Second Thoughts: Paramedic fees Exhibit A of new normal
by Jon Mendelson
Jun 19, 2009 | 3868 views | 41 41 comments | 14 14 recommendations | email to a friend | print
Two weeks ago, I wrote that we should expect a “new normal” when it comes to government, that our much-discussed financial troubles could very well leave us with “reduced services and an increased cost for the services that remain.”

Earlier this week, we got to meet Exhibit A.

When the City Council agreed 4-1 to charge a fee for receiving paramedic service from firefighters — what opponents might call a doorstep of death fine — residents of Tracy got to see firsthand how quickly the times are a-changin’.

The price for Tracy Fire Department-provided “advanced life support,” as City Manager Leon Churchill put it, will be $300 for Tracy residents and $400 for nonresidents.

The idea has merit, but we’ll get to the city’s side in a minute. First, let’s turn to the residents who, from all indications, are preparing torches and pitchforks for a run on the council chambers.

I get the initial anger. At first glance, this looks like a plan to profiteer off the sick and dying, to stopper a budget gap with the misfortune of others.

The umbrage is especially understandable if you consider, as Councilman Steve Abercrombie told me Wednesday, that people expect their taxes to pay for fire department services — all of them.

“Citizens expect police and fire when they live in a city,” said the only council member to vote against the fees, “and so I had a problem voting an additional tax on them, (making them) pay for that service that they should expect when they move into a city.”

When there’s an emergency, people don’t think about the cost of calling 9-1-1. Or at least they shouldn’t have to.

I favor universal health care because the value of your life should not be judged by the thickness of your wallet. The service provided by medical professionals benefits the whole community, which is why the whole community should pay for it.

But it follows, then, that cutting the budget for such service would hurt the whole community. This is where the city’s side of the story gets told.

From the perspective of city staff, the new fees are about protecting the quality of service residents have come to expect.

According to Churchill, the decision “provides insulation” to emergency response in a time when drastic reductions are the typical order of the day.

(Note that the money generated by the fees will go to the city’s general fund. Churchill said there’s an ethical understanding the money will “protect service from being reduced,” but I know of no in-writing guarantee.)

As for the idea that Tracy’s economic uncertainty fund — $25 million and falling fast — could have provided that padding, it was a possibility. But, as Churchill told me, that fund was designed with the idea an economic turnaround would be measured in months, not years.

As we know, that thought now belongs in Fantasyland. Tapping the reserve more than necessary “would just accelerate the date those funds would be exhausted,” Churchill said, bringing closer the day of to-the-bone cuts, possibly even to police or fire service.

So, instead of across-the-board tax increases or taking a knife to community protection, the city reasoned that those who use the paramedic services of the fire department should pay to ensure those services remain up-to-snuff. Call it a compromise between “user pays” and “social responsibility.”

According to the city manager, the number of people affected is relatively small — about 2,000 each year out of Tracy’s 80,000.

He also told me that the fee won’t be charged every time the fire department rolls to medical calls, which make up the bulk of fire crew responses. Only in “advanced life support situations” — heart attacks, lost limbs, etc. — in which the fire department provides intensive medical care would the fees be charged.

As for how those folks pay the city, Churchill insists there’s flexibility.

“The service is going to be provided,” he said. “…We’ll deal with how it gets paid for later.”

Insurance, if you have it, will cover you. If you don’t, there are payment plans and other options. If you really can’t afford it at all, there’s a chance you won’t have to pay at all.

And there’s always the up-front “insurance” option.

“(The policy) is not draconian,” Churchill said, though it does sound somewhat amorphous.

When all is said and done, Churchill hopes the city’s decision will prove a success.

He has some insider knowledge on the matter. Reading, Penn., site of his previous city manager gig, had a similar fee.

“It went over very well,” he said, noting that plenty of other cities choose to charge for such services instead of slash them.

Bottom line, when it comes to this City Council decision, there’s reason to complain. But there’s also reason to accept.

Like it or not, this is the new normal. No one said it was going to be easy.

• Share your thoughts with columnist Jon Mendelson at jmendelson@tracypress.com.
Comments
(41)
Comments-icon Post a Comment
JerryAutricity
|
June 24, 2009
who cares

$300 to caler 911 N ordre a taco wit hipetita

we cares

offtoworkigo
|
June 24, 2009
He knows
fortheunderdog
|
June 24, 2009
Who the heck is "Jerrrkkkkkkkkkk?"
JerryAutricity
|
June 23, 2009
neigbor , hint 911

why , too late it already happened

work , whatever
ConcernedNeighbor
|
June 23, 2009
My biggest concern is people "second guessing" themselves in calling for help for other people, better make it very crystal clear to the Tracyites on what they could expect so no time would have been lost in getting aid to anyone.
why?
|
June 23, 2009
Hey LEon, this is a lawsuit waiting to happen!
ConcernedNeighbor
|
June 23, 2009
How will the schools be charged if they call the paramedic for their students? Will their parents pay?

Church? Sporting events...Grand Theatre?

Shopping Centers, Mall, many places where people could go into distress and require medical attention... where and who would be responsible for these costs?

Just too headachy confusing!

ConcernedNeighbor
|
June 23, 2009
Leon Churchill is overpaid, period!
offtoworkigo
|
June 23, 2009
Jerkkkkkkkkkkkkk

Let me be a mindreader.

"I do not work for the gov."

Again, NUFF SAID
offtoworkigo
|
June 23, 2009
Jerrrrrrk

I see that you are really good at cutting and pasting your posts. Can't come up with anything original?

With people like you running the gov. it's no wonder we are in such a mess.

Oh ya, NUFF SAID
offtoworkigo
|
June 23, 2009
Jerrrrrk

Sounds as though you want to make sure that all options are left open, all windows are left cracked - for the politicos to slip in new taxes.

Which branch do you work for?
ConcernedNeighbor
|
June 23, 2009
Better incorporate plans when the Transit stations opens? Incorporate plans for when the Mococo line is in full operation? How much planning was made with that in mind?

Chemical spills on freight shipments?

Emergency plans in place for evacuations in Tracy?

So far, I feel there isn't one?

Cost factor in the planning of such event?

The missing two million dollars from his last city sure would take care of things here? Wink!

JerryAutricity
|
June 22, 2009
Wilderness , Just cuz some rich loser goes skiing at resort and gets lost and found in the frostbite and now you want us all to believe that we the taxpayers have to pay for his stupidity. No AB 1004 certainly not fair. Nuff said.
JerryAutricity
|
June 22, 2009
This bill would prohibit a public agency from

BELOW HAS BEEN HERETOFORE REMOVED ------

imposing a

fee or seeking reimbursement for any expense of an emergency response

for any other reason, if the fee or reimbursement is imposed absent

a finding or assessment of fault and is based upon the residence of

the persons involved making residency a

determining factor in determining liability for purposes

of

SECTION ABOVE HERETOFORE BEING NOW REMOVED

seeking reimbursement for the expenses of any emergency response

/////////////////////////////////////

LATEST REVISION AS PUT FORTH BELOW

\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\

This bill would prohibit a public agency from seeking reimbursement for the expenses of any emergency response

JerryAutricity
|
June 22, 2009
Duh Wouk YaGo , The same road as any county city fed state etc Yada Yada Yada Power to th poeple Ya Ya Ya Ya - Yaba Daba Doooo

Wilderness , LEGISLATIVE COUNSEL'S DIGEST

AB 1004, as amended, Portantino. Local government: emergency

response.

Existing law specifically authorizes a public agency to charge any

person who is under the influence of an alcoholic beverage or drug,

whose negligent operation of a motor vehicle, boat or vessel, or

civil aircraft causes an incident that requires an emergency

response, who makes a false police report, or who intentionally,

knowingly, and willfully enters into an area that is closed to the

public or drives a vehicle on a street or highway that is temporarily

covered by a rise in water level, the reasonable expenses of an

emergency response to the incident.

This bill would prohibit a public agency from imposing a

fee or seeking reimbursement for any expense of an emergency response

for any other reason, if the fee or reimbursement is imposed absent

a finding or assessment of fault and is based upon the residence of

the persons involved making residency a

determining factor in determining liability for purposes

of seeking reimbursement for the expenses of any emergency response

.
offtoworkigo
|
June 22, 2009
When the city started to dip into it's savings to balance the budget, they were following in the footsteps of the State. It is obvious that we are going down that same road.

We need a council that can make the cuts that will give us a balanced budget without making the citizens of Tracy pay more taxes.

This council is incapable of accomplishing that goal. Most of them are typical politicians that have held office for far too long and have gotten too comfortable in their positions.

We need to make it loud and clear that we will not accept tax leves of any sort from them. This is only the first of many attempts to nickle and dime us until we have nothing left (that time has already passed for a large percentage of taxpayers).

Are we to sit silently while the council flexes it's muscle over our heads?

Always remember - Power Corrupts
mnwild
|
June 22, 2009
Fortheunderdog:

There is an Assembly Bill -- AB 1004 -- under consideration that would make it impossible to charge different fees for service to residents versus nonresidents. This won't eliminate the charges just voted on, but it will just make it "fair". This may or may not have an impact on the Council's vote given there is a question about folks in Mountain House and the County serviced by Tracy Fire paying the same fees those of us within city limits are forced to pay.

Unfortunately AB 1004 went back for further revision, and it doesn't look like it will be up for consideration again before 2010. Also, the League of California Cities (of which I'm sure Tracy is a member) is pushing hard against AB 1004, and they have major political clout, so the bill may never be passed. But if it is passed, at least our out of town guests won't be discriminated against. (Lucky them, they too will be "allowed" to pay $300 for Fire Dept. response!!! Unless of course they go to a neighboring town with no fee for service to spend their $$$$!)
why?
|
June 22, 2009
The 911 operator will be legally bound to inform the caller of the charge - Is this why the town Leon came from, booted his --- out of town?
why?
|
June 22, 2009
911-(operator)Be advised - city of Tracy will charge you for ouremergency response-We accept VISA/MC,debit cards and your American Express. Please give us your card information before we send and emergency crew. The city of Tracy thanks you having your medical emergency within the city limits - Please feel free to dial 911 in the future!
mnwild
|
June 22, 2009
Last time I looked, TFD doesn't own ambulances. They could respond as they do now, but someone else would have to do the transport. That company would most assuredly have paramedics in their ambulances. This will once again result in double billing for medical calls and my having to pay the bill that isn't covered or the City's new annual "insurance" fee.

I wonder if this new fee for service is meant to add funds to the general fund so when the contract with AMR runs out the City will have sufficient funds to run its own ambulance service as was done in Reading, PA -- the City Manager's previous city. Makes you think!


We encourage readers to share online comments in this forum, but please keep them respectful and constructive. This is not a space for personal attacks, libelous statements, profanity or racist slurs. Comments that stray from the topic of the story or are found to contain abusive language are subject to removal at the Press’ discretion, and the writer responsible will be subject to being blocked from making further comments and have their past comments deleted. Readers may report inappropriate comments by e-mailing the editor at tpnews@tracypress.com.