July 13, 2008

COMMUNITY ALERT

Ambulance Fee Update:

Tell the Council to reject Bill 25-08, "EMS Transport Fee."    

Take action now

View a sample letter to send to the Montgomery County Council. 

Read our March 29, 2008, Community Alert. 

This past May, the Montgomery County Council declined to place ambulance fees into the County’s operating budget for fiscal year 2009. Thank you for expressing your views to the County Council regarding this important issue. Your calls, emails, and letters have made a difference.

The battle to keep ambulance service free is not over. This summer, the County Council and its Public Safety Committee will examine Bill 25-08, submitted by the County Executive, to charge residents an ambulance fee.  The full Council is expected to vote on the bill this fall.   

At a public hearing on July 8, officials from the Rescue Squad, other local fire/rescue departments, and members of the public testified in opposition to the proposed ambulance fee.   Several members of the Council expressed concern regarding the impacts of the fee on the poor, elderly, under- and un-insured, and those insured under certain federal employee health insurance plans. 

This year the County Council has to make tough budget decisions. But not all revenue-raising proposals are worth pursuing. Ambulance fees are a bad idea in principle and in practice, and the Council should reject such fees again.

Take action: Your calls, emails, and letters make a difference.   Please call, write a letter, or send an email so the Council hears your opposition to ambulance fees.

Take Action Now

Ambulance fees are a bad idea in principle and in practice, and the Council should reject such fees. Email or write: Please send an email to County.Council@montgomerycountymd.gov expressing your opposition to Bill 25-08. For a sample letter, visit www.bccrs.org . Or send a letter to the full County Council opposing Bill 25-08:

The Honorable Mike Knapp, President
Montgomery County Council
100 Maryland Avenue
Rockville, MD 20850

Please also call or email each Councilmember to make your voice heard:

Background

Ambulance service in Montgomery County is funded by taxes and donations and is currently provided at no charge to those who call for help. If approved by the County Council, residents will be charged $350 to $800 for calling 9-1-1 for an ambulance. An ambulance fee is an additional tax on County residents and has the potential for discouraging many, particularly the elderly, the under-insured, and those with insurance co-pays and deductibles, from calling 9-1-1.

A resident experiencing a heart attack, stroke, or other life-threatening emergency should not have to check his or her insurance card–or savings account–before calling 9-1-1. This is a basic public service, and we shouldn’t impose a separate tax on those who call 9-1-1.

Serious Concerns Remain; Questions About the Proposed Fee Are Unanswered

Our March 29 Community Alert (which can be viewed at www.bccrs.org) raised important concerns about the serious health and financial impacts of an ambulance fee on our community. Several of these concerns bear repeating, and other concerns have arisen:

Residents might be discouraged from calling 911. We have found no study or analysis that looks beyond jurisdiction-wide call statistics and examines specifically how ambulance fees affect the uninsured, under-insured, and other less-advantaged groups -- i.e., those most likely to be adversely affected by an ambulance fee. Until that’s done, we believe an ambulance fee will deter some people from calling 911 in a life-threatening emergency.

Other jurisdictions’ charges have mixed results. It’s true that neighboring jurisdictions have imposed ambulance fees, but with mixed results. On the revenue side, ambulance fees have generated less money than promised, particularly in the early years. Over time, rates have gone up, more intensive collection efforts have been pursued (“soft” billing is quick to be jettisoned as revenue needs increase), and fees have been expanded to other types of fire/rescue services. Also, a significant portion of the revenues are paid to billing companies, consultants, and additional employees to run the system. An ambulance fee would cost the County government at least $2 million a year in administrative costs alone, according to a 2004 County report.

What’s more, the use of the revenues is far different from what’s before the Council. Most jurisdictions share the revenue based on how the ambulance is staffed. Somewhere in the range of 10,000 EMS transports are staffed entirely by volunteers in our County; thousands more are staffed jointly by volunteer and career personnel. Using the formula in other jurisdictions, $5 million-$6 million (perhaps more) of the revenue generated from ambulance fees would be directed to local fire/rescue departments -- more than triple what the County Executive has proposed. (Importantly, B-CC Rescue Squad opposes ambulance fees on principle -- residents should not be charged for such a core public service).

Claims regarding Fire/Rescue budget needs are suspect. According to the Executive’s budget, revenue from the Fire Tax, fire code permits and enforcement, and federal/state grants in FY 2009 will exceed fire/rescue operating expenses by $12 million (assuming no ambulance fee). (See http://www.montgomerycountymd.gov/content/omb/FY09/psprec/frs.pdf at page 7). The overage should be available to address important capital needs (e.g., new stations, additional vehicles). While the legislation proposes using the fee to "supplement" expenditures for fire/rescue needs, the language is too subject to interpretation. Many subjective chargebacks and assignments of overhead costs occur in the budget process - a quid pro quo will occur that negates the intent of this provision.

County government expenditures, including within the Fire/Rescue System, need examining. Recent press accounts have highlighted the need for the County to eliminate wasteful spending. In addition, in a report that Councilmembers called “troubling” and “disturbing,” the County’s Inspector General has targeted the Fire Rescue System for scrutiny, finding excessive overtime and the prospect of fraud and abuse. The County needs to examine its spending practices to ensure efficiency before it hits County residents in the pocket with additional fees.

Charging Residents for Services Often Provided By Volunteers. More than 150 professionally trained volunteers at the B-CC Rescue Squad serve as EMTs, Paramedics and Firefighters. Hundreds more serve in other departments. We believe the County should not charge for a service we provide for free.

The Views of Others. Within the past several weeks, many groups have declared their opposition to this latest ambulance fee proposal, including: the Montgomery County Volunteer Fire-Rescue Association, Montgomery County League of Women Voters, Montgomery County Civic Federation, the Western Montgomery County Citizens’ Advisory Board, and several neighborhood associations.

Take Action Now

Please call or email the Montgomery County Council to express your opposition to Bill 25-08, "Emergency Medical Services Transport Fee."  Thank you for your support. Click here to view a sample letter. 

Community organizations are encouraged to publish this information in community papers, electronic bulletin boards, and listserves, and to reproduce and distribute copies of this release.

To receive email updates on this and other Rescue Squad issues, click here to sign up for our email newsletter.  

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The Bethesda-Chevy Chase Rescue Squad, Inc.

5020 Battery Lane, Bethesda, Maryland 20814