Advisory committee urges full cost-recovery for EMS; proposes communications, triage hotline and other revenue tools

The Utility Rate Advisory Committee presented a package of recommendations to the council urging adoption of a full cost-recovery model for emergency medical services (EMS) effective Jan. 2026 and a multi-pronged approach to reduce demand and increase sustainable funding.

Jamie Onokay, speaking for the committee, said members reached their recommendation after hours of research and expert consultation and asked the city to build a “robust communication plan” explaining why rate changes are necessary, how funds would be used and how a self-sustaining EMS benefits public safety.

Short-term measures the committee recommended include clearer public education on appropriate EMS use, enhanced EMS call data collection, incentivizing ACH payments for utilities to reduce processing costs and exploring a nominal per-call fee for exceptionally high-volume users. The committee also recommended adjusting the low-income senior eligibility threshold from 300% to 200% of the federal poverty level and conducting a two-year review after implementation.

The packet presented to council estimated the city currently pays roughly a 2.3% processing fee on card transactions; the committee said that fee translates to an annual cost in the low hundreds of thousands of dollars and a monthly cost on the order of $11,000–$13,000. The committee suggested offering a one-time bill credit to customers who switch to ACH and said recurring donation or “round-up” options could generate assistance funds.

For longer-term sustainability the committee recommended piloting a nurse triage hotline to divert nonemergent calls to appropriate care (the committee cited studies that showed up to a 40% reduction in nonemergent EMS responses in some jurisdictions), pursuing federal, state and private grants, contracting for professional grant-writing capacity, investing in economic development to broaden the tax base and considering voter measures such as a levy, bonds or a dedicated EMS or fire district.

Committee members said additional staff-collected data and a public outreach campaign would be needed before any major rate change. The committee scheduled a council workshop next Wednesday at 6 p.m. to brief council members and expects the council to consider action after that meeting.