Council Committee Tables Ambulance Fee in Montgomery

By Ann E. Marimow
Washington Post Staff Writer
Friday, October 24, 2008

Montgomery County Council members yesterday shelved County Executive Isiah Leggett's plan to create an ambulance transport fee after an onslaught of opposition, particularly from senior citizens in the politically powerful community of Leisure World in Silver Spring.

Montgomery's neighboring jurisdictions, including the District and Fairfax and Prince George's counties, charge for ambulance service. Leggett (D) stressed that his plan was designed to charge health insurers, not residents, as a way to increase funding for fire and emergency services.

But opponents, encouraged by the county's volunteer firefighters organization, contended that any charge might discourage residents from calling for help. Leaders of the volunteer organization, who say charging for service is fundamentally at odds with their mission, declared victory yesterday after the Public Safety Committee's action.

Eric Bernard, executive director of the Montgomery County Volunteer Fire and Rescue Association, said his members would move to discourage Leggett from reviving the bill. "The message is clear: This is done. Don't bring it back again," he said.

The three-member committee's unanimous vote to postpone action on the measure complicates Leggett's plans to close a projected $250 million shortfall for fiscal 2010. Leggett has said he will not seek to exceed the county's limit on property tax revenue, and he was counting on $13.8 million from the proposed fee to help balance the books.

Despite the committee vote, Leggett said he would continue to press the council to create a fee because he wanted to avoid severe budget cuts.

"We have to get it done at some point. The sooner the better," Leggett said. "If we don't do this, the consequences and difficulties and challenges we have will just multiply."

Under the legislation, county residents would not be billed, even if they don't have health insurance, and they would not be responsible for a co-payment or deductible. An insured patient who does not live in the county would be billed for a co-payment or deductible but could seek a waiver. The fee would range from $300 to $800, depending on the service provided, plus $7.50 per mile traveled.

The call for a timeout in the debate came after it became clear that there were not five votes for the bill on the nine-member council. There were conflicting interpretations of the committee action. Assistant Fire Chief Scott Graham said it was not a setback but a signal to keep working to address the concerns of residents about billing, paperwork and reimbursements.

But Public Safety Committee member Phil Andrews (D-Gaithersburg-Rockville) said the bill was unlikely to garner enough support on the council to be resurrected.

"They had the chance to make their case, and they haven't been persuasive," Andrews said of the Leggett administration. "It may well not be over, but I think it is dead. I think they are in denial."

Putting off action on the fee also affects discussions with union leaders about rolling back or deferring pay raises. John Sparks, president of Montgomery County Career Fire Fighters, IAFF Local 1664, said his members would be less willing to accept reductions if the council is unwilling to raise money in other parts of the budget.

"That message is the wrong signal to be sending to employees," Sparks said after the vote yesterday.

For at least six months, Leggett and his aides have been lobbying the council and residents to support the fee. The fee has been promoted in more than 30 community meetings, bilingual brochures and a YouTube video.

Leggett's team made the case that the fee was necessary to keep pace with demands for ambulance service from a population nearing 1 million and that opponents would essentially leave money on the table that other local governments collect from insurance companies, Medicare and Medicaid.

In recent weeks, the measure appeared to have gained traction with council members. But the volunteer firefighters organization turned up the pressure after winning over the Democratic Club of Leisure World.

Last weekend, two dozen volunteer firefighters handed out 1,500 fliers urging Leisure World residents to call council members. The president of the club, Jordan Harding, wrote to the council that the fee "creates unsettling concerns among those who use the ambulance service the most, our senior population."

Leisure World is the largest Democratic precinct in the state, and "when they say something, you listen," said committee member Don Praisner (D-Eastern County).

Volunteer firefighters also announced this week that they would seek a referendum on the ambulance fee if the council passed the legislation. A referendum would coincide with the 2010 council elections, and many members do not relish the idea of defending their seats and an unpopular fee at the same time.

Committee member Marc Elrich (D-At Large), a supporter of the fee, moved to table the bill yesterday. He said he hopes that his colleagues will come around as they confront tough choices to make up the budget shortfall.

Elrich also said he would try to counter what he called "misinformation." A flier distributed by volunteers, for instance, does not disclose that the legislation is intended to charge insurers, not residents.

"There was nothing we could do at this point to effectively change the public perception," he said. "I think it's shameful to call a bunch of elderly people and scare them."