Charges for using EMS: a California town’s plan sows confusion

The residents of Tracy, California, will soon be receiving a form in the mail to choose how they want to pay for an emergency medical service cost recovery fee program.

They will not – as has been widely reported – be charged a fee of $300 for merely dialing 911. The cash-strapped town approved the new law last June and has faced considerable confusion among residents who have misunderstood the policy’s parameters. As late as this week, city council member Mike Maciel went on the “Fox and Friends” morning show to defend the program alongside an irate resident, when he realized through the on-air introduction that the show had gotten it wrong.

“Journalists have been ringing our phones off the wall and even our town residents didn’t understand what we did, which shows the effects of viral misinformation,” says City Manager Leon Churchill. He and Mr. Maciel explain that the city of 80,000 copied the language from a law already adopted by 17 other California cities, including Fullerton and Costa Mesa. “Yes, we are having financial problems like all of California, which is up to its neck in debt because of the economy," says Mr. Churchill. "But for some reason, this has morphed into reports that every time you dial 911, you get charged $300, which is untrue.”

In fact, the town says it has bent over backwards to accommodate its citizens by allowing them to subscribe to the service for $48 per household per year, $36 if the household is low-income. The $300 fee is charged only if the first responder, in this case with the fire department, administers medical treatment. Maciel explains that the city already had a private ambulance service, and wanted to augment that with a fire department that also had medical personnel.

“The good side of this is if the fire department arrives, they have someone who can go into lifesaving mode,” says Maciel. “We felt this was a significant improvement over what we had.”

In a phone interview, Maciel and Churchill explain how the city has cut $7 million from its budget, and laid off 80 over 4 years – 40 in the past 12 months alone – to fill major gaps produced by the loss of property tax revenue.

The idea to improve the emergency service came when the town had been flush with cash. Existing tax revenue only covered the infrastructure of having a 911 system, not costs associated with medical attention given as a result.

The town has growing pains. Through the 90s Tracy's population grew by about 70 percent. It is estimated that in the first five years of this decade the population of Tracy has grown another 40 percent.

The EMS cost recovery program could be implemented as early as April. But the fees have already sparked wide debate well beyond the city and state. Experts say the move spotlights several concerns about the costs of maintaining 911 systems.

The nation’s 41-year-old 911 network has of late been besieged by stories of million-dollar-software crashes, sloppy dispatchers, and too many “victims” who call the number to report their own child’s refusal to go to school.

“The plight of local governments is real, and the action by the Tracy, California government will serve to call attention to how dire the situation has become,” says Robert Field, professor of law the Earle Mack School of Law at Drexel University in Philadelphia.

But people within government say the cost of purchasing 911 technology, maintaining the equipment, and paying staff to oversee it is a long-term cost.

In Sedgwick County, Kan., fire chief Ron Blackwell said in August, 2008 that he was "increasingly concerned" about a new $1.5 million computer-aided dispatch (CAD) system which firefighters complained wasn’t reliably alerting them to incidents.

And up to 80 percent of 911 calls in the US are non-emergencies. In Hayward, Calif., police charged a man in February, 2008 for making 27,000 false calls to 911. California that year passed a law that levies up to $250 fines against even legitimate callers who call more than once for the same emergency.

Tracy's Churchill says more municipalities will wrestle with funding 911 services in the future. "I don’t doubt the financial stress of 911 systems, which are used as the family doctor in some communities. You can call 911, get ambulance service, go to the front of the line at the emergency room, and not pay – for a headache."

A bill signed into law by President Bush on July 23, 2008, created the nation's first national 911 oversight board. It was intended in part to move the national system from analog to Internet Protocol (IP), which is less expensive and capable of handling new technology standards

And Richard Laermer, who has written a book “2011: Trendspotting,” says the trend is not as new as most people might think.

“911 is a system that's been strapped for years, as have fire departments and the emergency medical types,” he says.