Starting today, anyone who calls for an ambulance in Fairfax County will be charged for the service.
But before people get out their checkbooks, government officials say there are some important things patients need to know -- namely, that fees will not be collected up front, that no one will be denied service and, in most cases, that costs will be covered by the patient's medical insurance or Medicaid and Medicare.
As for those who can't pay? Officials say they won't have to.
"There will be no attempt whatsoever to submit your name to a collection agency or boot your car," Fairfax County Fire and Rescue Department spokesman Dan Schmidt said. "We won't coerce you or make you pay for something you can't afford, especially if you don't have insurance."
That's the message officials have tried to drive home, conducting a comprehensive public education campaign aimed in large part at poor and low-income elderly residents who might be discouraged from calling for help.
Jo Broadie, 64, of Lorton has no medical insurance, and she said she was concerned about the fee proposal until she got all the facts.
At first, "people totally misunderstood," Broadie said. "I didn't have a clue until I talked to people and asked questions and realized that I wouldn't be denied [service] if need be."
Under the new rules, the county will charge $300, $400 or $550 for an ambulance trip to the hospital, depending on the severity of the illness or injury, plus $7.50 per mile.
Fairfax is the latest jurisdiction in the region to charge ambulance fees. The District, Arlington County and the City of Alexandria charge for emergency medical transportation. Montgomery and Spotsylvania counties are considering such a move.
It has not been an easy decision in Fairfax, where fees have been the subject of emotional debate among those who feared that the elderly and poor would be hit hard. Others argued simply that Fairfax, one of the richest counties in the nation, could afford to provide free ambulance service.
Supervisor T. Dana Kauffman (D-Lee) initially was opposed to a fee. He said his mind was changed in part by the fiscal realities facing the county.
"Everything we're about doing these days is a focused effort to ease the impact on property taxes," Kauffman said. "Whether it's looking at hotel taxes or how fees are applied, it's basically a collective recognition that we can't continue to put it on the homeowners' back."
Based on information gathered at the hospital, patients' insurance companies will be sent a statement for ambulance transportation. Co-payment will be charged only to patients who don't live in Fairfax. For older residents, Medicare or Medicaid will be billed directly.
Patients with no insurance coverage will be sent a "request for information" that will include a waiver form. After three waiver notices are sent, the fees will be considered uncollectable, officials said.
Officials estimate that the revenue generated by the plan will be $6.6 million in the first year.
Although officials were particularly worried about a backlash, they said the outreach effort has largely allayed such fears.
Tom Garnett, a retired federal employee and Fairfax resident, said he believes that the county is right on this issue. "I pay a lot of money to Blue Cross/Blue Shield, and one of the coverages is ambulance service," Garrett said. "I've kind of fought the county sometimes, but this time it's a prudent and financially sound measure."
