In an 8-1 vote, the Long Beach City Council approved a First Responder Fee that would charge $250 to residents who use the Long Beach Fire Department for medical services. The measure is aimed at offsetting a projected budget shortfall of nearly $11 million next year.
LBFD Chief Mike Duree said that nearly 85 percent of the department’s calls relate to emergency medical service. Of the annual cost of over $22 million to provide those services, only about $11 million is accounted for in the department’s budget.
The vote makes the First Responder Fee effective immediately. However, it also calls for the city manager to return to the city council within 30 days with more information on a fee waiver plan for residents. It also called for a subscription fee that could be added on to a utility bill, with an opt-out clause. This subscription would offer an alternate means of levying the fee. A similar program is currently offered by the City of Anaheim.
Duree said the “paradigm has completely changed," in regard to the types of services carried out by the department and others across the country. He said the fees were common throughout the state, as emergency medical services were meant to be a fee for service amenity and are not accounted for by general funds and property taxes that go toward the cost of actual firefighting.
“Property taxes pay for the fire department’s fire suppression vehicles like fire engines and fire trucks,” Duree said. “The act of firefighting, hazardous materials, taking cats out of trees, that’s what your property taxes pay for. Nobody should think that their property taxes are paying for paramedic services.”
The fee would place the city’s department near the bottom in regard to other departments throughout the state polled by city staff in the process of identifying the amount to charge patients in the Long Beach. The Alameda County Fire Department charges a First Responder Fee of $433, Anaheim charges $350 and the Sacramento Metropolitan Fire District charges $276.
Duree said that over the first year it’s expected that about $1.8 million could be generated by the fee, of which about $200,000 would be needed to allocate for additional costs in billing. He said that by initiating the fee, the city will open itself to increased future revenues from state legislation that will reimburse emergency responders for portions of services provided to Medi-Cal patients, as long as the municipality was charging for the service before the introduction of the anticipated law.
The department doesn’t plan to spend the funds generated in the first year of the program, instead, it will use it as a data point for projecting future revenue patterns provided by the fee so it can better integrate it into its fiscal budget. After that, funds generated by the first responder fee would go toward resuscitating portions of the department shut down by budget cuts.
Multiple council members raised concerns of how it might negatively impact residents in their districts, and if instituting such a fee could result in less people calling 911 to avoid paying the fee. Ultimately, First District Councilwoman Lena Gonzalez was the lone vote against the fee, but that didn’t stop the rest of the council from raising their apprehensions to passing the fee.
“As city management says, winter is coming and we know that there are a number of tough decisions that need to be made by the city council in the years to come,” said Ninth District Councilman Rex Richardson. “I have some concerns about how this might impact disadvantaged communities as we move forward.”
Seventh District Councilman Roberto Uranga voiced similar concerns about the community he serves. He raised the idea of the subscription fee, much like the one in Huntington Beach and Anaheim, that charges residents monthly through their utility bills to cover the cost of the First Responder Fee.
“My district is very diverse as you may know; I have high income, middle income, low income families there,” Seventh District Councilman Roberto Uranga said. “I also have the highest level of senior citizen housing and those are real concerns of mine that it might affect my residents.”
Duree likened the fee to a toll road because residents would only “pay for it if they use it.” That logic prompted several questions about if the fee could act as a barrier to emergency service and whether or not other cities had witnessed declines in 911 calls because of the institution of fines.
In his discussions with the department in Sacramento, Duree said that there was a decrease in calls but only among those who were high propensity users of the current system. He said that it was communicated to him that because the fee is applied toward insurance, for the most part the fee didn’t serve as a deterrent, something he hopes doesn’t happen in Long Beach. He noted that people can decline the types of service that would trigger the fee
“If someone needs to call 911, we encourage them to do that. I don’t ever want anyone to not call 911, but the way this fee works is if the firefighters and paramedics get on scene and we actually find a medical cause to do an assessment on somebody or medical cause to actually treat somebody, with their consent obviously, then the fee would be applied,” Duree said.
Deputy City Manager Tom Modica said there are already provisions in place to protect those who are unable to pay the First Responder Fee in the form of a hardship waiver but also pointed out that residents are already charged upward of $1,200 to be transported to the hospital, the fee would just be an additional charge.
Those with insurance would need to provide documentation to the city so that the fee could be billed to the appropriate party. For those who are not insured or are unable to pay, it was indicated that the fee would not be collected in advance of filing for a fee waiver, something that is expected to be evaluated on a case-by-case basis.
However, East Village resident Jack Smith took issue with the idea of the hardship waiver, as well as the opinion that the fee would not serve as a deterrent. Smith said that after he received a large bill for medical services provided, he has since opted against calling 911. He also questioned the hardship waiver process, labeling it as time-consuming and possibly embarrassing, due to the intimate details needed to prove a person’s qualifications for the waiver.
“The hardship process is cumbersome, I’ve been through that,” Smith said. “It’s a lot of paperwork, it’s a lot of time, you reveal a lot of yourself to city staff that maybe you don’t care to reveal.”
With the vote, the fee became effective immediately. However, concerns about a possible subscription fee are expected to be addressed at a future council meeting.
Above, left: file photo.