# Castle Hills to charge for 911 calls



## MMiz (Feb 17, 2009)

*Castle Hills to charge for 911 calls*

Forget your one phone call from jail. Castle Hills city leaders unanimously passed an ordinance that says you get one free phone call for EMT help once a year. It's called the First Responder's Fee. If you call 911 and EMT's respond to your house more than once in the same year, you'll be charged a $55 fine. City leaders say the goal is to recover some of the response costs, and to stop the overuse of the system. 

*Read more!*


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## lcffemt (Feb 17, 2009)

Wow, is this for real? I can see some benefit of it, cutting down on the abuse. I wonder if this apply to nursing homes too?


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## JPINFV (Feb 17, 2009)

I hope it doesn't include SNFs or other care facilities. I can see it now, "Sorry, we didn't call 911 for your grandmother who is currently having a life threatening case of acute pulmonary edema. We ran out of funding for the $55 response fee."


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## daedalus (Feb 17, 2009)

I think its a good thing!


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## medic417 (Feb 17, 2009)

Great idea.  Might be another way to help fund paid EMS.  I shall have to keep it in mind when I teach others how to convert from volunteer.


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## Doug (Feb 17, 2009)

Just one more fee that will be ignored by those who abuse the system and another deterent to those who really need it.
  "so, why did your father get into the car and attempt to drive himself to the hosp with crushing chest pain then go into SCA and have an accident resulting in the death of 2 others?"  "He said his insurence didn't cover the $55 fee."
   Why is it called a fine, BTW?  Do these folks truly believe that only creatins call 911 more than once a year?  If they do this they better not accept any money from the town taxes.  THAT is double dipping and if I can't do it neither can a town.


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## Doug (Feb 17, 2009)

medic417 said:


> Great idea.  Might be another way to help fund paid EMS.  I shall have to keep it in mind when I teach others how to convert from volunteer.



You want your towns folk to rebel and not fund you at all, you go ahead with that plan, friend.


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## Doug (Feb 17, 2009)

PS when is the fine collected?  PSS with fines you are allowed to appeal, can you appeal this?  PSSS What happens when my neighbor asks me to call 911?  Do I say "Sorry, I'm saving it for me and my family."


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## VentMedic (Feb 17, 2009)

$55 is cheap compared to what some FDs charge.

http://alamedasun.com/index.php?option=com_content&task=view&id=4707&Itemid=10
*Costly Difference Between Emergency, Inconvenience* 

Written by Dennis Evanosky Published: Thursday, 12 February 2009 




> An alarm sounds; a fire engine and ambulance race to a reported fire. When they arrive, the firefighters and paramedics learn that there is no emergency. A homeowner forgot to clean the lint from her clothes dryer. The lint overheated, the homeowner saw smoke and, in a panic, dialed 911 to report a "fire."


 


> According to Kurita, AFD's response to calls varies from a single unit to a full first-alarm. The current full-cost hourly rate for a single unit with three personnel is $339. This includes the base salary for one fire captain, one apparatus operator and one firefighter.
> 
> The fee also takes into account a 30 percent add-on to cover benefits and an 18 percent administrative overhead fee. Under the ordinance, the complete cost for a full first-alarm of three engines, two trucks, one ambulance and one chief officer is $2,118 per hour.
> 
> If the call exceeds one hour, the fee will be adjusted pro rata, and the property owner will be billed the appropriate amount.


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## redcrossemt (Feb 17, 2009)

As others said, this city's frequent fliers calling for attention won't pay (what are you going to do - stop responding?) and people who need assistance due to chest pain won't call.

I assume the first responders are currently at least somewhat paid for by taxes. If there's such support that the board approved it unanimously, why not try for increased millages? Or why doesn't the city transport itself to pay the bills? Why are the first responders needed in the first place? Are they FR, BLS, ALS? What are their response times? What are the response times for the transporting agency?

This city could specify to their transporting agency a requirement for response times in their contract to avoid providing first response services. If the transporting agency isn't making great times, maybe it's time to contract with a different agency, transport themselves, or to make an agreement to collect a portion of each transport bill for their services.

I have lots of questions and no answers. Is there anyone here from that area that can help?


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## redcrossemt (Feb 17, 2009)

VentMedic said:


> $55 is cheap compared to what some FDs charge.



The Alameda FD only charges when the fire is due to neglect resulting in a fire. Makes sense. Our local departments, including police, fire, and emergency management, charge thousands of dollars per hour for response at at-fault or neglect-caused incidents - like haz-mat spills, transportation incidents, etc.

Castle Hills is going to charge for every medical call, regardless of emergency, transport, etc.

Maybe they shouldn't charge on accidents... like sports injuries... but should charge for neglect-of-health caused illness... like heart attacks due to obesity/high cholesterol.


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## VentMedic (Feb 17, 2009)

redcrossemt said:


> The Alameda FD only charges when the fire is due to neglect resulting in a fire. Makes sense. Our local departments, including police, fire, and emergency management, charge thousands of dollars per hour for response at at-fault or neglect-caused incidents - like haz-mat spills, transportation incidents, etc.


 
Alameda FD already charges for its ambulance service just like many privates in addition to the taxes for Fire each citizen pays. In addition to that, Alameda's little community hospital got into financial problems a few years ago and created a City of Alameda Health Care District with an annual parcel tax of $298. Of course, unless you are at the mercy of the FD ambulance, a resident of that little city will go to San Francisco or Oakland for healthcare. Even the FD ambulance will transport to the trauma center in Oakland if the patient meets criteria. 

&shy;


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## redcrossemt (Feb 17, 2009)

I'm interested... Does anyone know of any non-transporting services that charge for first response on medical calls? I'm especially interested in first response BLS. It seems more reasonable to me that ALS interventions with a refusal (D50 IV) may be charged.


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## remote_medic (Feb 17, 2009)

I could see after the 3rd call (starting with the 4th call) ...but not on the second or the third call within a year...


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## emtfarva (Feb 17, 2009)

I like the idea. Where I live when PD respond for a silent alarm, the first four are free, the fifth one cost money. and it progression from there. I think this like others have said before me will cut down the abuse. It should only be for private homes. I don't business' should be charged for their customers or employees. And definitely not for SNF or Assisted livings.


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## marineman (Feb 17, 2009)

I didn't read the article in full and I don't know what the proposed law says in full but if it's a flat $55 for anyone that calls an ambulance more than once in a year I see no good coming from this. Anyone that works in that area can look forward to a steep drop in call volume but 99% of your calls will be PNB's. 

I could change my view to stand behind this if certain measures were taken to protect those that truly need ambulance services. Granted if you need an ambulance $55 is a drop in a hat but that's not how most people will see it. If they put a clause in somewhere similar to what medicare has that if a physician can sign off that ambulance transportation was the only feasible method then they should not be charged. I also think something needs to be put in the law to protect a good samaritan/witness calling to help others, otherwise you will see a sharp drop in good samaritans which is no good at all.

Overall it's not a terrible idea but they need to be careful with their wording to really hit the intended target.


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## Ridryder911 (Feb 18, 2009)

Ironically my local city is considering charging for Fire & Police services as well. If one is resident within the city they may give discount or not be charged. I know of cities that have now done this and is charged per unit that is needed to respond. i.e Squad $$, Battalion Chief $$$, Pumper $$$$$.

It will be interesting to see if the firefighters will still maintain their "hero" image after the patient recieves a $400 bill for a wash down. 

R/r 911


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## daedalus (Feb 18, 2009)

redcrossemt said:


> As others said, this city's frequent fliers calling for attention won't pay (what are you going to do - stop responding?) and people who need assistance due to chest pain won't call.
> 
> I assume the first responders are currently at least somewhat paid for by taxes. If there's such support that the board approved it unanimously, why not try for increased millages? Or why doesn't the city transport itself to pay the bills? Why are the first responders needed in the first place? Are they FR, BLS, ALS? What are their response times? What are the response times for the transporting agency?
> 
> ...


Frequent fliers who do not pay will be sent to collections, and than eventually court where their wages and government assistance checks can be garnished. The chest pain who doesnt call will have to live (or die) from the consequences. People need to take responsibility for themselves, we are not here to do it for them.


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## reaper (Feb 18, 2009)

daedalus said:


> Frequent fliers who do not pay will be sent to collections, and than eventually court where their wages and government assistance checks can be garnished. The chest pain who doesnt call will have to live (or die) from the consequences. People need to take responsibility for themselves, we are not here to do it for them.



This is why I won't step foot on Cali!


You can charge for refusals and treatments. I think charging to call 911 is going to lead to a lot of problems and the city council will be paying the settlement, when that happens.

If you think this will cut down on abuse by frequent flyer's, you will be dead wrong. It will hurt the normal Tax paying citizen that already pays a fee for 911 use. Is the city going to stop charging 911 fees on the citizens phone bills? Are they going to charge fees when a citizen reports a broken water main or pothole in the road?

Education to the public is the best idea. You will never stop the abuse calls, even by charging a fee. Collections does not do anything to help recover fees!


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## daedalus (Feb 18, 2009)

reaper said:


> This is why I won't step foot on Cali!
> 
> 
> You can charge for refusals and treatments. I think charging to call 911 is going to lead to a lot of problems and the city council will be paying the settlement, when that happens.
> ...


I spent a week in light duty up at corporate. We send people to collections all the time. 

And no, nobody pays taxes or otherwise to support EMS in my county. Its private company transport and we bill for services rendered.


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## reaper (Feb 18, 2009)

daedalus said:


> I spent a week in light duty up at corporate. We send people to collections all the time.
> 
> And no, nobody pays taxes or otherwise to support EMS in my county. Its private company transport and we bill for services rendered.




Just because they are sent to collections does not meas that it will be collected.

You do pay taxes for 911 service. Look at your phone bill, everyone pays it! I will gladly pay a $55 fee, if they stop charging the taxes. I have never had to call 911 from my home, so I could save a ton of money!!


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## VentMedic (Feb 18, 2009)

reaper said:


> Just because they are sent to collections does not meas that it will be collected.


 
If you don't have insurance or it is a crappy insurance, one can be looking at a $2,000 ED bill and a minimum of $20,000 for a brief hospital stay. And then, there is worry about how to pay for a minimum of $200 dollars of meds. If you are living on an unemployment check as so many are now in this country, it is a struggle especially if you have any chronic disease. Even hypertension alone can be very expensive and difficult to manage in stressful situations.  The unemployed who are trying to maintain their own insurance will face a monthly premium of $400 to $900 per month and that might be just for a single person.  There is also the rent or house payment and the matter of putting food on the table for the family. 

Just respiratory meds like one maintenance and one rescue inhaler may be well over $400 per month. Many of my COPD patients average $700 in just respiratory scripts. They still have to find money or struggle to get their insurance to pay for DM, cardiac and BP meds. Several of the new inhalers are not covered by some insurances. Often the noncompliance is not caused by the attitude of the patient but from the attitudes in big business and our government.


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## medic417 (Feb 18, 2009)

Medical bills unless you sign a contract of repayment are basically un collectable.  You send to collections but you can't garnish wages, can't take their home, can't put it on their credit.  Now after the emergency if they sign an agreement for repaying then that is a different story.

I realy like the idea so I am putting it to my city to help fund us.


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## medic417 (Feb 18, 2009)

Doug said:


> You want your towns folk to rebel and not fund you at all, you go ahead with that plan, friend.



They won't rebel.  The avg person doesn't call for EMS 1 time in 10 years at least probably longer.  So this actually only affects abusers and chronic conditions.  Perhaps if the call is found to be serious then the Paramedic could assign a waiver of the charge.


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## lightsandsirens5 (Feb 18, 2009)

medic417 said:


> They won't rebel.  The avg person doesn't call for EMS 1 time in 10 years at least probably longer.  So this actually only affects abusers and chronic conditions.  *Perhaps if the call is found to be serious then the Paramedic could assign a waiver of the charge.*



Now there is an idea!


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