County Council Studies Ambulance Fee

>Note: Our friends at the Silver Spring Penguin (which you should definitely read) asked if we could cover a couple of County Council events. We usually don’t focus on County government, but since they have direct bearing on events in Our Fair City, we thought we’d publish them here too, with permission from the Penguin. The original article is here. We encourage any Rockville Central reader who has opinion on the ambulance fee issue to submit a contributor opinion article for consideration by sending us an email.

Last Thursday morning, the County Council’s Public Safety Committee held a worksession to discuss the proposed new ambulance fee. A procedural meeting, the Committee heard that the Fire and Rescue Commission had voted 4-3 to oppose the measure. They received technical amendments to the proposed legislation from Ike Leggett’s office. And they got answers to questions they had posed to the Executive after their July 24 worksession on the bill. On hand were representatives of volunteer rescue squads in Montgomery County.

Fire and Rescue Commission chair Kevin Maloney reported that at the previous night’s meeting, his commission had narrowly voted 4-3 to oppose the measure. “This process worked,” he said. “Maybe the outcome didn’t come out the way some wanted, but the process worked. . . It didn’t become a fractious discussion; it was a positive discussion.”

Next up: a delegation from the County Executive’s office. Leggett’s office had sent along a series of proposed amendment to the measure. According to Deputy County Attorney Marc Hanson, it seems that the original language of the bill would have actually allowed private insurers to refuse to pay claims for ambulance fees. It took a letter from private insurer GEHA to point this out.

Leggett’s office offered amendments that make explicit an assumption that had been embedded in the measure: that County residents’ taxes are being treated, in essence, as “prepayments” for any ambulance fees the County might impose. This follows a similar system already in place in Columbus, Ohio, according to Kathleen Boucher, the County’s assistant chief administrative officer.

At their July 24 worksession on the proposed ambulance fees, the Public Safety Committee had asked Leggett’s office a few questions. Among other questions, the Committee had asked about the possibility that imposing an ambulance fee would discourage people from using the ambulance when they need it. Opponents of the measure have pointed to this as a key argument.

According to attorney Ted Wolfberg, who is working on this issue as outside counsel for the County, this is a “laudable and legitimate policy debate.” But the studies opponents cite don’t actually support that position. While the studies do point out that income affects health care use, he reported, the studies don’t make a connection to ambulance fees.

Council Member Marc Elrich said, “I agree with how you read these studies, they just don’t indicate that fees have a deterrent effect. . . . If you do not have insurance . . . the magnitude of the ambulance fee is just a small portion of what you’re about to be hammered with. . . . people will still be afraid of going to the emergency room because if you don’t have insurance, you’re in deep, deep trouble.”

Council Member Don Praisner agreed, “I think this question is irrelevant. Neither side can prove to me [what will happen].”

However, John Bentovoglio, counsel for the Bethesda Chevy Chase Rescue Squad, pointed out that in Fairfax County, the year they imposed an ambulance fee — ambulance calls went down. “We are concerned about [the fee's] impact on people,” he said.

Council members expressed the most concern about what the possible paperwork and other administration might look like. “The devil is in the detail in this thing,” said Elrich.

Committee Chair Phil Andrews said that there would also be one more worksession — “which may be the final one” — at which the committee will get into the fiscal assumptions behind the bill, and just how efficient an ambulance fee will be at raising revenue.