By Bill Brubaker
Washington Post
Copyright 2007 Washington Post
WASHINGTON — It’s been a part of Loudoun life for as long as anyone can remember: the no-fee ambulance ride.
But with the county’s coffers expected to take a huge hit in 2008, largely because of declining property values and lower revenue from real estate taxes, some officials are considering charging for rides to the hospital.
“A lot of jurisdictions do it,” Budget Manager Ari Sky said. “You could structure it in such a way that you could bill the individual’s insurance for the ambulance fee. And people who do not have insurance would not be charged.”
No decision has been made on whether to include an ambulance fee measure in the 2009 budget proposal, which will be unveiled in the spring, Sky said. And there probably will be strong opposition if a fee is proposed. The Board of Supervisors would make the decision.
“Charging a user fee for emergency services just rubs me the wrong way,” Supervisor James Burton (I-Blue Ridge) said in an interview Friday.
Ambulance fees could bring in as much as $3 million annually, Sky said. That would help soften a budget shortfall that is projected to be $251 million for fiscal 2009 if the real estate tax rate remains the same and the board approves all of the school system’s spending proposals, county officials said.
Charging for ambulance pickups has been considered — and rejected — by previous boards. The idea also is opposed by some volunteer fire and rescue companies that provide the free service to county residents and that rely on them for donations.
“There is some concern on the part of volunteer companies that an ambulance fee could affect their ability to fundraise,” said Ben Mays, Loudoun’s deputy chief financial officer.
Some county residents “have a perception that if they know they are going to get charged for a transport they may not be as free to donate money,” Mays said. “I mean, I could see why it would cause that concern for the volunteer companies.”
Company leaders say an ambulance fee could result in a double whammy to fundraising efforts. Some are concerned that a decision by the board this year to create a tax district to pay for fire and rescue services has dissuaded potential donors from writing checks.
This year, for the first time, property tax bills displayed two numbers, one for general taxes and another for fire and rescue taxes. The figures previously were combined.
With the creation of the tax district, some would-be donors have begun questioning whether the volunteer companies need additional funds.
“It’s had an impact. It would be a lie to say it hasn’t had an impact” on fundraising, said Robert W. Ritchie, president of the Purcellville Volunteer Rescue Squad. “I have been answering a lot of e-mails and a lot of inquiries from the public as to ‘Why should I donate?’ I mean, they don’t word it so harshly. But essentially that’s what they want to know.”
Mike DeBaise, president of the Hamilton Volunteer Fire Department, offered a similar assessment.
Burton, who was the board’s leading advocate for the fire and rescue tax, said he will reverse his position if the volunteer companies are having trouble raising funds.
“If that’s the case, I’m more than willing to reconsider,” he said. “We will discuss this in the upcoming budget exercise, and I’m not above changing my mind on it.”
As for ambulance fees, county officials say they have been studying what other jurisdictions in the Washington region have been doing. Most, they have found, are charging fees, ranging from $200 to $550 per call.
Some Loudoun officials seem interested in the Fairfax County model, in which ambulance charges are billed to the patient’s health insurance program. The uninsured may apply for a waiver on grounds of hardship.
“If you have insurance, you are probably already paying for ambulance service,” Mays said. “It’s probably already built into your premium, and the insurance companies expect this to be part of any treatment you have.”
Ritchie said he hopes Loudoun doesn’t imitate Fairfax, which he calls “big brother.”
Burton said he’s prepared to fight any attempt to impose ambulance fees. “Well, they can look at it all they want,” he said of the county’s financial administrators. “But they don’t make that decision.”