Both Sides Of The Montgomery County Ambulance Fee Issue, Proposed Cuts
Oct 6, 2010 12:42 - 6 Comments
The Maryland Court of Appeals recently ruled to include the question of Ambulance Reimbursement on the ballot on November 2, 2010, so Montgomery County residents will be able to decide. The County Executive and County Council have already approved Ambulance Fees and the budget was formulated with the expectation that Montgomery County would begin to collect payments from health insurance companies for all ambulance rides this year.
Here is the Ballot Question A:
Referendum on Law Enacted by the County Council
Emergency Medical Services Transport Fee
Shall the Act to require the collection of an emergency medical services transport (ambulance) fee from: (1) County residents to the extent of the resident’s insurance coverage; and (2) non-County residents subject to a hardship waiver become law?
Voting “No”
The Montgomery County Volunteer Fire and Rescue Association (MCVFRA) has worked to get this decision on the ballot, and are urging a “No” vote because:
- Charging for ambulance service already paid for by taxes is wrong.
- Residents will have to make-up the difference between what is charged and what is collected.
- Some people won’t call 911 in an emergency.
- Insurance rates will go up.
- It is wrong to charge for service provided free by volunteer fire and rescue personnel.
The estimated (and disputed) $14 million revenue anticipated in the current fiscal year was not going to be directed to the fire/rescue budget anyway (according to the legislation approved by the County Council). Regardless, $14 million is only 0.3% of the total Montgomery County budget. If the revenue from an ambulance transport fee is not available, it can easily be made up from other budget sources.
Voting “Yes”
The Montgomery County government urges a “Yes” vote for the following reasons:
- No Cost, No Tax, No Bills for County Residents
- The Same Excellent Quality Services
- $170 million Dedicated by Law to County Fire & Rescue Over 10 Years
- Improved Ambulance Response Times
- Additional Fire & Rescue Equipment and Personnel
If the vote is “No”, what might the buget cuts look like? Yesterday WTOP reported on the County Executive’s “just-in-case” scenario if voters repeal the county’s ambulance fees. These budget cuts would have to be approved by the County Council. Here are the proposed cuts:
- 118 public safety jobs, including nine police officers in school
- 11 ambulances would be pulled out of service
- $1 million in road resurfacing
- 4 sports academies that serve “at-risk” teenagers
- 8 of 15 “RecExtra” programs for “at-risk” middle school kids
- Sunday service at area libraries
- Cuts to “Care for Kids”
- Cuts to Maternity Partnership
The Chief’s Blog from the Montgomery County Fire and Rescue Service includes an observation about volunteer crews being free. The vast majority of EMS calls are handled by career staff. The cost for an all volunteer crew is not free because of the expenses for equipment, gas, uniforms, and wear and tear on vehicles. Montgomery County provides many of the volunteer stations with funding to help with operating expenses. Many of the vehicles have been purchased by Montgomery County taxpayers.
A more detailed case detailing why voters should vote “Yes” has been listed on the Montgomery County government website under Ambulance Reimbursement Facts:
Ambulance Reimbursement will raise $14-$17 million a year in revenue that will be dedicated to maintaining and enhancing Montgomery County’s world-class emergency medical services.
County residents will not pay anything. Ambulance reimbursement will be billed directly to residents’ insurance companies, which have already factored the cost of patient transport into their rate schedules. Ambulance reimbursement will be waived for uninsured residents and will be covered by their tax dollars.
Montgomery County is one of the few jurisdictions in the region that is not already collecting ambulance reimbursement from insurance companies. Fairfax County collects the fee, as well as Frederick, Prince George’s, Carroll, Charles, Arlington, Washington, and Prince William counties. Cities such as Alexandria, Baltimore, and the District of Columbia also collect ambulance reimbursement.
There is no evidence that those in need of transport will be dissuaded from calling 911 because their insurance is going to be billed or because they are uninsured. In the jurisdictions that have been collecting ambulance reimbursement, there is no evidence of that happening. Montgomery County will fund a public education campaign to make sure that residents know there are no charges to them for emergency medical services and no changes in service.
There is no evidence that ambulance reimbursement will raise insurance rates. Ambulance bills are in the “hundreds” of dollars, compared to hospital, physician, surgeon, rehab, device, and drug bills, which are typically in the “thousands and tens of thousands.” Ambulance expenditures account for less than 1 percent of insurance expenditures. Since most insurance companies determine rates on a regional basis – and most jurisdictions in the region bill insurance companies for this charge – in most cases County residents may already be paying for ambulance service as a part of their premiums.
The quality of patient care will continue to be the highest priority for Montgomery County’s Fire & Rescue Service. A resident’s ability or non-ability to pay will never be considered when providing service.
When a resident makes that 911 call, the first priority will be to take care of that patient’s immediate medical needs. If deemed necessary, the patient will be transported to the hospital. If not, ambulance reimbursement will not be charged to the insurance company.
It’s up to the Voters
As County Executive Ike Leggett recently pointed out, the County had to make $1 billion in budget cuts this year. If voters reject Ambulance Fees, the decision requires additional cuts in personnel and services, which he is beginning to propose in advance of the vote. This allows voters to have a clearer understanding of the choices, because they will decide.
The Volunteers are concerned about one thing only and that is there donations going down. They provide very little of the service provided to the residence of the County.
The citizens of this county deserve full coverage, by a professional force, thats always there, always ready and well trained.
Your health insurance company is already charging you for this service, your rates won’t go up because of this legislation.
Please Vote YES.
I have yet to see ANY advertising or ANY “education campaign” about this that informs uninsured voters about how this would affect them; instead all the advertising is the other direction, designed to make them afraid that they’ll be shouldering huge medical bills should they need an ambulance. If the County is planning an education campaign to get all the above points across, the time to begin is at least a month ago. As it is, there will be a great deal of resistance from voters who’ve already made up their minds because of the scaremongering.
I don’t appreciate the draconian scenarios being put forth by the County council, either. So far the dialog seems to consist of “People won’t call 911 for fear of medical bills so people will die needlessly” or “If we don’t charge this fee, the only services MoCo will be able to provide across the board are the basics.” Has there been any dialog between the two extremes, or is this a case of being perpetually at odds. Has there been any thought given to a more modest fee which would at least reduce the shortfall?
On a side note, of course the volunteers are concerned about those donations. New equipment that is NOT being funded by the County (and IMO should be!) IS being covered by those donations.
I was reminded of this issue when a friend sent me this link: http://www.wpsdlocal6.com/news/local/Firefighters-watch-as-home-burns-to-the-ground-104052668.html That’s one different tax scenario and how it might play out, and I’m actually a bit surprised that one side or the other on this debate hasn’t latched onto it yet.
These are scare tactics from the Leggett office. Leggett needs more money to continue to over-indulge himself and his group of top executives with outrageous salaries and fringe benefits. So far, Leggett has not made any adjustments at the top. He has been cutting from the bottom which means the front line employees.
In reality, MoCo Fire and Rescue has received and will continue to receive millions of dollars from many different Federal programs for Emergency Prepareness, Homeland Security, and the Recovery Act. These are enough to mantain the current Fire and Rescue department intact. Andrews is right, there is no need for this “fee.” Leggett want these monies to balance his budget. I say, look somewhere else.
The only thing MoCo Fire and Rescue needs is better management and oversight. In other words, stop overpaying the captains and batallion chiefs. Stop the abuses, favoritism, and over-pampering of top officials.
Thanks for the info.
The volunteer points are not completely factual. The County will accept whatever standard charge an insurer pays — no difference to be paid by residents. No evidence of reluctance to call 911 in any jurisdiction around us that has fees. Also, no evidence of insurance rates going up — that’s because these premiums are ALREADY being paid. We will be saving lives with these resources- at no cost to Co. residents.
I am a bit confused by the “budget cuts [that] would have to be approved by the County Council”….
118 public safety jobs, including nine police officers in school
11 ambulances would be pulled out of service
$1 million in road resurfacing
4 sports academies that serve “at-risk” teenagers
8 of 15 “RecExtra” programs for “at-risk” middle school kids
Sunday service at area libraries
Cuts to “Care for Kids”
Cuts to Maternity Partnership
That seems outlandish….the 118 police officers alone should be about or more than $14-17M per year, perhaps….why does this list continue? The way it’s written, it makes it seem like ALL of this would be cut if people vote NO. Are these each single examples of making up $14-17M?…..seems like something doesn’t add up…
Aside from this exaggerated sounding cut list, I think the YES side makes some compelling arguments….thanks for the info
Most of the 118 public safety jobs mentioned above are career fire fighters that will lose their job over this. These men have risked their lives to project the people of Montgomery County. The people of Montgomery County will feel the pain if this proposal is voted down. Please vote YES.