Ambulance Service

SEARCHING for ways to pay for growing demand on its strained paramedics-ambulance service, an Anne Arundel task force recently considered charging an impact fee on developers of nursing homes and other group living facilities for seniors. The same idea surfaced in Carroll County discussions. There's no question that the growing segment of older residents disproportionately increases demand on emergency medical services; local demand is magnified by concentrations of seniors in group living facilities.

In a way, the problem with Harford County's ambulance service, which appears to be running in the red these days, according to a recent presentation to the Harford County Council, is emblematic of the problems facing the U.S. health care system. The short version: There's a lot of money involved and a lot of people who aren't directly involved in providing health services have a financial stake in what's going on. The long version is complicated and mind-numbingly detailed, but worth taking the time to understand.

The cost of being transported by a city ambulance to a hospital is going up -- but not as much as originally proposed.Baltimore's Board of Estimates yesterday unanimously approved an increase in fees from $75 to $150 for basic ambulance service, and from $100 to $250 for advanced life support transport.Two months ago, the Baltimore Fire Department, which operates the ambulance service, proposed increasing both fees to $475, the maximum acceptable level under federal guidelines, to ease the service's strain on its budget.

The thing that's odd about Harford County Executive David R. Craig seeking access to the financial records of the volunteer fire companies that serve the county as a condition of getting government funding is that it's taken so long. It's been decades since the volunteer fire companies that serve Harford County have been obliged to arrange carnivals and other fundraisers largely because a substantial portion of the volunteer fire service's money comes from government and government-enabled sources.

A proposal to impose a fee for ambulance service -- at least for patients with health insurance -- has been rejected by the County Council amid uncertainty about how the measure would be implemented. However, the idea proposed last year by County Executive Janet S. Owens will remain under study by the administration, which is studying such concerns as the cost of billing, the legality of seeking fees only from some users, and elderly riders' receiving bills and worrying about paying for the service.

Baltimore's fire chief has given up on a controversial idea to privatize the city's ambulance service, pleasing the heads of unions representing paramedics who warned such a move could cost lives.Chief Herman Williams Jr., who headed a board that examined the proposal, said through a spokesman yesterday that a private company could not provide emergency response cheaper than the city does for $8 million a year."Based on bids submitted, there is no cost-savings to privatize the ambulance service," said Battalion Chief Hector L. Torres, a Fire Department spokesman.

The squabble over billing for ambulance services flared again Monday, when the Carroll County Firemen's Association gave the Reese station 30 days to rescind its decision not to charge for emergency medical service or risk losing county funds, officials said yesterday.In February, the Reese membership voted contrary to the county commissioners' recommendation that fire companies bill residents' insurance companies for ambulance service. Eleven of the county's 14 fire companies have begun the billing.

The Carroll County Firemen's Association, in an effort to improve ambulance service in north Carroll, has allocated $69,000 to pay for emergency medical service positions at the Manchester and Lineboro volunteer fire departments.The money makes it possible for Manchester to continue to provide weekday ambulance coverage and will allow Lineboro to ensure that such coverage is available in its service area.Over the past five years, most of Carroll's 14 volunteer fire companies have found it necessary to hire emergency medical service workers to provide ambulance service during daytime hours, when volunteers frequently aren't available.

INDIVIDUAL DECISIONS of four volunteer fire companies to charge for ambulance runs this year underscores an inevitable change in the delivery of emergency medical services in Carroll County.Sooner rather than later, the other 10 volunteer companies will have to charge for their ambulance runs, even if the membership is divided over such fee-for-service operations. That will have a serious impact on the philosophy of volunteer fire/emergency service that has prevailed in Carroll for more than a century.

The County Commissioners and leaders of Carroll's volunteer firefighters association reached partial agreement yesterday on the touchy question of billing insurance companies for ambulance service.The commissioners agreed to give the Carroll County Volunteer Firemen's Association a year to implement a proposal from Robert Cumberland Jr., association second vice president.But the association did not agree to support the commissioners' plan to have the county go forward with a proposal of its own if Cumberland's proposal fails.

An article in the Aug. 12, 1911 edition of The Argus reported on damage from a severe storm. Lightning struck the home of Mr. Emil Fisher, Smithwood avenue, last Friday night, causing damage of several hundred dollars. The bolt struck the roof near the chimney and entered the house, ripping the plaster off several rooms. No one was injured. The home of Mr. Fisher was struck by lightning about six weeks ago in the same place. *****' Rabbits and partridges are said to be more plentiful than for a number of years.

Since its inception in Harford County, ambulance service has been provided by proud and dedicated volunteers, mostly those associated with the volunteer fire service. With the relatively small shift of $2.2 million in the county's budget of nearly $609 million, the county government is poised to change decades of tradition, hopefully, for the better. A reality of modern medicine is that emergency medical services require highly-trained people. Though a core of volunteers in Harford County has been up to the challenge of taking on this training, their numbers have been far too few to keep up with the demands of the county's citizenry.

Officials at the state prison complex in Jessup are requesting emergency ambulance service for inmates who are not sick or injured enough to merit locally funded transportation to hospitals, a Sun review of Anne Arundel County records shows, raising concerns among fire officials that county services are being improperly used. One of every four 911 calls that the county Fire Department has responded to in Jessup in the first eight months of the year appears to have been for non-life-threatening injuries, according to call data reviewed by The Sun. Under the Fire Department's policy, only inmates who are at risk of dying are supposed to be taken to hospitals in county ambulances.

Battalion Chief Martin C. McMahon, who transformed the Baltimore City Fire Department's Ambulance Service and played an important role in the development of mouth-to-mouth artificial respiration and closed-chest massage, died of a heart attack Feb. 5 at a Lewes, Del., nursing home. He was 94. "He was a pioneer and known nationwide for improving pre-hospital care, bringing first-aid courses to firehouses and was at the very beginning of the Maryland Emergency Medical System," said Division Chief Donald W. Heinbuch.

When Carroll County commissioners unanimously approved a plan yesterday to distribute nearly $2 million in emergency medical funds to the county's volunteer firefighters, they ended months of debate over how to spend the money. The plan is designed to beef up round-the-clock ambulance service by giving more money to stations to hire additional personnel. It gives $190,000 each to stations that already receive county money for overnight ambulance personnel: Westminster, Sykesville, Taneytown and Manchester.

Volunteer firefighters in Union Bridge are the biggest winners in a reworked proposal to distribute nearly $2 million in county money for emergency medical services to Carroll's volunteer fire departments, according to a breakdown of the plan obtained by The Sun. Union Bridge Volunteer Fire Company is to get $190,000 -- $130,000 more than it would have in the original plan -- according to the documents. The most recent plan, designed to beef up round-the-clock ambulance service in the county, was approved at a closed-door meeting this month by the Carroll County Volunteer Firemen's Association, which has refused to release details of its proposal.

Since its founding in 1948, the Reese & Community Volunteer Fire Company has helped pay for its battles to extinguish fires and save lives through ham and oyster suppers, bingo games, Christmas tree sales and a six-day carnival generating thousands of dollars each year. But a proposal to start billing customers for ambulance service threatens to upset this fund-raising equation and create a rift between Carroll County's volunteer fire companies. Like other communities across the country facing growing populations and dwindling numbers of volunteers, Carroll County is asking all its fire companies to charge fees for ambulance calls.

Members of the Reese volunteer fire company have vowed to resist any demand from the county firefighters association to force them to charge a minimum $200 fee for ambulance service. Jerry Dayton, president of the Reese and Community Volunteer Fire Company, said his company will go to court if necessary if the association withholds its county funding for ambulance service. Tempers flared at the monthly association meeting last night after Dayton said, "You have been strong-arming us and hounding us to begin billing.

SEARCHING for ways to pay for growing demand on its strained paramedics-ambulance service, an Anne Arundel task force recently considered charging an impact fee on developers of nursing homes and other group living facilities for seniors. The same idea surfaced in Carroll County discussions. There's no question that the growing segment of older residents disproportionately increases demand on emergency medical services; local demand is magnified by concentrations of seniors in group living facilities.

Two public hearings are scheduled to precede Tuesday's Harford County Council meeting, and four bills are scheduled to be introduced during the business meeting. At 6:45 p.m., a hearing is scheduled on two bills in the Chesapeake Critical Area Management Program. One seeks to change zoning and correct a mapping error on the Perryman peninsula, where a marina, restaurant and residential development is planned by Gablers Shore LLC, while the other seeks to change zoning for the Bush River Yacht Club property on Long Bar Harbor.