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ANOTHER sign of change in Carroll County: volunteer fire companies charging patients for emergency ambulance calls. And not just a token donation, either -- it could cost $500 a run.

There's not enough money from carnivals, dances and bake sales to finance this essential emergency service. Not enough volunteers to staff the shifts and spend endless hours in training. Too many people in need of these volunteer stations to provide the necessary coverage.

The reassuring word to the public is that charges will be billed to insurance companies. The $3 million or so that Carroll residents would claim from their insurers will be insignificant, we are told. No one without insurance will be dunned. All calls will be answered without reference to payment ability, officials insist.

This dubious assessment of insurance company indifference aside, there is no doubt that the county must begin collecting a fee for this life-saving service. The money is needed to sustain the emergency medicine service that all of us may have to use one day.

There is also no question that it must be done on a consistent countywide basis, not left to the individual decisions of the 14 independent volunteer outfits in Carroll. The county has asked the companies to study the issue.

Fees collected must go to the county, not to the responding company, but be earmarked for ambulance services provided by all the volunteer companies. Charges should be reasonable.

A break with tradition

Although it may break with the tradition of volunteer service that has been at the heart of fire companies in Carroll for nearly two centuries, the trend toward billing for ambulance calls is growing.

Last year, Westminster's fire company began billing for ambulance services, hiring a private firm to handle the paperwork. Union Bridge also started charging. It has tried to avoid dunning the uninsured and the underinsured, but that is a difficult task and one that needs a clear policy to assure equitable treatment.

That's another reason to have uniform county guidelines. Ambulances may respond to calls outside their immediate area, covering for another department whose emergency unit may be in service elsewhere. What you are billed should not depend on what area of the county you live in.

Increasing amounts of tax money are flowing to the volunteer fire companies to maintain their invaluable services. The Carroll County Volunteer Firemen's Association, the umbrella group that doles out operating funds to the companies, got $200,000 more this fiscal year than the previous year. In July, the funding jumps another 13 percent to $3.8 million, more than Carroll pays for its resident state trooper program, which serves as the police force.

This year's county bonds allocate $2.5 million in loans to volunteer fire companies for construction and new equipment.

Medical technicians have been hired with county funding to cover ambulance shifts, as it becomes increasingly difficult to find volunteers to staff emergency medical services and to spend hundreds of hours in training and regular recertification testing.

Since 1993, it has been the volunteer companies' policy to provide paid ambulance personnel where late-response and no-response rates have not met the standard. Only two of the 14 stations don't have paid paramedic staff, at least on part-time duty.

Hampstead is simply the latest to underline the public need. That fire company handles 1,000 ambulance calls a year, rising 10 percent annually, with only 60 volunteers. It has two part-time paid emergency medical specialists, and is asking for government funding -- town or county -- to hire two more full-time technicians.

It is important to make the distinction between emergency medical services and firefighting services, although the same volunteer companies provide both, from the same station and membership.

It may go against the spirit of volunteerism, but county residents must have that life-saving service. And that means paying more for it, even if based in volunteer fire companies. Paying through user-billing may not be a bad way to do it -- unless citizens want to fund the service fully through higher taxes.

County billing system?

Eugene Curfman, president of the firemen's association, says that companies might support a county billing system that was equitable. The fight will be over which stations get how much money. That argues for a stronger county hand in dispensing these emergency medical funds.

Community response to annual solicitations by the fire companies is lukewarm, perhaps because citizens expect the county to pay for that program. It's another indication of the need for broader tax support of ambulance service, as well as for charging user fees.

Volunteers will continue to be the backbone of fire and ambulance services in Carroll for years to come. There's understandable fierce resentment of charging for a volunteer response. But the paramount need is to maintain competent emergency ambulance service. There's no dispute about that.

Mike Burns is The Sun's editorial writer in Carroll County.

Pub Date: 4/20/97

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