Vashon Island Fire & Rescue this week began billing Islanders for non-emergency ambulance service, nearly three years after the department’s board of commissioners first told the department to charge for the service.
As of Monday, the fire department started charging $200 for a transport to an on-Island medical clinic and $450 to go to a hospital or other location off-Island, said Ron Turner, a member of the fire department’s board of commissioners. The fees, he said, could bring as much as $100,000 a year to the department, which has an annual budget of approximately $4 million.
The fees only apply to what’s called basic life support transport, where patients need the aid of an emergency medical technician (EMT) but are not in a life-threatening situation. There will be no charge for transporting advanced life support people, a service covered by King County Medic One.
The commissioners agreed last November, in a four to one vote, to initiate the new service fees, in large part because the majority of insurance companies cover such costs. Turner said at the time that it made little sense for taxpayers to subsidize such services if insurance companies will pay for them.
But on Tuesday morning — a day after the new billing system started — fire department officials said questions about whether insurance companies and Medicare will actually cover on-Island ambulance fees have not been resolved. As a result, the commissioners were to consider a resolution at their meeting Tuesday night (too late to make The Beachcomber’s deadline) calling on the department to drop the $200 on-Island fee.
Brett Kranjcevich, the department’s acting chief of operations, said it’s not too late to alter the fee structure. “We’re only 36 hours into it,” he said.
But Turner, who’s been advocating for such fees for some time, said he’s frustrated that the department could so quickly change its direction.“They’ve already advertised twice what they’re going to do,” he said, referring to two brochures that have been issued on the new fees. “Now to change it at the last minute doesn’t make sense to me.”
This isn’t the first time the issue has come before the commission. According to Kranjcevich, the department charged Islanders for ambulance transport for two years or so in the 90s. He wasn’t sure why it was dropped.
Then, a little more than two years ago, the commission — concerned that the tax-funded department was losing money to insurance companies — voted to again institute ambulance fees. The department produced a color brochure on the new fee structure, but it was never instituted, Turner said.
Finally, last November, the commissioners again told the department to charge the fees. They did so with the caveat that those who can’t pay will not be turned over to a collection agency.
“If you don’t have insurance or don’t want to pay, you’re not going to be sent to collections,” said Turner. “This is a good-faith attempt.:
But some in the department and at least one commissioner question the wisdom of charging for ambulance service. Medicare, which many of the Island’s retirees depend on, doesn’t cover ambulance fees for people who aren’t homebound, said acting Chief Mike Kirk. So if an elderly person on Medicaid hurts his or her leg and wants a transport to a medical clinic on Vashon, Medicare won’t cover it, he said.
What’s more, he said, some elderly people who really can’t afford to pay may do so anyway “out of a sense of integrity.”
“There are personal feelings about it,” Kirk added. “Overall the crew is not happy about it.”
Commissioner Gayle Sommers, the one dissenting vote last November, said she, too, is concerned some will end up paying for a service they can’t afford or, in some instances, opt not to dial 911 for fear of having to cover transportation costs.
