Ambulance Charges By Fairfax Criticized

Loudoun Board Might Seek Review of Plan

Loudoun County supervisors are considering asking for a legal review of Fairfax County's plan to impose ambulance fees on the patients it picks up in Loudoun.

Fairfax has a mutual aid agreement with Loudoun, meaning that the nearest available ambulance is dispatched when someone calls 911, even if it has to cross county lines. Most of the Loudoun emergency calls that Fairfax handles are in eastern Loudoun.

Fairfax officials have announced that they plan to charge fees for transporting Loudoun patients, starting July 1. The fees will range from $400 to $675, depending on the level of life support services, and an additional fee of $10 per mile will be charged.

But some Loudoun supervisors said the fees will amount to a double payment because Loudoun residents already pay a local tax for emergency services.

Last week, a Loudoun Board of Supervisors committee voted to have the full board consider asking staff members, including County Attorney Jack Roberts, to examine Fairfax's allegation that it is legally obligated to charge all ambulance users the same fees.

"The average man or woman on the street would ask, 'How could this possibly be fair?' and I need to give them a better answer than, 'Well, just because Fairfax said so,' " said Supervisor Stevens Miller (D-Dulles), whose district borders Fairfax.

The board will take up the matter at its next business meeting, July 1, Miller said.

Fairfax began charging ambulance fees to its residents in 2005. Because it receives money from the Medicare and Medicaid programs, it is required to charge the same rates to all the patients it transports, said Dan Schmidt, spokesman for the Fairfax County Fire and Rescue Department.

Fairfax bills ambulance users in all neighboring localities except Loudoun, Schmidt said.

"They're the last to come on board of all the other surrounding jurisdictions," he said.

Fairfax handled 529 emergency medical services responses and 174 ambulance transports in Loudoun in fiscal 2007, Loudoun officials said.

Fairfax imposes a fee only if an ambulance ride is given to a patient, Schmidt said, adding that health insurance typically covers ambulance fees. Those who lack insurance and are unable to pay the fee can ask to have it waived, he said.

"We have a very compassionate service," Schmidt said. "If they request a waiver, we grant that."

Miller said the Loudoun board might consider adopting the same system as Fairfax, charging ambulance users for each ride rather than imposing a countywide tax for the service.

But there are problems with that approach, he said, noting that more than 15 entities hold emergency medical services licenses in Loudoun, most of them volunteer fire and rescue companies. To avoid a logistical nightmare over billing procedures, the county would probably have to consolidate all those licenses into one county-held license, he said. Miller said he would want to take the pulse of the volunteer squads before proposing such a change.

According to a report on the ambulance issue prepared by Loudoun County staff members, "Volunteer companies . . . will voice concern that this ambulance billing may impact private donations to their respective companies."

"We don't want to do something that would be injurious to the volunteer agencies," Miller said.