Montgomery County Executive Isiah Leggett (D) on Monday introduced amendments to a bill that would reinstitute an ambulance fee struck down by referendum in 2010.

Volunteers with the Bethesda Chevy Chase Rescue Squad transport a patient on Oct. 28, 2010, in Bethesda, Md. (Jahi Chikwendiu/The Washington Post)

But volunteer firefighter groups in the county have opposed the fee because they say it would make residents hesitant to call for assistance and could drive up insurance premiums. (County spokesman Patrick Lacefield said that the ambulance fee is too small to have an impact on insurance premiums. He added that because many other local jurisdictions have an ambulance fee in place and because insurance companies set premiums regionally, the premiums theoretically have already been raised.)

After dueling campaigns that involved hundreds of volunteer and career fire and rescue personnel, the original law, approved by the County Council in 2010, failed in referendum. Some volunteer firefighters have vowed to bring the current bill to referendum if it is approved.

Leggett said he’s okay with that, because the county needs the extra revenue. He said he expects that changes in state school funding will create substantial costs to the county in the long term. County officials said Monday that the bill could bring in $8 million in fiscal year 2013 and $94 million over the next six fiscal years.

“I think it’s right to go back to the people and say, ‘Are you ready to reconfirm it?’” said Leggett at a town hall meeting in Friendship Heights last week.

Still, the referendum has made council members hesitant to vote for the law again, council officials say. So the Leggett administration is trying to woo legislators by amending the bill. Among the amendments he has proposed are the creation of a patient advocate to provide customer service to patients and requiring semiannual reporting concerning the program.

Meanwhile, county officials have been meeting with county residents to persuade them to support the bill. In sometimes divided votes, several citizen advisory boards, which advise Leggett and the County Council, have voted to support the legislation. And county officials are bringing in officials from nearby counties to publicly support the bill.

Still, some council members, such as Council member Phil Andrews (D-Gaithersburg-Rockville) oppose the bill. “I think it would be potentially a career-ending move” for council members who voted for the bill, he said.