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Home > Topics > EMS Management
July 01, 2014

Calif. fire department to charge $100 for medical calls not requiring a transport

It's part of a cost-recovery effort; residents can avoid all out-of-pocket EMS expenses by enrolling in a membership program for $48 a year

By Alene Tchekmedyian
Burbank Leader

BURBANK, Calif. — The Burbank Fire Department in July will begin charging $100 for its response to emergency medical calls that don’t include transporting someone to the hospital, which officials said is a way to recover personnel costs.

The paramedic-assessment fee was approved by the Burbank City Council this week as part of the fiscal year 2014-15 budget.

“This is just a cost-recovery program for the General Fund — something that’s being done up and down California,” said Burbank Fire Chief Tom Lenahan, adding that neighboring cities such as Glendale and Pasadena have similar fees.

The department responds to roughly 7,800 emergency medical calls a year, Lenahan said.

Roughly 60% of the calls include transporting someone to the hospital, the fees for which range from $1,100 to $1,500. But for calls that don’t require transportation to the hospital, he added, there’s still a cost to the department.

The fee, which insurance companies will generally cover, was derived by calculating personnel costs for a typical response, which generally lasts 20 minutes and includes a fire captain, engineer, two firefighters and two paramedics, Lenahan said.

Burbank residents can skirt the per-response fees by enrolling in the department’s Emergency Medical Service Membership program, which costs $48 a year. Under the program, all permanent residents in the subscribing household can avoid out-of-pocket expenses for hospital transport and paramedic response.

Officials said the program is beneficial for those with high insurance deductibles, a chronic medical condition or for those without medical insurance.

Roughly 5,000 households are currently signed up, a number that’s grown by 700 in the last couple months through community outreach, Lenahan said.

“If you’re a subscription member, you wouldn’t have any out-of-pocket costs,” Lenahan said. “It’s the ride of your life and it’s worth having that little bit of insurance that you’re not going to get any bill for it.”

———

McClatchy-Tribune News Service
©2014 the Burbank Leader (Glendale, Calif.)

Comments
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Dominick Walenczak Dominick Walenczak Tuesday, July 01, 2014 1:19:14 PM Maybe the fire department should reconsider sending extra, non-essential personnel to cut costs. Send the ambulance, not the fire truck... unless the patient is on fire.
Jimmy English Jimmy English Tuesday, July 01, 2014 1:22:42 PM who do they bill if the patient isn't the caller therefore did not request the response
David Newton David Newton Tuesday, July 01, 2014 1:29:44 PM Another Fire Department is Business. They say they should take over Private Paramedic Providers because they are in it for the money. Sure sounds like a money thing to me. If you can not aford to run EMS, give it back to a Private Paramedic Provider. they do not work with tax payer funds and charge patents at the same time like Fire Departments do. So, tell me, who is in it for the money.
Keith Robbins Keith Robbins Tuesday, July 01, 2014 1:31:59 PM Our EMS service also does this.
Lucy Koszykowski Lucy Koszykowski Tuesday, July 01, 2014 1:37:29 PM I totally agree with the charge . I know where I am we have people we call frequent flyers that call 911 if a eyelash falls out. If nothing else maybe it will teach people to become a little bit more mindful before they pickup the phone!
Lucy Koszykowski Lucy Koszykowski Tuesday, July 01, 2014 1:39:38 PM I also think they shouldn't send a fire resue truck unless there is a rescue involved I think if the call is totally a medical call only the ambulance should respond
Chris Mancuso Chris Mancuso Tuesday, July 01, 2014 1:54:39 PM Why do you need 6 people there to begin with? There is your problem.
Steve Jacobi Steve Jacobi Tuesday, July 01, 2014 1:56:34 PM This sucks for the people who didn't ask for 911 to be called. There are a zillion wannabe heros running around with the EMT patch who call 911 for just about anything and anyone whether they want it or not.
Alan Flournoy Alan Flournoy Tuesday, July 01, 2014 2:22:16 PM We all ready over pay them !Now they want to charge us to!! fire tax! respones tax whats next!!!!!!
Sanford Frasier Sanford Frasier Tuesday, July 01, 2014 2:25:24 PM This could be a 'double edged sword'. On the one hand, they can recover allot of lost revenue. But, then you have to think about word of mouth. People could take the "free ride" to the hospital just to avoid being charged. And, not to mention what that would do to the E.R., and triage! Our job is all about the 'what if', and this one has me worried!
Brian McCrady Brian McCrady Tuesday, July 01, 2014 2:32:18 PM Fire dept's are tax funded. Work within your budget, if you can't afford to run an EMS system turn it over to private ambulance.
Carol Gilliam Carol Gilliam Tuesday, July 01, 2014 2:44:48 PM Does Burbank do there own transports? The story seems a little misleading in that there is no out of pocket for subscribers. That would only be for non transports. The people most effected by this are the elderly. Out of fear they will most likely pay that fee because they will perceive it to be that they cant get a response with being a subscriber. Finally, I hope if they are going to be doing this that their approach to the those that call often is that the caller has a perceived emergency and not push an AMA.
Carol Gilliam Carol Gilliam Tuesday, July 01, 2014 2:47:26 PM Those people will still continue to call. They just wont pay the bill. The city has to respond if they call 911. So its not going to change that culture. It will however cause some people to not call out of fear for a bill, and most likely they are the ones that need the help.
John Greenaway John Greenaway Tuesday, July 01, 2014 3:21:30 PM If reading this remember it cost money to have equipment respond to medical call where the person doesn't require transport. This help off set the operating cost of that call. I'm sure if you check closely you'll also find out that Private Ambulance also charge a fee for Non Transport. If you look at the precentage of Ambulance call that not paid by insurance company it adds up into the millions. In Pennsylvaina Welfare only pay $60 for Basic Ambulance call the average cost is $ 200-300. Alot of these call don't reqiure Ambulance. Alot of people look as free ride to hospital or they will get faster service in the Emergancy room . Try to pay your fuel cost and Workmans Comp at that rate. Not everything is free. Remember when your waiting for Ambulance for love one and the Ambulance is mile away . It's not about another Fire Department into the Business it about providing care to the people but it does come at cost. It doesn't matter if your public or Private your going to still be charged the same amount
David Fisher David Fisher Tuesday, July 01, 2014 4:10:01 PM I feel there should be a charge for someone who calls out the squad but then refuses transport. There are many calls placed by "the lonely older lady" that the only reason is to have a visitor. While I feel for those type of people, that is not what EMS is there for.
Eric Hackett Eric Hackett Tuesday, July 01, 2014 4:16:05 PM What a disgrace!! Is this really the direction that our profession is heading??? If I am correct, the residents of Burbank pay taxes to cover their fire services, now they're having to pay a second time? This is some bull right here.
Kevin Wright Kevin Wright Tuesday, July 01, 2014 4:16:37 PM Just send a medic truck not a whole engine (The fee, which insurance companies will generally cover, was derived by calculating personnel costs for a typical response, which generally lasts 20 minutes and includes a fire captain, engineer, two firefighters and two paramedics, Lenahan said) TALK ABOUT OVER KILL OF RESPONDERS.
Kenny Colson Kenny Colson Tuesday, July 01, 2014 5:10:18 PM Im an EMT the reason the FD sends an engine company to the scene of medical calls ..yes,even when theyre not on fire..is because the firefighters on that truck are also Advanced Life Support EMTs and Medics and the rescues are usually tied up with other patients or dropping them off at the hospital or the closest rescue is busy so the rescue is coming from across town and the engine is closer so they get personnel on scene ASAP to assess the situation and the patient start treatment and let us guys on the rescue know what were walking into then they hand off care to us and we transport
Tyler Allen Tyler Allen Tuesday, July 01, 2014 5:16:14 PM A fire engine response is a first response situation. Most fire departments do this because they can get to you sooner thus starting care sooner. I work for a dual agency and wish we would do this. So many people call for stupid reasons such as I stubbed my toe two weeks ago and it still hurts and these people have multiple cars in the drive way. As far as having to take into account of 4 fire fighters there let's be honest if something happens to uncle so and so and he weighs 450 plus pounds it takes a few people to pick him up and move him to the ambulance. And for those saying give it back to private by all means please take it and yall can deal with the insurance and the bull shit it comes with. 911 transport is just slightly different then dialysis, with 911 you don't get to "pre - qualify" who you take and who you don't take.
Guillermo Macias Guillermo Macias Tuesday, July 01, 2014 7:42:37 PM What will the two firefighter/paramedics do when a patient is extremely heavy and need additional assistance to carry the patient onto the gurney, and load into the ambulance? What will they do when they respond to a full arrest (heart attack) patient? More than two rescuers are needed to perform CPR, hook up IV lines, get the monitor connected, etc., etc., etc. this is simply one scenario.
Guillermo Macias Guillermo Macias Tuesday, July 01, 2014 7:48:18 PM What will the two firefighter/paramedics do when a patient is extremely heavy and need additional assistance to carry the patient onto the gurney, and load into the ambulance? What will they do when they respond to a full arrest (heart attack) patient? More than two rescuers are needed to perform CPR, hook up IV lines, get the monitor connected, etc., etc., etc. This is simply one scenario.
Leon Hall Leon Hall Tuesday, July 01, 2014 7:56:45 PM The department responds to roughly 7,800 emergency medical calls a year, Lenahan said. AMR Las Vegas averages 125,000 calls annually. AMR Las Vegas responds to a call every 5.17 minutes, 365 days a year. Private companies only charge if you are transported. Seems the government tax base system is now able to charge you twice for just showing up.
Richard Trevino Richard Trevino Tuesday, July 01, 2014 7:57:56 PM Waller county EMS is already doing this. At $200.
Kiana Bee Kiana Bee Tuesday, July 01, 2014 8:18:12 PM What they will do, Mr. Macias, is call for additional support or have that information obtained and accommodated by dispatch (when possible) during the initial call. That's what happens in logical, fiscally responsible regions.
Jay Dedo Jay Dedo Tuesday, July 01, 2014 8:20:23 PM Just send a ambulance
Kiana Bee Kiana Bee Tuesday, July 01, 2014 8:24:34 PM Oh and by the way, Mr. Macias, a full arrest and a heart attack are NOT EVEN CLOSE to being the same thing. A heart attack is one of innumerable medical causes of a full arrest, not to mention the traumatic causes. I won't bring my fire extinguisher to any 9-1-1 fire calls if you don't being any of your medical expertise to my medical emergencies.
Steve Schneider Steve Schneider Tuesday, July 01, 2014 8:26:29 PM Been doing this for years
Gerry Hart Gerry Hart Tuesday, July 01, 2014 8:53:52 PM Wow...another example of how public sector math just doesn't work well! Five people responding and tying up this people resource for 20 minutes, (5 x 20 = 100 man-hour minutes). 100 man-hour minutes/$100.00 00=$1.00/minute or stated another way each man-hour is based on a cost of $.20/minute. Therefore the average man-hour cost for fire personnel is $.20 x 60= $12.00/hr.? Geez, how stupid do you really think the general public is? And please name an insurance company that will pay this "fee" as the private sector providers would love to bill for non-transports that account for nearly 30% of all their responses. What a sham!
Marge Apolito Marge Apolito Tuesday, July 01, 2014 9:03:59 PM Stock upon band aides California
Anthony Summers Anthony Summers Tuesday, July 01, 2014 9:32:17 PM I am glad you think they are over paid.... I guess the reason most fire personnel have second jobs is just to fill their off time!
Anthony Summers Anthony Summers Tuesday, July 01, 2014 9:35:56 PM One question.... Do you think a private EMS company would do it for less than $100?
Guillermo Macias Guillermo Macias Tuesday, July 01, 2014 9:41:46 PM So next time someone calls 9-1-1 because your mother is having a heart attack, let's just send two firefighter/paramedics. Once on scene, they can delay the service that your mother deserves due to the fact that there isn't enough manpower. Dispatch doesn't always know what is 'really' happening with the patient. They are solely going off of the information provided by the caller. A lot of times the caller doesn't really know what's really going on with the patient. A lot of times the patient doesn't know what's really going on either. Another scenario. You call 9-1-1 because your son fell off a balcony. The nearest fire department resource is a fire engine with four trained firefighter/EMTs onboard, but the paramedic ambulance is on the other side of town because they were transporting a patient to the hospital. Is it okay for the fire engine to stay at the station and wait for a fire while the paramedic ambulance responds to your son's aid, or would you rather have the fire engine respond to the call and treat your son while they wait for the medic ambulance to arrive on scene? When time is of the essence, the fire department 'needs' that manpower. No ands, ifs, or buts! Life is precious, we will ALWAYS do our best to save a life.
Raymond Chapman Raymond Chapman Tuesday, July 01, 2014 10:31:31 PM Obviously you have never tried to run a fire department on taxes alone. It doesn't work. You think it costs a lot with the Fire Department, privatize it and see the cost raise. Private service make up their fees with no oversight and I have seen non transport fees as high as $800.00 for a 10 minute on scene time.
Xmedic Barney Xmedic Barney Tuesday, July 01, 2014 10:41:22 PM Local agencies here are paid $75 to respond to EMS calls. Many a night they would wave as we pushed our equipment in - and drive back to the station. County paid, not patient.
John Nelson John Nelson Tuesday, July 01, 2014 11:22:48 PM Sounds like a great way for firefighters in LA to hold onto their $100k+ salaries without continuing to bankrupt California
Wednesday, July 02, 2014 12:43:48 AM Charging a response fee is nothing new. I worked for a private service for several years in MN and they would charge $75 for each response without transport.In most cases the patients' insurance would pay the charge knowing the costs associated with operating the ambulance.All this is now, is the changing financial and political structure that operates our fire and EMS systems. You can't get something for nothing anymore.....Like it or not,it's the way things are now and for the foreseeable future.
Nicholas Reynolds Nicholas Reynolds Wednesday, July 02, 2014 3:14:21 AM I was reading some of the comments below and I think that if u dot know anything about EMS u need to keep your comments to yourself and do some research before u start flapping off at the gums! Just saying!
Justin Serrecchia Justin Serrecchia Wednesday, July 02, 2014 5:22:13 AM You would be paying those guys to be sitting in the station, so you not saving any money. The problem with ems is not personnel or even managment. It's that 70% or more of the calls we run are for minor sickness or just plain abuse because people want to skip the waiting room. The last thing we should do is assume before we get there because the other 30% really need the help
Martial BrotherKnowledge Lee Martial BrotherKnowledge Lee Wednesday, July 02, 2014 5:58:28 AM This isn't a sensible argument, Mr. Macias. The simplest solution is to stop sending the engine out with the ambulance, and simply make a Rescue trucks a 3 man crew if it isn't already. Any code, any call can be run by a three man crew. Boom. Problem solved. The only time additional resources would be needed is when the patient is biggie sized or when there are multiple patients.
Anthony Summers Anthony Summers Wednesday, July 02, 2014 6:01:31 AM Ever try to work a full code with only 2 people?
Robert Munson Robert Munson Wednesday, July 02, 2014 6:49:48 AM Private for profit ambulance services shouldn't do 911. They charge ridiculous amounts compared to fire based EMS or non-profit ambulance services.
Matthew Ervin Matthew Ervin Wednesday, July 02, 2014 7:03:01 AM First time call to the address, no, second time then maybe, third time and anytime thereafter, yes....if you have to call 3-times or more for something like a lift-assist, then perhaps home-health should check on you daily, or it's time to hire a long-term caregiver. However, I do question the effectiveness bc most people won't pay, and 100 bucks isn't enough to turn over to collection.
Keenan France Keenan France Wednesday, July 02, 2014 7:05:18 AM I find the argument of having an entire fire crew responding to a medical emergency call amusing. 3 bodies can handle any med run. The military runs medivac calls with 2 Pararecuemen, or 2 flightmedics in a hostile enviroment everyday. Not saying this is remotely the same scenarios our fine public servants respond to daily as they have a multitude of other calls besides trauma calls. But my point is 2 trained and conditioned bodies can handle nearly anything. If the situation requires additional assistance odds are paramedics are also enroute anyways. No need for a full crew to roll out to every single call.
Dominick Walenczak Dominick Walenczak Wednesday, July 02, 2014 7:35:34 AM Guillermo Macias, for a "heart attack" I want a transporting unit to arrive promptly with the knowledge and equipment necessary to detect a myocardial infarction and prompt transport to a PCI center. Unless I'm having a heart attack from being on fire, I don't require anything else. If you mean cardiac arrest, I like having the fire department present for pit crew CPR. But not everything is a cardiac arrest. Knee injuries, hand injuries, fractures... so many calls that are obviously not cardiac arrests. I would be fine with the fire department responding for all Echo responses or dispatched as needed based upon dispatch information or on scene responders. Though, a recent study showed that fire department response to cardiac arrest has made little difference. http://www.ncbi.nlm.nih.gov/pubmed/9472187
Dave Cook Dave Cook Wednesday, July 02, 2014 9:10:11 AM Certain dispatches trigger fire response because they are trained in first aid, cpr, and some places the pumpers are als. Many cities have far more fire trucks that are closer to calls than the ambulance, that's why they dispatch both.
Dave Cook Dave Cook Wednesday, July 02, 2014 9:13:38 AM Medical aid and the possible need for life saving people and equipment can't be simplified down to a math equation. Fire responds usually because they are closer, time counts in emergencies. Once they are there and find out it isn't an emergency they cannot leave until the ambulance gets there, otherwise it's pt abandonment.
Gerry Hart Gerry Hart Wednesday, July 02, 2014 9:29:56 AM Dave Cook You missed my point entirely. First, the proposed $100. fee doesn't begin to address the true cost and therefore it is disingenuous on its face and 2nd it is highly doubtful that any insurance plan will cover this fee and for the fire department to say otherwise in the "selling" of this proposal is also disingenuous...again a sham and an attempt to squeeze additional revenue from the taxpayer.
Chris Mancuso Chris Mancuso Wednesday, July 02, 2014 10:21:30 AM Yes
Chris Mancuso Chris Mancuso Wednesday, July 02, 2014 10:23:17 AM They said a normal response . Pedi arrests. Adult arrests.
Kert Evans Kert Evans Wednesday, July 02, 2014 10:43:41 AM Well, Lucy, thank God you will never be in charge of a fire department. There is a reason you need 4 FF minimum
Raymond Chapman Raymond Chapman Wednesday, July 02, 2014 2:10:07 PM I'd like to know the private company that doesn't charge for showing up andnot transporting ssomeone.
Derek Dinges Derek Dinges Wednesday, July 02, 2014 5:25:35 PM Stop sending a fire truck to a medical call. Is my patient on fire? no. Then I don't need you. Save your department money.
Chris Mancuso Chris Mancuso Thursday, July 03, 2014 4:23:29 PM What is this "good" reason,Kert? Over 30 years, I can do it with 2 people 99% of the time.
Kert Evans Kert Evans Thursday, July 03, 2014 5:23:01 PM Chris, you would think being in EMS for 30 yrs you would have a clue why 4 is better than 2. But I guess not. You must be a super awesome paramedic to handle 99% of calls with 2 ppl. Good luck.
Dave Cook Dave Cook Thursday, July 03, 2014 5:46:43 PM Chris Mancuso no offense, but 30 years doesn't mean shit. I worked 12 years for a private company that did mostly transfers and a few 911 municipalities, then went to a very high volume big city and within 6 months ran more shit than than I ever saw in those 12 years. You shouldn't be responding to calls with the "99% of the time" mentality. You should be thinking of the worst. Yeah, 99% of the time 1 person can handle the run, but when it's a bad cardiac or respiratory or cardiac arrest, those extra people make all the difference getting everything together or performing high quality CPR. I don't want my 911 responders thinking - what's the minimum I can do this with....
Alan Flournoy Alan Flournoy Thursday, July 03, 2014 9:42:59 PM Are you Cal Fire! if not then whats your problem!!You must be a partimer? you Do you pay the fire TAX. because i have to pay it because i dont live in town. they tell me its to teach town pepole not to start fires Right
Lucy Koszykowski Lucy Koszykowski Friday, July 04, 2014 3:54:35 AM Private end where I am minimum I have seen 700.00 bill handed to the pt upon arrival to the Ed .the difference on how. We do things is we are dispatched to a call usually 2 emtB's and if the call we were responding to was a ALS call we have a private company that responds with us which has a ALS provider on board and also we have a county coordinator that also responds . All I was saying was we don't have ff that are certified to respond on a medical call .i just didn't understand why a fire truck was dispatched to a medical call that was all
Jesse Bell Jesse Bell Friday, July 04, 2014 5:48:19 AM Chris Mancuso Working a full code with only 2 people? I call bullshit on that.
Chris Mancuso Chris Mancuso Friday, July 04, 2014 6:56:23 AM Jes
Chris Mancuso Chris Mancuso Friday, July 04, 2014 7:02:06 AM Jesse, call what ever you want. I was there. At the time there was no one to call. In a rural area. Today I have people I can call on. My company does however have protocol to work a code with 2 peopl
Chris Mancuso Chris Mancuso Friday, July 04, 2014 7:03:40 AM I say that
John Overton Lewis III John Overton Lewis III Tuesday, July 08, 2014 4:53:37 PM Everyone's talking about money and Municipalities vs. Private providers. Everyone must understand medicare, Medicaid and private insurance does not pay the same dollar amount across the board. It depends on the area and type of service provided, not to mention the type of response/call (als vs bls) and what the complaint was. All of these factors are weighed against what the going rate in that area is. And ultimately just because a provider charges a certain dollar amount doesn't mean insurance (private or public) is going to pay it. I do not believe in charging people for non-transports. It's going to deter people from calling for situations they may assess themselves and feel are minor. Some costs have to be swallowed and this is one of them. EMS is an unpredictable mistress.
Rasheeta Ceus Rasheeta Ceus Wednesday, July 16, 2014 2:41:47 PM I think it's fair all around.

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