D.C. Mayor Sharon Pratt Dixon's transition team on health issues has advised her to separate the city's ambulance service from the fire department, and to reverse some emergency medical system policies put in place by former mayor Marion Barry.

A proposal, drafted by the transition team last December, would alter the controversial policy of sending fire trucks to answer every medical 911 call. It also calls for hiring more employees and buying more equipment -- raising the number of ambulances on the street during peak hours in the afternoon and evening from 26 to 39.

If embraced by the mayor, it would be the most dramatic change in the city's three years of zigzag efforts to improve its ambulance service, whose crews frequently have been criticized for slow responses.

Dixon spokesman Vada Manager said this weekend that the mayor will consider the report, in consultation with Fire Chief Ray Alfred and the city admnistrator's office, during the next two weeks.

Officials from the fire department and the City Administrator's Office would not comment on their ideas for ambulance service. But Alfred long has opposed establishing a separate ambulance operation.

In addition, a 1989 report by Productivity Management Services, an agency in the City Administrator's Office, said the best long-term solution to the ambulance problems would be to eliminate the civilian ambulance agency and train all firefighters to work on both fire engines and ambulances.

In its own 23-page report, the transition team said that the fire department has a "track record of failure" in running the ambulance service. The report said there is "friction and division" between the two agencies, in part because their mandates are so different.

Mark Smith, chairman of the department of emergency medicine at George Washington University Hospital and chairman of the transition team, declined to comment on the proposal, which also calls for naming a doctor as head of the new ambulance agency, a Cabinet-level position. The transition team was made up of private and hospital physicans.

Their report, a copy of which was obtained by The Washington Post, said the proposed changes would cost the city $4.2 million a year more than the $15.2 million currently budgeted for ambulance service.

The team said most of the extra money could come from fire department funds now used for ambulance supply, maintenance and communications, and from more aggressive collection of fees charged to people transported by ambulance.

Under the plan, firefighters would continue to accompany ambulances on 911 medical calls that dispatchers say are life-threatening. But only ambulances would respond to non-life-threatening calls. Firefighters now respond first to calls labeled non-life-threatening, and if a patient wants an ambulance, firefighters call for one.

Of 20 U.S. cities closest in size to the District, only two -- Baltimore and Memphis -- have a civilian ambulance force within the fire department, as the District does, according to a 1990 survey by the Journal of Emergency Medical Services. Eight operate separate fire and ambulance departments, it said. The ambulance bureau employs 263 people, the transition team report said, with 94 of its 357 authorized positions vacant.

The transition team's report said ambulance service has been plagued by low morale, antiquated medical protocol, insufficient coordination between dispatchers and ambulance workers, high rates of unscheduled leave and poor response times on medical emergencies.

Barry tried to address those problems in April 1990 by firing ambulance bureau director John M. Cavenagh and promising to appoint a physician as the new head of the agency. Barry also pledged to create a civilian "sworn officers corps" of ambulance workers, with rank and pay equal to that of firefighters.

Both changes were to be effective Oct. 1. However, no medical director has been appointed, and the sworn officers corps does not exist.

A fire department spokesman, Capt. Ted Holmes, blamed the delay on the mayoral transition. "The chief was not going to appoint a new medical director and expect someone else to come in {to the mayor's office} and live with it," he said.

But the ambulance union, which supports the transition team's proposal to separate the ambulance and fire agencies, said the fire department is dragging its feet because it wants to control ambulance operations.

Calvin Haupt, president of Local 3721 of the American Federation of Government Employees, said he began pushing for independence last fall "because we saw clearly that the sworn officer corps was a dead issue."