Lincoln’s ambulance service may get some CPR — or at least a few bandages — after a report detailing 23 recommended changes is presented to city leaders.

The city-run ambulance service lost nearly half a million dollars last year, owes about $1.5 million to the city and has requested a $250,000 city subsidy this year.

The ambulance service has been run by the Lincoln Fire Department since 2001, after voters were convinced they could deliver the service faster, better and cheaper.

The ambulance service is now faster.

“Better is subjective,” said Fire Chief Mike Spadt. “Care was good back then; care is good now.”

Cheaper? Not so much.

In response to the troubling financial picture, City Councilman Jon Camp assembled a public-private group in January to take a look at the ambulance service’s finances, operations and quality of care. The committee of two dozen was chaired by Lincoln businessman Russ Bayer. The report is expected to be presented to the City Council.

All of the members were supposed to vote last week on whether to approve the recommendations, and as of Thursday morning, Bayer hadn’t received all the votes, but of those he did, all were “yes.”

He said the report contains things that not everybody on the committee likes, but taken as a whole they “owe it to the community” to vote yes.

Although Bayer, Camp and other committee members refused to release the report before it is presented to the Council, Bayer agreed to talk about its contents in general:

n Quality assurance: While the committee concluded the quality of the ambulance service is “fine,” the group will recommend quality assurance reporting requirements.

n Day-to-day operations: The group will recommend an in-depth study of staffing patterns and responses to certain types of calls. For example, the number of ambulances that should be staffed 24 hours a day and the need for both a fire truck and ambulance on less critical calls.

n Revenue: The group will recommend financial reporting and ways to increase revenue and cut expenses.

Bayer said city ordinance, state law and union contracts dictate “what’s going on in the system,” so in some cases the group recommends lobbying to change laws or labor contracts.

When the current labor agreement with firefighters expires, Bayer said, the city should look at how employees are paid, 24-hour ambulance shifts and the possibility of just having paramedic classifications.

For example, he said the group recommends striking any written rule or law that restricts the Fire Department’s ability to make staffing changes, just as a private business sometimes needs to do.

“Their hands are tied, and we want to untie their hands in some cases,” Bayer said of city management and the Fire Department.

Councilman Camp said the group wants a neutral body to ensure the recommendations are implemented.

“If the recommendations are implemented, the city’s ambulance operation should break even and in fact it should be able to return money to the city treasury to pay back the debt that it has,” he said.

Spadt was a member of the committee.

“I think it’s a good report,” the fire chief said, even though he said the three-month process was rough and, “It’s not going to make my life easy in some respects.”

He said committee members learned about limitations due to state law or labor contracts, and the challenges facing the nation’s ambulance services.

Two of the recommendations are major, Spadt said, and would require City Council authorization.

The head of the Lincoln Firefighters Association, Dave Engler, did not return a call seeking comment on the report.

Reach Deena Winter at 473-2642 or dwinter@journalstar.com.