By Dave Forster
The Virginian-Pilot (Norfolk, VA.)
SUFFOLK — Diane Whitmore needed help when she dislocated her hip at home in January 2007, so her friend’s daughter called 911.
The ambulance came fast. The bill for $366 came nine months later.
“I thought, ‘What in the world is this?’ ” recalled Charles Whitmore, Diane’s husband.
Suffolk had recently joined most other Hampton Roads cities and started charging for ambulance trips. Charles Whitmore, a shipyard foreman, paid up after the second bill arrived .
“I thought if I don’t pay it, when I need it again they won’t come,” he said, half joking.
What Whitmore didn’t know then is sort of an open secret now in City Hall. It’s something the fire chief and mayor and others would like some people to know about the ambulance fees but can’t legally tell them.
The city doesn’t try very hard to collect .
The matter surfaced last week , when Councilman Leroy Bennett asked staff to explain the collection policy on the fees, which began in September 2006 and brought in about $900,000 last year.
Some of Bennett’s constituents had complained , and he himself was under the impression that the fees were only to target insurance companies.
Fire Chief Mark R. Outlaw told the council that the city’s billing company sends up to three notices on each account. The last two are bills.
“Then it stops unless the city decides to go forward,” Outlaw said.
Mayor Linda Johnson asked if the notices explain that uninsured people don’t have to pay the fee.
“Legally, I don’t believe we can do that,” Outlaw said.
If people don’t have the means to pay, it’s up to the city to take action if it wants to collect, “which I do not recommend and do not believe we would do,” Outlaw said.
But the city can’t advertise that, he said.
Bennett then put City Attorney Ed Roettger on the spot. He asked what he can tell the next constituent who calls to complain.
“Can I legally tell them, if they don’t have insurance, they don’t have to pay it?” Bennett asked.
Roettger didn’t want to say much in the public forum.
“If we’re going to discuss this at great length, I think we probably ought to do it in closed session, but I wouldn’t tell them,” he said.
Wary of the legal tightrope he must walk, Deputy Fire Chief Brian Spicer chose his words carefully when he tried this week to explain what happens after the second bill.
“Right now, that will be the end of what they will receive,” he said. “We do not have in place a collections process.”
That said, the city does want people who can afford it to pay, Spicer said.
City Manager Selena Cuffee-Glenn stressed at the council meeting that no one will be denied ambulance service if they don’t pay a bill.
Other South Hampton Roads cities that charge for ambulance rides take court action to collect on some accounts, although they appear to vary on how aggressively they pursue the money. Virginia Beach, which relies on an ambulance service staffed mostly by volunteers, does not charge.
In Norfolk, the finance department will work on delinquent accounts to set up a payment plan, said Terry Bishirjian, a city spokeswoman. If the city isn’t satisfied with the outcome, it will take the matter to court, she said.
Norfolk began putting more of an emphasis on collecting its fees about five years ago, Bishirjian said. The city now collects about $3.1 million a year - about 30 percent of the total amount billed, she said.
Chesapeake looks at employment records to determine if someone should be able to pay, Treasurer Barbara Carraway said.
She recalled “just a few” cases in which the city went as far as issuing liens against employers to collect on outstanding balances.
Like Norfolk and Chesapeake, Portsmouth will grant hardship exemptions for people who show they can’t afford to pay. But other delinquent accounts will be sent to the treasurer for collection through liens and garnishments, said Portsmouth Battalion Chief Ron Early.
“We try to collect 100 percent of every account,” Early said. “We’re not here just to collect insurance money. We try to actively pursue every penny on the accounts because that is fair and consistent.”
Portsmouth recovers between $1.2 million and $1.5 million a year on its fees, which amount to about $3.5 million annually, Early said.
The Suffolk City Council voted to allow the fees in 2006. Bennett said he recalls being told the fees would only seek to recover insurance money, and that even people with coverage would not be asked to pay for any part of the bill their policy didn’t cover.
Outlaw said the billing is a “very successful program” that saves taxpayers money. The revenue goes into the city’s general fund.
Spicer, the deputy fire chief, said he will meet next week with the city’s billing company to discuss creating a hardship exemption.
The fee is not popular among the city’s volunteer rescue squad, which has seen donations fall drastically since its inception. Rusty Hundley, a deputy chief with the Nansemond-Suffolk Volunteer Rescue Squad, said at least one person calls every day to complain about a bill.
Donations fell to about $52,000 in 2007, down from about $93,000 in 2006, Hundley said.
Hundley said the revenue does not benefit their unit because none of it is earmarked for them.
Dennis Craff, a city spokesman, said the group does benefit from the fee, since they get much of their funding from the city’s operating budget. Meanwhile, the Department of Fire and Rescue is taking over more and more of the ambulance duties from the volunteer squad, which now staffs only one station on nights and weekends, Spicer said. That extra responsibility is a big reason why the fire department’s budget has risen to about $12.5 million in 2006 from $5 million in 2000, he said.
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