MCCAB Ambulance Fee support with conditions

April 27, 2010
The Honorable Nancy Floreen
President, Montgomery County Council
100 Maryland Avenue
Rockville, Maryland 20850
Dear President Floreen and Councilmembers:
I am writing on behalf of the Mid-County Citizens Advisory Board (MCCAB), to convey our general support of Bill 13-10, Emergency Medical Services (EMS) Transport Fee - Established, along with our concerns regarding certain aspects of the draft legislation.
In the past, the MCCAB has opposed the establishment of this fee. However, in light of the current fiscal situation the County faces, and with reassurances from the Montgomery County Fire and Rescue Service (MCFRS) about how fees will be collected, the MCCAB voted to support the proposal with some conditions. This decision was made at our April meeting following presentations by Fire Chief Bowers and Assistant Chief Scott Graham and comments made by representatives of the community, the Montgomery County Volunteer Fire Rescue Association, the Wheaton Volunteer Rescue Squad, the East County Citizens Advisory Board and the Silver Spring Citizens Advisory Board.
While the MCCAB did vote to support Bill 13-10, we had some concerns about the legislation as proposed. The MCCAB members felt that:
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language should be added to the legislation to clearly state that transport fee bills and/or invoices will be sent directly to the insurance company of the patient - no County resident will receive a bill for any reason.
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the phrase in subsection (h) Use of revenue, “…and in the first fiscal year this fee is implemented, …” should be deleted. The Board feels strongly that the revenues collected from these fees should be dedicated to the Fire and Rescue Service indefinitely and recommend the establishment of a dedicated enterprise fund to accomplish this.

In addition, the MCCAB supports the provision of the Bill requiring that the transport fee “…must be used to supplement, and must not supplant, existing expenditures for emergency medical services and other related fire and rescue services provided by the Fire and Rescue Service…” In November 2009, the MCCAB urged “…the adoption of EMS patient outcome measures into the County’s Fire and Rescue Master Plan….” We felt then, and continue to feel, that the establishment of EMS patient outcome measures, such as EMS patient survival from sudden cardiac arrest, would contribute to improved performance by the MCFRS. Similarly, we also believe that it is important to ensure the revenues from the transport fees are returned to the patients, through improvements to emergency medical services delivered at a regional level, rather than towards supplanting other Montgomery County Fire and Rescue Service operating costs.
Sincerely,
Sheldon Fishman
Chair
cc: Isiah Leggett, County Executive