The Winnipeg Regional Health Authority has to give Winnipeg $4.5 million more money next year or tell the city which ambulance services to cut, the Winnipeg Fire Paramedic Service says in a budget presentation to city council.

Fire-paramedic Chief John Lane said Monday that flat provincial funding for ambulance services has left the city with the shortfall that was not anticipated when his department prepared its budget for 2018.

As a result, he said the city has no choice but to ask for additional funding from the Winnipeg Regional Health Authority or ask the WRHA which ambulance services it wishes to reduce or eliminate next year.

Non-core ambulance services include inter-facility transfers, tactical paramedicine (which assists the Winnipeg Police Service) and community paramedicine, which involves assistance for homeless people and others that are frequent users of fire-paramedic services.

Lane's comments came as his department elaborated upon a funding shortfall Mayor Brian Bowman announced last week, when the mayor revealed the WRHA sent the city a letter on municipal budget day, stating that ambulance funding has been frozen at 2016 levels.

The city is facing a $2.5-million ambulance-funding shortfall for 2017 and a $4.5-million shortfall next year due to what the city describes as a provincial decision not to cover inflationary increases in operating costs.

These costs are separate from a drop in revenue that resulted from the province's decision to drop the retail cost of an ambulance ride from $529 to $425 this year and then plan to reduce the cost of that ride to $340 on April 1, 2018.

The province is compensating the city for this drop in revenue by providing $7.8 million in additional revenue in 2018, according to Winnipeg Fire-Paramedic Service budget documents.

But without additional funds to cover inflationary cost hikes, the fire-paramedic service said it will need the Winnipeg Regional Health Authority "to increase funding or direct where service reductions are to be made" in order to deal with this shortfall.

Last week, Manitoba Health Minister Kelvin Goertzen disputed the city's calculations and said the province has offered Winnipeg dramatic increases in ambulance funding going into 2016.

The Winnipeg Regional Health Authority has to give Winnipeg $4.5 million more money next year or tell the city which ambulance services to cut, the Winnipeg Fire Paramedic Service says in a budget presentation to city council. 2:05 On Monday, Goertzen said the city is still in talks about funding for next year.

He reacted with some surprise to Lane's assertion cuts to ambulance services are on the table.

"I'm not suggesting Mr. Lane was trying to inflame the discussions, but I do think there will be reasonable discussions going forward," Goertzen said following question period.

The Manitoba Government and general Employees Union, which represents paramedics, said all of the services Lane identified as outside the core of ambulance operations are actually needed.

President Michelle Gawronsky said the city and province need to keep talking to each other.

"I would suggest that there be no cuts to this and that they take a look at how do we ensure that we are able to get funding to be able to provide services that are needed," she said.

Those talks may involve more than just funding. Earlier on Monday, council finance chair Scott Gillingham said Winnipeg ought to stop operating ambulances and hand over responsibility for the health-care service to the province.

Gillingham told council's protection and community services committee that he plans to ask city staff to study the idea of handing ambulance services over to the province.

Gillingham said he will make a motion at Wednesday's executive policy committee meeting to give city staff three months to study the idea.

"Health care is a provincial matter and so it makes sense from my point of view, at this time, to have our public service come back within the 90 days and give a report on a detailed plan to devolve ambulance services to the Winnipeg Regional Health Authority," Gillingham said.

The councillor said Winnipeg has no choice but to study the idea after the Winnipeg Regional Health Authority froze provincial ambulance funding at 2016 levels.

He said his motion is not political posturing and Winnipeg is serious about uploading ambulance service to the provincial government, which is responsible for health care.

United Fire Fighters of Winnipeg president Alex Forrest said this uploading is possible and Winnipeg has done everything it can to satisfy the province when it comes to reducing the retail cost of ambulance rides.