• County Question A: Emergency Medical Services Transport Fee on the Ballot
• It's All About Saving Lives... (English pdf | Spanish pdf)
• Ambulance Reimbursement: Yes to saving lives (English pdf | Spanish pdf)
• Visit montgomerycountymd.gov/emstransportfee
• A Vote for Ambulance Fees is a Vote for the Poor - Washington Post (10-10-2010)
• Ambulance fees still make sense (10-6-2010, Gazette)
• Memo from Executive to Council on Filling $14 Million Budget Hole (10-5-10 | PDF | 314KB)
• "Leggett proposes cuts if ambulance reimbursement is killed: 11 Ambulances, 107 Fire & Rescue Personnel" - Wash. Post (10-6-10)
• Washington Post Urges 'YES' Vote on Ambulance Reimbursement (10-4-10)
• Montgomery League of Women Voters Supports Emergency Transport Fee
• Area Fire Chiefs Back Ambulance Fee - Washington Post (10-22-2010) (pdf)

“Given our already tight budget, any further cuts will echo across the County. Our obligation is to maintain a balanced budget. If residents vote against the ambulance fee, they will be voting for $14 million in cuts to services.”

-- Montgomery County Council President Nancy Floreen

County Question A: Emergency Medical Services Transport Fee on the Ballot

On November 2, voters will have the opportunity to vote either for or against County Question A: Emergency Medical Services Transport Fee. Below is the sample wording for County Question A as it will appear on the ballot:

What does this mean?

A vote FOR will allow the County to bill residents’ insurance companies, Medicare or Medicaid for ambulance transport.  County residents would not pay anything additional.  Residents without medical insurance would not be billed.  Montgomery County Fire & Rescue Service will continue to serve anybody in need, regardless of ability to pay.

A vote AGAINST would mean the County could not seek reimbursement from residents’ insurance companies, Medicare or Medicaid for ambulance transport and the County would continue to pay the full cost for all.  Montgomery County Fire & Rescue Service will continue to serve anybody in need, regardless of ability to pay

Statement by County Executive Ike Leggett On Council Approval of the Ambulance Reimbursement That Will Save Lives at No Cost to County Residents. (See Statement)

Montgomery County’s Emergency Medical Services (EMS) are world class and it is important that we do everything possible to keep them that way. Unfortunately, it’s not easy as we are facing increasing resource demands and decreasing revenue due to current fiscal constraints.

County residents will not pay anything under the new fee. The fee will be billed directly to residents’ insurance companies, which have already factored the cost of patient transport into their rate schedules. The fee will be waived for uninsured County residents.

On June 10, 2008, County Executive Isiah Leggett introduced to the Council Bill 25-08: Emergency Medical Services Transport Fee - Imposition which will allow the Fire and Rescue Service to impose and collect a fee to recover costs generated by providing emergency medical service transports from health insurance companies. On May 19, 2010, the successor Bill 13-10 passed and was signed into law by County Executive Isiah Leggett.

The choices were clear. Either a dedicated revenue source was needed to help keep our emergency medical services first class or taxes would have had to be increased to make up the difference.

Up until now Montgomery County was one of the few jurisdictions in the region that was not already collecting ambulance reimbursement from insurance companies, Medicare, and Medicaid.

Ambulance Reimbursement will keep our emergency medical services strong. It is projected to raise $14 million and net $12.7 million in the first full year of operation and an estimated $170 million over the next ten years. One hundred percent of the net proceeds will be dedicated to meeting the rising costs and increasing resource demands, and to fund enhancements. New fire apparatus, additional staff, new stations in the growing upcounty area, and incentives for volunteer opportunities will all be supported by the EMS fee.

Ambulance Reimbursement has the support of the County Senior Citizen Fire Safety Task Force, the International Association of Fire Fighters, Local 1664, the Montgomery County Uniformed Career Officers Association, the East County Citizens Advisory Board, and the Montgomery County Education Association, among others.

See editorials from the Washington Post and the Gazette in favor of Ambulance Reimbursement.

Adrienne Lees, Silver Spring, MD —

"Being a retired Emergency Room Nurse, I was opposed to the ambulance fee proposal when I first heard about it. After reading and talking with people and getting the facts, it is clear to me that this proposal has been given thoughtful consideration and every concern that people might have has been addressed. I strongly support the ambulance fee proposal and it should be enacted the sooner the better."

LeRoy Oettinger, Brookeville, MD —

"...I believe that the one true measure of a fire and EMS department's effectiveness in delivering emergency service to the community is the amount of time it takes from when they call 911 to the arrival of help. This response time is critical in effectively treating a medical emergency or beginning the attack on a hostile fire. Both station location and staffing levels contribute to the overall response time. Bill 25-08 will insure now and for the future that response times will decline as service improves.

Over ten years ago, I and others attempted to convince fire and government leadership that failing to charge for EMS service was, in fact, leaving money on the table. The timing for this was not right and the idea didn't go very far. At the time there was no County Fire Chief and the service was much more divided than today.

The opponents used the same arguments then as they will now about people being hesitant to call for fear of being charged for the service. I had staff check with jurisdictions that charge for this service and they found no reduction in call load.

It is certainly an idea whose time has come and I applaud your submitting the legislation."