Supervisors OK Stiff Hikes in Ambulance Fees

Ambulance patients in Los Angeles County’s unincorporated territory and in 61 cities within the county face higher-priced trips to the hospital after the Board of Supervisors on Tuesday adopted a series of rate increases for ambulance service in those areas.

The supervisors unanimously approved the new rates, which will raise the basic maximum fee for each ambulance trip from $109.50 to $151, as part of an across-the-board increase in charges ranging from night service to the cost of oxygen tanks.

For the first time, the board also added a provision to county law requiring ambulance operators to meet minimum response times when answering emergency calls.

“We think . . . that this is a justified increase,” said Robert Gates, director of the county’s Department of Health Services.

County officials said the rate increase will affect about two dozen private ambulance companies that operate in the county’s unincorporated territory, as well as in 61 cities that do not have their own ambulance services.

There was no public opposition to the rate increases, and of the four supervisors present, only Ed Edelman questioned the new fees.

“This is a pretty steep increase,” Edelman said. “In some cases, it’s doubling and tripling (charges). Why such large increases?”

Gates responded by explaining that ambulance companies are facing escalating insurance rates and rising labor costs and have only been granted modest cost-of-living increases over the last few years. He added that the companies have also been saddled with bad debts because they are transporting more indigent patients--similar to the problems that have plagued private hospitals in the county’s emergency-care network.

Since a 1986 court ruling, the county has been administering emergency ambulance services where needed. Although the county set aside $3 million last year to pay for the services, ambulance companies contend that the actual cost is closer to $4.5 million.

“That additional $1.5 million has been absorbed by the ambulance operators, and that needs to be translated into user fees,” said Roderick G. Dorman, a representative of the county’s 16 emergency ambulance providers.

Officials said the increases will boost Los Angeles County rates to only the ninth-highest among California counties for basic ambulance service. The rate for paramedic service will place the county in 18th place, health officials said.

By comparison, the city of Los Angeles’ private ambulances can charge $114.50 merely by responding to a call and $149.50 for paramedic services.

While approving the rate increase, the board also agreed to require minimum response times for the first time. Previously, the health agency had included such requirements in their contracts with private ambulance companies, but Gates said the county regulation will tighten controls on ambulance companies.

Under the new law, the county can suspend or revoke the licenses of companies falling short of minimum response times in more than 10% of their calls.