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Fr­ I <br />JAN <br />BOOKd F ,E 85 <br />the better choice to go out to this company, but she felt we must <br />keep looking at this continuously as -we gain experience. <br />Commissioner Scurlock did not feel this shortfall is a <br />result of anything we have done wrong. We based our budget on <br />existing data. What he wanted to make plain is, and this was <br />identified up front, that this is going to be an extremely costly <br />service we are providing to our community. It is one our <br />community suggested they have a desire to have, but he felt we <br />are going to have to look very strongly at the equity in how we <br />bill and possibly pursue other options of generating enough <br />revenue. Commissioner Scurlock noted that we have adopted a <br />process of user fees as much as possible, and he felt we need to <br />act a little more aggressively towards employing that concept for <br />this particular activity than we have. He felt strongly that <br />between now and next October we must evaluate all of our options <br />and get some equity into the system. <br />Commissioner Wheeler expressed his feeling that this <br />community has shown that they want ALS, paramedics, etc. out here <br />in life threatening situations, but he doesn't know if the <br />individual can afford all this. It is, however, a community <br />service that is available to all of us, and there is some value <br />to having .this service available whether we use it or not. He <br />also agreed that "you pay for what you get" has been our <br />philosophy, but he does have a question as to whether the <br />individuals can afford to pay for it; it is very expensive. <br />Commissioner Scurlock believed there are many ways to <br />address this, i.e., you could have a sliding scale based on <br />income. He stressed he is not suggesting that we give a lesser <br />level of care to indigents because they can't pay, but there is a <br />certain level of service that you must balance with the ability <br />to pay and he is just emphasizing that we must think very hard <br />about this between now and next October. <br />Commissioner Bird gave the example of a senior citizen who <br />needs a cab to drive somewhere and a limousine shows up that he <br />22 <br />