Orcas Fire implements cost recovery program

Orcas Fire and Rescue is following in the footsteps of its counterparts on Lopez and San Juan by implementing an EMS cost recovery program.

“There will be no additional burden to Orcas residents,” said OIFR Acting Chief Mik Preysz. “As call volume and expenses go up, this is a way to have another source of revenue … We are the last fire department in the county to do it.”

OIFR’s budget is primarily funded by residents’ taxes. An EMS cost recovery program will enable the department to be reimbursed by insurance companies to support the capital and operational funds – without raising taxes. OIFR held four public meetings on the topic and put together a community panel that studied the program.

The board of fire commissioners approved the initiative on July 16. The launch date was set for Aug. 1 but the financial details are still being worked out. Preysz says San Juan County acts as the bank for the fire districts and all of their money is overseen by the county auditor.

“We aren’t willing to start it until everything is in place,” he said.

The average cost for EMS treatment and transport is $1,742. That includes fuel, supplies, vehicle and equipment maintenance, training, volunteer stipends and employee wages. Those with insurance are already paying for emergency services, but as it is now, OIFR doesn’t receive any of those funds.

For Orcas residents – and that includes renters and those who live on the island part-time – once their insurance is billed, any remaining balances like a co-pay or a deductible will be waived. If a patient does not have insurance, then no one will be billed. Orcas Fire Commission Board Chair Barbara Bedell says she has never heard of an EMS cost recovery program causing insurance premiums to go up.

“Once your insurance company pays, that is it,” Preysz said. “And if this isn’t working in the community, we will pull the plug.”

For visitors to the island, remaining balances will not be waived and those without coverage will be billed in full. If that is not paid, the chief has the option of sending that person to a collection agency.

“We have in the resolution that we can go to debt collection for someone who has no connection to the tax base – but it’s entirely up to my discretion,” Preysz said.

Ideally, he says, a social security number and a signature would be taken at the time of a call – unless someone is incapacitated. It’’s the same information that Airlift Northwest collects from a patient during a med-flight.

Preysz says a cost recovery program is “common practice” on the mainland. More than 90 agencies in Washington state currently have a similar setup.

“Many places just bill the patient – we will not be doing that,” he said.

Preysz says EMS call volume has increased 145 percent since 1999, and 2015 is up 18 percent over last year.

The recovery program is predicted to bring in between $130,00 to $150,000 annually. The money will go into the capital fund for emergency and community services.

Preysz plans for a portion of the funds to go into Orcas CARES, an OIFR program that helps seniors and the disabled with care on the island. Partners are the Orcas Senior Center, Lahari, Orcas Lions and Hearts and Hands.

According to “Funding Alternatives for Fire and Emergency Services” released by the Federal Emergency Management Agency, as the demand for EMS has increased, many jurisdictions across the country have begun to look for ways to offset some of the costs.

“Most jurisdictions that provide ambulance transportation either charge transport fees or offer subscription plans,” it says. “Fees for the medical supplies used have also been adopted in some areas. Some jurisdictions also have added charges for treatment where no transportation is provided … direct billing of the insurance carrier is most efficient.”