $65.01
`2014 value based on overall King Counfy increase of 3. 7890 projected by the King County economist
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The 2014-2019 Medic One/EMS Strategic Plan financials differ from previous levies by:
1. Limited new proqrams and expenditures: With previous levies, substantial increases were
implemented during the first year of each new levy. In contrast, there is reduced planned
spending in the first year of the 2014-2019 levy, when adjusted for inflation. Proposed new
services and programs are minimal and are offset by reduced expenditures. Overall proposed
increases across the levy span are less than projected CPI plus increased population.
2. Reduced proposed revenues: The 2014-2019 levy proposes using funds from the 2008-2013 levy
to reduce, or "buy down", the amount needed to be raised over planned expenditures. Estimated
savings are $21 million, or a reduction of 1.6 cents, and result in the proposed levy rate of 33.5
cents per $1,000 assessed valuation. The savings are due to changes in reserve levels,
aggressive management to control expenditures, and conservative revenue forecasts.
The "buy down" of the rate reflects management strategies that include the application of millage
reduction reserves that were mandated in the current levy and by use of fund balance. The
savings are also realized through not adding finro anticipated 12-hour ALS units during the 2008-
2013 levy period, reducing of previous contingency assumptions such as the ALS Disaster Relief
Contingency, reducing 200&2013 strategic initiatives, and regional services using existing
program balances. These forecast savings from 2012 and 2013 are assumed toward a buy down
for the rate.
The average annual amount of $111 million is estimated, with total revenues of $668.1 million
forecasted over the six year period, as shown below:
Forecasted Property Tax Revenue for 20142019 (in millions)
2014 2015 2016 2017 2018 2019 TOTAL
City of Seattle $39.2 $39.8 $40.3 $40.8 $41.3 $41.9 $243.2
KC EMS Funds $67.0 $68.6 $70.1 $71.5 $73.1 $74.6 �424.8
Total $106.2 $108.4 $110.3 $112.3 $114.4 $116.5 $668.1
Growth in Total Levy 2.07% 1.75% 1.81 % 1.87% 1.84%
Expenditures
The proposed financial plan anticipates $694.4 million to support programs and services. The table
below denotes the costs by program area:
EMS Expenditures by Program Area
The Task Force Finance Subcommittee endorsed these expenditure and revenue assumptions.
These assumptions include policies for the "buy down" use of reserves, inflator policies, and the use
of a 65% confidence level financial plan.
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Continue with EMS levy: ■ Six-year EMS levy, per RCW 84.52.069
■ Forecasted budget of $695 miilion over six-year span, including reserves
■ Levy rate of 33.5 cents/$1,000 Assessed Valuation
■ Would be run at either the 2013 Primary or General election, with the King
County Council determining which election
Continue services from 2008- • Continue operations with the 26 units currently in service
2013 levy: � Fully fund eligible costs of existing paramedic services to prevent cost shifting
to agencies
• Project annual increases using a compound inflator
Provide to meet expected • No new medic units over the span of a six-year levy
demands: • Reserves to cover unanticipated and one-time expenses
• Efficiencies to refine ALS costs and increase effectiveness
• Funding for a possible 12-hour medic unit in the later years of the levy in case
demand for services increases
Continue services from 2008- • Partial funding for BLS services (firefighters/EMTs)
2013 levy: • Maintain King County portion of BLS funding at same percentage of overall
expenses of previous levy period
• Maintain current funding formula for allocation (based 50/50 on
Assessed Values and Call Volumes)
Provide to meet expected • Programs and Initiatives that help manage growth, reduce impacts and
demands: increase the role of BLS agencies in regional decision-making
Continue services from 2008- • Essential Regional Services programs that support the Medic One/EMS
2013 levy: system
Provide to meet expected • Re-scoped and enhanced Regional Services programs to meet emergent
demands: needs
Continue services from 2008- • Conversion of 2008-2013 Strategic Initiatives that have improved the quality
2013 levy: of service and managed growth and costs into Regional Services programs to
become ongoing programs
Provide to meet expected ■ Revamped and new Strategic Initiatives
demands:
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