New fees possible for some using EMS

Panel says nursing homes, others strain paramedics

Anne Arundel

November 14, 2003|By Ryan Davis | Ryan Davis,SUN STAFF

A committee studying Fire Department spending is weighing new fees on nursing homes, assisted-living facilities and age-restricted communities - businesses and developments that some say strain Anne Arundel County's beleaguered paramedics.

"It's something as a county that we need to take care of very quickly," said County Councilman Ronald C. Dillon Jr., a committee member, at a meeting yesterday.

The committee also is considering an overhaul of the county's emergency medical services, which Fire Chief Roger C. Simonds is credited with designing.

Simonds, meanwhile, made some of his strongest comments yet about the roots of his department's spiraling overtime budget. He said inadequate staffing was driving up overtime costs and blamed the county administration, past and present.

"I've been here for 34 years and we continually rob Peter to pay Paul," Simonds said.

Yesterday's session marked the sixth meeting of the group that County Executive Janet S. Owens formed after the department came under scrutiny for spending a record $7.2 million on overtime last fiscal year. That's millions more than other Baltimore-area counties. Simonds used some of the overtime money to complete an unauthorized warehouse renovation.

Owens asked the eight-member panel at its first meeting to determine if the county needs to hire more firefighters or paramedics. The group may be leaning toward making such a recommendation, but with the county facing a budget shortfall next year, members are seeking ways to pay for new hires.

Fees on developments and businesses that burden the county's paramedics could be an answer, the group said yesterday. Its members cited the rules imposed to help county schools.

Anne Arundel County requires that adequate space for new students be available in public schools before new housing can be built. The county also charges school impact fees.

To avoid the school adequacy requirements, several builders have turned toward age-restricted communities. Many cater to persons 55 and older. While that may ease the burden on schools, Simonds said, it strains his paramedics.

The committee discussed recommending to Owens that she charge higher paramedic-related impact fees for developers of age-restricted projects.

Nursing homes also strain paramedics, Simonds said. When they can't get adequate service from their private ambulance companies, they turn to the county for free patient rides to the hospital. The county does not bill for its ambulance service.

He added that late-night medical facilities will call the Fire Department to clear out their waiting rooms before they close.

The committee discussed charging operating fees to businesses that regularly use county emergency medical services for patients who do not have serious injuries.

Paramedics, who responded to 30,000 calls in 1998, are expected to respond to about 55,000 calls this year, fire officials have said.

While Simonds and the committee generally agreed there's a problem related to paramedic use, the chief strongly disagreed when the committee considered a recommendation to require just one paramedic - not two - to ride in an ambulance.

Simonds introduced the current two-paramedic requirement about 30 years ago, when he was a paramedic supervisor.

The county has 29 fire stations but only 15 paramedic-staffed ambulances working at a time. Replacing one of the paramedics in each ambulance with a qualified firefighter would free up additional paramedics. It would allow the department to distribute them to other stations without paramedics, possibly reducing response times, members said.

Simonds said the proposal could compromise medical care. "What we are doing now," the chief said, "is working exceptionally well."

He also told the committee to look higher than him when assessing the problems that his department faces.

Referring to paramedics who are forced to work extra shifts, Simonds said: "The only way we can fix this is more people. Overtime is not the issue."

He added, "In five years, if we don't do something to fix the system, it will fail. We're that fragile as an organization."

Sun staff writer Julie Bykowicz contributed to this article.

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