Supervisors Target Paramedic Fee


An ambulance owned by Lynch Ambulance Service of Anaheim.

The fate of a $388 fee charged when Orange County Fire Authority paramedics respond to an emergency call was called into question Tuesday, with two county supervisors showing strong opposition to its very existence.

“The taxpayers pay for service. They deserve it when they finally need it,” said Chairman Shawn Nelson.

“It’s kind of an insult” to send a bill, he added.

Supervisor John Moorlach called the fee “double taxation,” and at one point wondered aloud whether he and his colleagues should try to cut or eliminate the fee altogether.

“Why am I being charged twice, when I’m paying for the whole infrastructure?” Moorlach asked.

The advanced life support or ALS fee is charged to people transported by ambulance, with the money going to the Fire Authority for its paramedic response.

The fee, which is in addition to those collected for the private ambulance service, amounts to $4.5 million per year for the Fire Authority.

Fire Authority officials have said the fee recoups only 60 percent of their marginal costs for paramedics.

Supervisor Pat Bates was comfortable with the fee and worried aloud that if the county doesn’t include the fee collection in upcoming ambulance contracts, the Fire Authority could try to pass on to the county its costs for collecting the fee.

“If they’re already 40 percent underfunded,” Bates said, supervisors would be “adding another assignment to them."

But in Nelson’s view, the Fire Authority is simply playing budget games.

“It’s not a reimbursement,” Nelson said. “It’s just an opportunity to get some more money.”

Supervisors ended up delaying a decision on the issue until their March 25 meeting.

The debate comes as county officials gear up to take over ambulance contracting from the county Fire Authority in 19 cities.

That came as the result of a state determination that the county had improperly allowed the Fire Authority to oversee the process.

As part of its new role, the county must submit a proposed request for bids, known as an RFP, for state approval.

State officials are requiring that the contract be awarded to the highest-ranked bidder, possibly cutting out county supervisors from the decision.

That didn’t sit well with Supervisor Todd Spitzer.

“All we can do is either accept the recommendations or throw them out,” Spitzer said. So he suggested that supervisors themselves serve on the review panel.

“The board needs to talk about whether we should be on the panel, plus some experts,” Spitzer said.

“That way at least we’ll be able to weigh in” on who will provide service in our areas, he added.

Nelson disagreed. He said the state is tired of seeing the highest-ranked firms not getting contracts because of a “lobbying effort” by a lower-ranked firm.

So the state isn't really cutting decision-makers out, Nelson said. Instead it wants supervisors to set up “a righteous process” that they stick with.

“That’s completely valid, and we need to go through that,” said Nelson.

The county is also being required to develop an emergency management plan, with three community meetings planned to gather public comment.

The ALS fee is currently $387.50 and was raised to that level last September by supervisors.

While they're in charge of raising the fee, it’s unclear whether the supervisors have the legal authority to eliminate it entirely.

Please contact Nick Gerda directly at  and follow him on Twitter: @nicholasgerda.

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