EMS pact still intact, attorney maintains

County officials say fire companies can charge for services

February 04, 1999|By Mike Farabaugh | Mike Farabaugh,SUN STAFF

Carroll's volunteer fire companies are not violating a mutual aid agreement with neighboring jurisdictions by charging out-of-county residents for emergency medical services, county officials said yesterday.

County attorney Laurell Taylor said she disagreed with Baltimore County Executive C. A. Dutch Ruppersberger's interpretation of the 1989 agreement between Carroll's volunteer fire companies and Baltimore, Harford, Anne Arundel and Howard counties and Baltimore City.

Ruppersberger said Carroll's new policy of charging for emergency medical services violates terms of the agreement, which specifies that the jurisdictions would not charge each others' residents for services. He has promised to push for legislation blocking Carroll from charging Baltimore County residents.

However, Taylor said the agreement not to charge fees among the parties does not prevent billing of residents or their insurance companies.

Carroll's billing practice began Jan. 1 because of rising costs and an increased number of calls for emergency medical service, said fire and emergency authorities.

Carroll Commissioner Donald I. Dell said yesterday he opposes Baltimore County's attempts to block the volunteer fire companies from billing recipients of emergency medical service.

"The Volunteer Firemen's Association in Carroll, which finds it necessary to bill for emergency medical services, is separate from the government," said Dell. "But I support their efforts 100 percent."

In a letter Tuesday to the Carroll commissioners, Ruppersberger said he was "disturbed" that the Hampstead volunteer company was billing Baltimore County residents for medical services.

Ruppersberger said billing for mutual aid services could mean Carroll's emergency medical personnel would lose immunity under the state's Good Samaritan Act.

The Hampstead fire company notified Carroll and Baltimore County residents of the change last month. But Ruppersberger said the company failed to give 90-day written notice of its intention to withdraw from the mutual aid agreement.

Taylor said the 90-day notice was required if a party wanted to withdraw from the mutual aid agreement. The Carroll County Firemen's Association has not expressed any intention of withdrawing from the mutual aid agreement, she said.

Taylor also said that charging fees for medical service does not jeopardize the immunity guaranteed under the Good Samaritan Act.

Bob Alexander, president of the Carroll County Volunteer Firemen's Association, said members believe Ruppersberger might be misinformed about what is actually occurring.

Eleven Carroll County volunteer fire companies began billing for emergency medical services Jan. 1, Alexander said. Harney does not operate an ambulance. New Windsor and Reese are not billing.

"Those companies are not billing individuals, but their insurance companies or Medicare, which do pay for emergency services according to the level of aid," said Alexander.

Alexander estimated that the average billing is $300.

"In emergencies where IV [intravenous] lines are used to administer drugs, care must be given by those with a higher level of training and can be very expensive," he said.

In some instances, no bills are sent, said Alexander, explaining that an ambulance crew might be called for a splinter in a child's foot. If the parent has no car and the child needs to be transported to the hospital to have the splinter removed, the crew takes the child and no one is billed, he said.

"Nor is one sent if a crew responds for a homeless person," he said.

Carroll crews responded to nearly 1,700 out-of-county calls last year, Alexander said. He said he hoped to soon have accurate figures to reflect how many of Carroll's responses were to Baltimore County.

Baltimore County made 109 responses into Carroll County last year, said Elise E. Armacost, a spokeswoman for Ruppersberger. Baltimore County officials were unable to determine immediately how many of those responses were for emergency medical service, she said.

Half of all emergency medical service calls to Hampstead might be for Baltimore County, Alexander said. He did not have Hampstead's statistics.

"Baltimore County has no ambulance crews based in its northwest corner," Alexander said. "That makes Hampstead the closest emergency provider for Upperco, Arcadia, Boring, Glyndon and Butler."

A spokesman at Baltimore County's emergency communications center said the nearest ambulance service in the northwest sector of Baltimore County is in Reisterstown or Hereford.

Officials in both counties said emergency medical service would continue to be available while the mutual aid issue is being resolved.

Pub Date: 2/04/99

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