By Andrew Edwards
San Bernardino County Sun
SAN BERNARDINO, Calif. — To Edward Poffek, paying $200 for paramedics when he already pays taxes is just ridiculous.
A 30-year resident of San Bernardino, Poffek never had to call 9-1-1 for medical service until Sept. 16 of last year.
The first time he ever heard of the charge was when he got the bill in November.
“I refuse to pay,” he said. “I’m not going to pay it. They can take me to court. They can file a lien.”
“The Police Department doesn’t charge if I call 9-1-1. It’s a public service,” Poffek said later.
Charging for emergency medical services has become an increasingly populary way for local governments to shore up their budgets.
Loma Linda’s city council joined San Bernardino and Montclair by approving a similar fee in February, resulting in a wave of public outcry. In response, Loma Linda is taking up the issue again and will discuss possible changes to the program during its meeting tonight.
But unlike Loma Linda, fire officials in San Bernardino and Montclair said the charges were instituted, not in response to any specific budget troubles, but to account for the increased expense of advanced paramedic services.
San Bernardino residents can pay an annual paramedic subscription of $24 or $200 per paramedic response. The billing system has been in place for at least 10 years, and the council reduced the response charge from $250 in 2006, said Bernard Horak, the Fire Department’s emergency medical services coordinator.
The fee can be waived for low-income residents, Horak said.
Fire departments typically receive more calls for medical attention than actual fires, but the billing structure in San Bernardino and some other cities appears to be based on the premise that advanced paramedic services go above and beyond fire departments’ traditional duties.
San Bernardino added paramedic services in 1977, but that decision was not matched with a commensurate increase in funding, Horak said.
The department has since grown from two paramedic squads to nearly 70 paramedics aboard a dozen engines, a hook-and-ladder and a single paramedic squad.
Paramedics, unlike less-trained emergency medical technicians, are able to insert breathing tubes into patients and deliver intravenous medication.
Horak said San Bernardino paramedics have recently taken on training to detect heart attacks with what’s called 12 lead EKG technology and to deliver medication directly into the bone marrow if a patient’s lungs are collapsed.
“We have a drill now that will allow you to get right into the bone,” Horak said.
In Montclair, Fire Chief Troy Ament said his department took on advanced paramedic work in 2001. The subscription fee program was created at that time to pay for the new work, which was previously handled by a contractor.
San Bernardino publicizes its paramedic subscriptions by occasionally putting notices in water and trash bills, but the charge has surprised Poffek and others.
“Anytime somebody receives a service it can be a difficult realization,” Horak said.
Horak said fire officials to again publicize the charges during the fiscal year that begins July 1. Ament similarly said Montclair officials are working on a new marketing plan for their paramedic subscriptions.
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