In an effort to increase tax revenues, the Haines Borough Assembly is discussing billing for ambulance service, a charge opposed by ambulance and fire volunteers.
Many communities in Alaska charge a fee when a person calls an ambulance and also pay for their emergency medical services from their general fund.
The fees, typically based on Medicare and Medicaid reimbursement rates, range from $300 to $800 depending on the level of need.
In Haines, the borough charges half a percent of sales tax for medical service and deposits those monies into a special fund.
The borough received $268,000 from the half-percent tax this fiscal year. Money raised by the tax goes into a medical service area fund, which also pays for local emergency planning and a portion of dispatch costs.
In the coming year’s budget, money transferred out of the medical service area fund includes $10,000 toward a future ambulance purchase and $44,500 to pay for half of the installation of e911 equipment.
Skagway offers a subscription fee for ambulance service. Individuals can pay $10 and receive free service for a year. Couples pay $25 and families pay $20. Otherwise, customers pay $350 for a basic life support call and $500 for an advanced support call.
Petersburg charges a flat $300 fee but is currently looking at increasing its rate. The borough brings in around $34,000 in ambulance fee revenues.
Petersburg Borough Manager Steve Giesbrecht said the borough’s ambulance fees “don’t cover anywhere near the cost of ambulance services.” A private company manages fee collection and can better handle billing issues and medical confidentiality laws.
Ambulance captain Al Badgley told the borough assembly during a budget work session that he’s against billing for service, partly because it may influence a person’s decision to call for help.
“I had the wife of a person who died of a heart attack in the back of our ambulance say they would have called two hours earlier but they did not want to call because they did not think they could afford the ambulance. They did not know the ambulance would not bill,” Badgley said. “That still sticks with me 25 years later.”
He added other communities in Southeast Alaska don’t fund their ambulance services with sales tax.
“If we took that half percent out we would go bankrupt,” Badgley said. “We could not afford to do it. I’m all for the half percent sales tax, but I am not for billing for ambulance calls.”
He said the half-percent tax already provides money for ambulance service costs and questioned where additional ambulance fees would go.
“I don’t have a problem with potentially charging if our ambulance service needed more money, but we have more money than we need,” Badgley said.
Haines emergency medical services responds to between 250-300 calls a year, Badgley said.
A representative from a private ambulance service in Wrangell said they respond to roughly 350 calls a year. They also charge between $300 to $500 for service.