The Everett City Ways & Means Meeting held on February 22, 2024, focused on the city's emergency medical services (EMS) billing structure and the operational challenges faced by the fire department. The meeting began with discussions regarding the billing rates for Basic Life Support (BLS) and Advanced Life Support (ALS) calls, highlighting the financial implications of utilizing external services from Cataldo Ambulance.

The fire chief explained that for BLS calls, a specific rate is charged, while ALS calls incur an additional fee due to the involvement of paramedics. The city is responsible for a $500 charge per ALS intercept from Cataldo, which is factored into the billing process. The chief clarified that the city bills at a higher rate for ALS services, ensuring that the additional costs are covered.

Concerns were raised about the aging fleet of fire apparatus, with the chief noting that maintenance costs are higher for specialized vehicles compared to standard personal vehicles. The need for prompt repairs was emphasized to maintain operational readiness.

Councillor Van Kampen inquired about the rate-setting process for EMS services, seeking clarity on whether it is determined by ordinance or at the discretion of city officials. The chief acknowledged that the current rates were established prior to his tenure and committed to providing further details on the rate-setting history.

Councillor Jabun expressed confusion over the decision to purchase a new ambulance while still relying on Cataldo for ALS services. The chief explained that the national EMS sector is facing significant response time challenges, prompting the city to enhance its own capabilities. Since the introduction of the BLS system, the city has responded to over 1,200 calls, improving service delivery.

The discussion also touched on the differences in training between EMTs and paramedics, with the chief noting that the extensive training required for paramedics is a significant barrier to developing an in-house ALS capability. The city has not yet pursued this option due to the costs and complexities involved.

The meeting concluded with a commitment to further investigate the rate-setting process and explore potential solutions to enhance the city's EMS capabilities while managing costs effectively. The discussions underscored the ongoing efforts to improve emergency response services in Everett.