The Haines Borough plans to restart discussion of charging for ambulance service.

“(The Haines Borough Volunteer Fire Department is) on target to have the busiest year that they have had and not only is it busy, but the severity of the calls is much higher than it used to be, and so we are starting to have conversations about billing for ambulance services,” interim manager Alekka Fullerton said at an assembly meeting earlier this month.

“We are looking into those costs, what it would mean and what we can do to cover people who do not have insurance,” Fullerton said. She didn’t offer specifics for when or in what form the discussion will take place.

At present, ambulance service is funded through a half-percent sales tax.

“In a normal year, we collect enough sales tax revenue to pay for the service, but we’ve kind of had a triple squeeze: Sales tax revenue is down because of COVID-19; there are more volunteers who are reluctant to respond because of exposure, so we’ve been more reliant on paid staff; and each call takes more time because they have to do extensive decontamination (as pandemic mitigation),” borough chief fiscal officer Jila Stuart said in an interview Monday.

The pandemic-driven trends—decreases in volunteers and revenue, and an increase in calls for service—are present nationwide, and have been taking their toll on ambulance service providers, according to a recent New York Times article.

This isn’t the first time the idea of charging for ambulance service has come up in Haines. Every few years, in an effort to increase borough revenue, discussion begins anew. In 2010, staff were directed to look into how other Alaska communities cover ambulance costs in the wake of a $41,000 deficit for the service, according to CVN archives. In 2017 the topic was, again, revisited.

Whenever billing for ambulance service has come up in the past, fire and ambulance volunteers have come out in opposition, concerned that charging per call could deter people from requesting help when they need it.

Longtime fire department volunteer CJ Jones said her sense is that this feeling hasn’t changed. “In general, we don’t support it,” she said.

Fire chief Al Giddings confirmed that the borough has directed the department to look into the matter. He emphasized that the idea didn’t originate with the department and that starting a discussion is very different from deciding to move forward with billing for ambulance service.

“It’s not a light switch you just turn on. The discussion is at the very beginning,” he said.

Some issues that require consideration before billing could be implemented include coverage for people who don’t have insurance and administrative costs associated with fee collection.

According to a 2017 CVN article, a number of communities in Southeast cover ambulance costs by charging a fee per call and covering deficits with general fund dollars. The fees are typically based on Medicare and Medicaid reimbursement rates, which range from $300 to $800 depending on the level of need.