INSIDE

Fire district looking at
charging for ambulance transports

By Meg Olson

The Point Roberts fire district is preparing to join other county providers in charging for emergency medical transports.

“It’s a free service right now,” said commissioner Susan Brownrigg at the July 13 meeting of district commissioners. “Everybody’s billing except us,” agreed fellow commissioner David Gellatly. “We should have been out of the gate last year.”

Fire district chief Bill Skinner said he had met with a company that provides emergency medical transport billing for fire district that provide ambulance service, such as North Whatcom Fire and Rescue Services (NWFRS) and the fire district serving Ferndale.

“We only want to cover our costs and put a little in the bank to replace apparatus,” Skinner said. Of 18 fire districts in the county voters have approved EMS levies in five of them. Other districts either do not have an ambulance service or bill for that service. “When I tell people we don’t charge for our service they’re incredulous,” Skinner said.

In 2004 the fire district provided 58 emergency transports, taking 30 patients directly to the hospital and transferring 24 patients to Medic One paramedics, who provide advanced life support throughout the county and basic life support where the fire districts don’t have an ambulance.

When a patient is transferred to Medic One in Blaine they get a bill from Medic One, but are not charged for the fire district 5 part of the trip. If the local ambulance, the only one in the county to provide intermediate life support services, takes the patient all the way to the hospital they are not billed for transport or any supplies or medications used. Skinner said Medicare/Medicaid or private insurance pay for most ambulance trips. The former will pay a base rate of $370 plus $5.90 per mile and private parties or insurance agencies are billed approximately $400 and up to $11 per mile.

With the county’s recently released plan for emergency medical service (EMS) transferring responsibility for all basic life support transports to the fire districts, Skinner said the department would need to set up cooperative relationships with other districts to help share the work load. “They have paid staff and we don’t,’ he said, suggesting a partnership with NWFRS. “It’s not unusual to have two providers involved in a transport.”

“My concern here is the fire district does not receive one penny for EMS and fire levy is paying for it instead,” said Gellatly. “The tax dollars we receive now are meant to be for fighting fires.” He added that there appears to still be a public assumption that the volunteer fire department bingo revenues paid for ambulance services, which they no longer do. “They used to,” Gellatly said.

With the county poised to put another EMS levy to the voters to support the Medic One program, Skinner predicted the public would be testy about any new fees. “Our timing over the last few years has not been optimum,” he said.

Commissioners agreed that they needed more information about what the local ambulance would charge and how Canadian visitors could make sure they were covered by insurance in an emergency. “Are we going to get people saying, ‘well if they’re charging for transport let’s just throw him in the station wagon and head for Delta,’” Gellatly asked. “An education program is essential. We need to fair with people and up-front about what’s going on.”

Skinner said commissioners had a responsibility to convince the public of the reality that ambulance service couldn’t keep coming for free. “I don’t think we should keep soft selling,” he said. “If you keep turning down taxes and fees for EMS there won’t be an EMS service. People need to ante up if they want the service.”

Commissioners agreed to discuss the billing options available further after more information about costs, insurance options, and possible collaborations was available.