It took about a minute for a San Rafael fire engine to get to the scene of a bad hit-and-run accident on Grand Avenue on Wednesday that left a 53-year-old bicyclist fighting for his life.

The ambulance wasn't there for another four minutes - but because the San Rafael Fire Department has a paramedic on every engine, someone began helping the victim right away, firefighters said.

"It's very important that every patient be assessed by a paramedic, and we can do it much quicker by providing a paramedic on the engine," said Capt. Paul Crimmins, who oversees the department's emergency medical services.

Proponents of San Rafael's Measure I on the Nov. 2 ballot have touted the department's large number of paramedic-certified firefighters and quick emergency response times as reasons to support a proposed paramedic tax increase, which they say would maintain service levels and finance new equipment and training. The hike is one of 13 paramedic tax measures that will be put to voters throughout the county.

The proposed increases in San Rafael, Marinwood and adjacent areas would raise the maximum paramedic tax from $85 to $108 for residences and from 11 cents to 14 cents per square foot for commercial properties over a four-year period.

County Service Area 28's Measure M would increase the $40-per-parcel tax by $24 in a 351-square-mile area including San Geronimo Valley, Point Reyes Station, Stinson Beach, Bolinas, Inverness, Tomales and other communities.


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In the Ross Valley Paramedic Authority's service area, which covers Larkspur, San Anselmo, Sleepy Hollow, Ross and and adjacent unincorporated areas, the proposed tax measure would keep the rate at $42.50 next year with the potential to raise it $3 each of the three subsequent years. The final rate would not exceed $51.50.

In Corte Madera rates would stay at $60 next year and increase $5 a year for the next three years.

Some opponents of the San Rafael-area measures have questioned why their paramedic taxes are higher than those in Ross Valley and West Marin, with the issue coming up at Marin County supervisors' meetings.

"We service a lot more people - we have a lot more calls and, quite frankly, we think we have one of the best services available," San Rafael Mayor Al Boro said in defense of the higher cost.

San Rafael's large number of paramedic-certified firefighters - who make up more than half of the 75-member department - also guarantee patients better care once they're in the ambulance, paramedic Bob de Lambert said.

"In the old days, I'd be the only medic there," said de Lambert, who was on the ambulance that took the injured bicyclist to Marin General Hospital on Wednesday. "En route ... we had three (paramedics) in the back, and we basically split the patient in thirds."

Ross Valley's paramedic tax may seem low compared with San Rafael's, "but it's not because we're doing anything drastically different in order to save costs here," said Bob Sinnott, Larkspur's fire chief and the Ross Valley Paramedic Authority's executive officer.

"We have one ambulance that we primarily support," Sinnott said. "Other agencies like San Rafael support many ambulances, so their costs are going to be higher."

But Ron Marinoff, a former Marinwood volunteer firefighter who filed formal opposition to the County Service Area 13 measure in Lucas Valley, wants to know why the San Rafael Fire Department's paramedic service is "twice as expensive."

Marinoff has also asked for a probe into how many firefighter salaries the paramedic tax is financing.

"They're doing something that's legal, but as far as I'm concerned borders on the immoral," Marinoff said. "They're using paramedic tax to pay the salaries of firefighters. They should use the paramedic tax to only pay the difference between firefighter pay and paramedic pay."

San Rafael's paramedic program funds 18 paramedic salaries and covers the 10 percent pay incentive 12 other paramedics receive for their certification, City Manager Ken Nordhoff said. The program has a $5.6 million annual budget, with $3.5 million coming from the city's paramedic tax and $2.1 million coming from third-party ambulance billing.

"It's a great level of service they've been providing," Marinwood Fire Chief Thomas Roach said of San Rafael. "I don't think it's unjustified how they pay for those positions. One of the reasons their costs are higher is there are more paramedics in Service Area B than, say, in the Ross Valley area."

In his argument, Marinoff also called the tax increase "a thinly veiled attempt to take over the Marinwood Fire Department." Meanwhile, a second group has filed an opposition argument accusing San Rafael of trying to solve its budget shortfalls at the expense of Marinwood residents.

"The basic concern is that we the Marinwood community are already subsidizing the San Rafael Fire Department to the tune of about $300 per household per year, and why should we subsidize them further?" said Walter Dods, a former Marinwood board member who signed the Measure Q opposition argument.

San Rafael and Marinwood officials have been in talks about a reverse services agreement that would put San Rafael in charge of the Marinwood fire station - but it remains unclear whether that will move forward.

About $13 or $14 of the proposed $23 tax hike would fund three paramedic positions in Marinwood should a merger happen, Nordhoff said.

Bill Hansell, who serves on the Marinwood Community Services District board, said he didn't sign the argument for the tax hike because of that uncertainty.

"Personally, I've put a lot of time into the fire negotiations with San Rafael, and the final aspect of the paramedic tax has been an important part of the negotiations," Hansell said. "I see potential benefits, but it's all based upon where the fire negotiations go."

- Measure C: Continues Corte Madera's parcel tax for paramedic and emergency medical services at a rate of $60 per residence and $60 per 1,000 square feet of floor area for nonresidential uses for fiscal 2011-12, increasing $5 a year to a maximum $75 per residence and $75 per 1,000 square feet of floor area for nonresidential uses in 2014-15.

- Measure D: Continues Fairfax paramedic parcel tax at $42.50, rising to a maximum of $51.50 in the fourth year. The tax per residence, or per 1,500 square feet of structure of each developed parcel in nonresidential use, is in addition to ambulance fees charged to insurance providers.

- Measure E: Continues Larkspur paramedic tax at $42.50, rising to a maximum of $51.50 in the fourth year. The tax per residence or per 1,500 square feet of structure of each developed parcel in nonresidential use, is in addition to ambulance fees charged to insurance providers.

- Measure G: Continues Ross paramedic tax at $42.50, rising to a maximum of $51.50 over four years. The tax per residence or per 1,500 square feet of structure of each developed parcel in nonresidential use, is in addition to ambulance fees charged to insurance providers.

- Measure H: Continues San Anselmo's paramedic tax at $42.50, rising to a maximum of $51.50 in the fourth year. The tax per residence or per 1,500 square feet of structure of each developed parcel in nonresidential use, is in addition to ambulance fees charged to insurance providers.

- Measure I: Boosts paramedic taxes in San Rafael up to $23 annually, to a maximum of $108 per residence and up to 14 cents per square foot on nonresidential structures.

- Measure J: In County Service Area 13 in Marinwood, boosts paramedic services $23 a year to a maximum of $108 per residence.

- Measure K: In County Service Area 19 in San Rafael, boosts paramedic services $23 a year to a maximum of $108 per residence.

- Measure L: In County Service Area 27 in unincorporated Ross Valley, continues special paramedic tax at $42.50, rising to $51.50 in the fourth year. The tax per residence or 1,500 square feet of structure-developed parcel in nonresidential use, is in addition to ambulance fees charged to insurance providers.

- Measure M: In West Marin's County Service Area 28, boosts the $40 paramedic tax by $24 annually.

- Measure O: Continues Kentfield paramedic tax of $42.50, rising to $51.50 over four years. The tax per residence, or 1,500 square feet of structure developed parcel in nonresidential use, is in addition to ambulance fees charged to insurance providers.

- Measure Q: In Marinwood Community Services District, boosts paramedic taxes $23 a year to a maximum of $108 per residence.

- Measure R: In Sleepy Hollow, continues paramedic tax of $42.50, rising to a maximum of $51.50 over four years. The tax per residence or per 1,500 square feet of structure-developed parcel in nonresidential use, is in addition to ambulance fees charged to insurance providers.

Contact Jessica Bernstein-Wax at jbernstein-wax@marinij.com


Read more Election stories at the IJ's Election section.

Marin County paramedic tax measures