MARTINEZ -- Contra Costa County could soon charge fees for some emergency medical calls to reduce a budget shortfall under a proposal by the fire chief that was endorsed in principle Tuesday by the board of supervisors.

Fire suppression, rescue and medical response services provided by the Contra Costa County Fire Protection District currently are financed mostly with property taxes. With the fire district facing a projected deficit of $10.2 million in its $106 million fiscal 2014-15 budget, officials are looking for alternative funding sources.

The proposed fees could generate about $1 million a year.

An ambulance leaves the scene of a shooting in San Ramon on Sept. 18, 2013.
An ambulance leaves the scene of a shooting in San Ramon on Sept. 18, 2013. (Jim Stevens/Bay Area News Group archives)

Fire Chief Jeff Carman proposes a first responder fee of slightly more than $400 for the assessment and treatment of medical patients. He estimated there would be ¿just under 2,500 fee payments a year.

The fee would not include transport, a service that is provided under contract in Contra Costa County by American Medical Response.

The fee would be billed to a patient's health insurance provider. MediCal and Medicare do not pay assessment fees under current legislation. The fire district's report cites a section of the California Health and Safety Code that allows districts to charge fees commensurate to the cost of providing services.

Some fire districts in the Bay Area and elsewhere in the state already charge medical response fees, according to the report and other sources.


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  • The Sacramento Metropolitan Fire District charges a first responder fee of $275.58.

  • The Novato Fire Protection District bills a $425.16 first responder fee to health insurers when it provides the service outside its boundaries.

  • The Orinda-Moraga Fire District, which also provides transport, charges an assessment fee of $316.50 when it performs patient assessment and the patient refuses services.

  • The San Ramon Valley Fire District charges insurers $450 per incident

    when a district ambulance provides emergency medical services and the patient declines transport, said spokeswoman Kimberly French.

    The board instructed the county staff to draft a first responder fee ordinance but did not set a date for a public hearing.

    Contact Tom Lochner at 510-262-2760. Follow him at twitter.com/tomlochner