$300 fee to call 911 if EMS is preformed?

[USN2UNC]

http://www.ktla.com/news/landing/ktl...,3459346.story

Video included in link above.

LOMA LINDA -- Residents making 911 calls requiring emergency medical services now have a choice -- pay $300 per call, or sign up for an annual fee.

The Loma Linda Fire Department plans to charge residents $300 for each 911 call, beginning Monday, under its new "Fire Medical" program.

Residents can also choose to pay a $48 dollar annual membership fee and not be charged for each call.

The fee covers each household.

Non-residents will be charged $400 per call or an annual fee of about $60.

No fee will be charged for police or fire emergencies.

The cost does not cover any charge from a private ambulance company.

The money will go to the fire department, which hopes to offset the costs of providing specialized services to the community.

Officials say the fire department responds to more than 3,000 calls each year, about three-fourths of which are for emergency medical services.

Thoughts?

[dfwpa]

drop in the bucket compared to what careflight charges around here if you need a ride.

[medic25]

Every other branch of medicine charges for its services; no reason why EMS shouldn't be doing the same. Unfortunately Medicare and the insurance companies will generally only reimburse for care if the patient is actually transported, so first-responder agencies need a mechanism to recoup some of their expenses when they are not the transporting agency.

[jwpa]

I agree. This may discourage inappropriate use of 911. But might it also discourage use by those who need it, but can't afford it or are in denial. What about those who have 911 called on their behalf, but don't really need it like a known seizure patient. Tough problem.

[USN2UNC]

Exactly. I do see how the EMS and city need to find ways to reimburse expenses. However the average senior citizen living on social security may not want to shell out the $300 on the chance that he/she may be having a MI, and will not be able to when it is too late. It does seem however that this high price $300 dollar fee is a quasi scare tactic so that everyone signs on for the $48 annual fee.

[istat2]

Correct me if I'm wrong. But don't residents already pay in taxes?

[rev ronin]

istat2, it will vary from place to place. In my county, ALS is paid for by taxes, so a medic unit ride is free to the patient. BLS transport, on the other hand, is primarily handled by private companies who bill. No reason it couldn't be tax supported; I don't begrudge paying $50/year as a homeowner for ALS transport.

[dreamin2baPA]

Correct me if I'm wrong. But don't residents already pay in taxes?

How is this different that other patients being held responsible for paying what private insurance, Medicare, or Medicaid do not pay. We all pay taxes that support Medicare and Medicaid. In many systems this is referred to as a "membership." Pay your annual fee and the agency bills insurance and eats the rest. Non-residents using EMS should pay higher amounts as local taxpayers are subsidizing their care.

[istat2]

Hey Rev,
Sorry partner, I was being somewhat of a smart a55. I worked the rigs as a P for 15 years and am familiar with most funding models. The service district involved is a fire/medical model handling their own transports. The rationale is to be able to bill private insurers for the services provided. So for the locals there is a $300 charge per run, and the institution of a subscription service.
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So I guess the appropriate approach now is following the private insurance model. You tax is your deductible, and the per-run charge is the co-pay. Is this money going to be used to decrease the debt load on the people living in the service district? I somehow have a problem believing it will. The bureaucracy and politicians never seem to decrease how much they take out of people’s pockets. I guess that I just have a conceptual problem with the approach. Most Governmental entities already take too much funding from the general population.

[narcan]

Having worked as a paramedic in a busy urban system for the past few years, I understand Loma Linda's desire to recoup some of their unreimbursed costs. However, there is a big difference between calling 911 for an emergency charging for the response and calling 911 for an emergency and charging for the transport. As said earlier, who do you charge when a 3rd-party caller activates EMS for someone who didn't want EMS or is unable to give consent?

What makes more sense as a revenue-generating model is a voluntary subscription model where an annual fee provides for free transports. I think Loma Linda is trying to encourage people to buy the subscription by tacking a $300 fee on the response itself. While it's difficult to get people to shell out money for a service they don't think they'll use, there are better and safer ways to incentivize people to buy "insurance" against a medical emergency.

[Josheppe]

Also being done in NC.

http://www.wakegov.com/emsfund/

[USN2UNC]

Also being done in NC.

http://www.wakegov.com/emsfund/

Yes it is! We had a guy who was late to therapy last week because his car overheated and the engine caught on fire. He was parked on the street and yelled to his neighbor to call for the fire dept. The neighbor said no, he said didn't want to be the one charged for the service. so the guy had to quit trying to put out the fire and run inside to call the 911.

[srward]

Yes it is! We had a guy who was late to therapy last week because his car overheated and the engine caught on fire. He was parked on the street and yelled to his neighbor to call for the fire dept. The neighbor said no, he said didn't want to be the one charged for the service. so the guy had to quit trying to put out the fire and run inside to call the 911.

Really? The Wake County EMS Fund fee has nothing to do with calling 9-1-1 and especially has nothing to do with fire-related services. The subscription fee is designed to provide a small ofset for patients who have no insurance at all. The $60 fee covers all of your ambulance transports costs within a calendar year if insurance doesn't provide any reimbursement. Without the "subscription" you would be responsible for the $400-$900 (rough estimate) ambulance bill for each and every time you require the service. This is nothing unique, and is quite common in both all-volunteer EMS services as well as paid municipality based services.

I'm not opposed to such creative fundraising practices; I'll be the first to tell you that the thought of your taxes properly covering fire, EMS and policing services is a tremendous myth. Taxes do little to cover the real operating costs of an EMS service and reimbursement rates for transport services are frequently under 30%, especially with Medicare and Medicaid programs footing much of the bills. As primary care becomes harder and harder to get in a timely fashion (a Medicaid patient will have to wait 2.5 months, on the average here, to get an appointment with their doctors office for even serious complaints. So they turn to EMS and the ED for their primary care because there is no waits, no copays and no one actually "forces" you to pay the bill. the problem is that the service is frequently abused for lower acuity calls that certainly do not require emergency or even urgent medical attention.

I'm more of an advocate for charging copays for ambulance transportation or ED visits for complaints that triage out as lower acuity- you wouldn't be seen in the doctor's office or urgent care center without paying a copay for such complaints, why should the ambulance or ED be any different? (Before you hit the Post Quick Reply button in rapid-fire motion, I know there are some disadvantages to this plan and advocate properly researching and planning it implementation.) Sadly, it may delay many people from getting immediate care for a sore throat, cough or the like. However, it will improve the liklihood that the paramedic ambulance is available for that looming STEMI or cardiac arrest around the corner as opposed to being tied up taking the proverbial stubbed toe to the emergency department.

A fee just for dialing 9-1-1, however, now that is plain absurd.

[jlaldrich]

Is this in addition to current BLS/ ALS services? If not, then its pennies in comparison to the $500 charged for BLS transports and $900+ charged for ALS transports. Its like any other medical service; it needs to be paid for somehow. You have to keep doors open and ambulances staffed and operating and its not cheep to do so. I assume these are billable service charges and life threatening emergencies cannot be turned away, right? If it were up to me everyone would get free medical care, in-hospital or pre-hospital but that’s why I'm not in administration- we would all be out of work.