Fee for ambulance transport considered
By Kevin Kelley
Westlake
Published Jan. 3, 2007

If you experience a medical emergency and have to be transported to a hospital in an ambulance by city paramedics, should you — or your health insurance company — be charged for it?

In recent years, more and more communities have instituted an ambulance fee. Now Westlake, which currently does not charge, is the latest city contemplating the fee.

The proposed ordinance to enact ambulance and paramedic fees had its second reading before City Council Dec. 7. But council wants more time to gather facts about how a fee would be implemented and did not vote on the ordinance at its Dec. 21 meeting. Instead, council members plan to discuss the proposal at a public committee meeting some time this month, Council President Michael Killeen said.

Under the proposed ordinance, revenue from ambulance charges would be placed into an EMS Revenue Fund or similar fund. Money would be used to purchase or maintain emergency medical equipment and supplies or purchase emergency vehicles. The proposal also states funds could go toward “other uses which facilitate or are related to the delivery of emergency services, including administrative costs.”

Westlake Fire Chief Richard Pietrick conducted a survey of 60 local communities to discover how many charged ambulance fees. Of the 31 cities which responded, 26 had such fees.

When asked by West Life if he supports enacting ambulance fees, Pietrick responded, “If we’re going to improve the level of service, then I’m for it.”

Pietrick said there has been no discussion yet concerning what the fees would be in Westlake. However, the chief said other cities typically charge between $350 and $600.

The patient’s health insurance company is charged the fee in most cases. The proposed Westlake ordinance has a clause allowing the city’s law director to waive the fee if the patient is unable to pay. Killeen and Mayor Dennis Clough said Westlake does not intend to pursue an ambulance fee in cases where the insurance company does not cover the cost.

Pietrick told West Life it’s a fallacy that citizens will be reluctant to call for an ambulance because they will have to pay.

That’s the same conclusion reached by McGrath Consulting Group in its audit of the city’s fire department last year.

“Most communities make it very clear that service will never be based on ability to pay,” the McGrath report stated. “The consultants have not witnessed a decrease in ambulance usage after a user fee has been imposed.

“The justification for municipalities implementing a user fee is that the revenue generated does not meet the expense of providing the service,” the McGrath report went on. “Rather than raise everyone’s taxes to maintain the present service level, the cost will be passed on to those that actually use the service.”

The report noted several advantages to charging a fee, among them the fee generates needed revenue, stops abuse of unnecessary ambulance calls, and won’t let non-residents get the service for free.

Objections noted by the report are that many paramedics feel they provide the service out of caring for the individual and don’t feel a charge should be added. Many citizens feel they already pay for the service through taxes and the city can afford it.

Ultimately, the McGrath report said Westlake should institute a fee.

“The consultants recommend a different flat rate for residents and nonresidents, plus the incorporation of an itemized list of charges for actual services rendered,” the report stated.

Joe Kilbane, a past critic of the administration of Mayor Dennis Clough and an unsuccessful candidate for the Ward 5 seat of Councilman Ken Brady in 2005, told council Dec. 7 he believes the ambulance fee is unnecessary because the city has enough money.

“Do we really need this additional revenue?” Kilbane asked council members.

Brady, who was serving as council president pro tem Dec. 7, repeated that  the city would only charge a fee if the insurance company pays for it.

“One of the feelings is that the residents of Westlake are now paying for it indirectly in their insurance premiums because we’re paying for it in other communities,” said Brady, who is still officially undecided on whether he supports the proposed ordinance.

Guy Turner, who works as a captain in the Westlake Police Department, spoke out against what he called “a sad proposal.”

Turner said his research has indicated many insurance companies are not paying the ambulance fees and sending the patients the bill in hopes that the fee will be waived.

“We are a stable financial community,” Turner said, “and we didn’t get there by billing people whose backs are against the wall. A user fee for EMS speaks poorly of our priorities.

“To me its like selling life preservers to a man that’s drowning.”