The Bangor Fire Department wants to charge a fee when its personnel repeatedly are called to the same households to help out in times of nonmedical need.
The department occasionally hears from the same people five or more times in a single day requesting help that doesn’t require transport to a local hospital. In 2015, a single person called emergency services 171 times requesting nonmedical help. Most commonly, the department receives calls requesting “lift assists,” and firefighters or emergency medical technicians must help a person who has limited mobility but is in no immediate danger back to his or her feet or move from one place to another within the home.
“They’re calling us to basically be their in-home health care service when our primary mission is emergency services,” Bangor Fire Chief Tom Higgins said.
The fire department is proposing to charge $25 per every department vehicle that responds to an individual’s household for a situation that requires no medical transport. For an individual, the fee would kick in starting with the fourth call to emergency medical services in a nonemergency situation in a given year. The fee would rise to $125 per vehicle for the ninth fire department response.
Institutions such as nursing homes and assisted living facilities would face the $25 per vehicle fee for the first three calls to the fire department in a given year. The fee would jump to $125 per vehicle starting with the fourth call.
Higgins said he hopes the department never has to charge anyone. Instead, the excessive use fees would send a message. The fire department and paramedics are there for emergencies and times of medical need. When there’s no emergency, however, the prospect of paying a bill might force some people to think twice before calling for unneeded help.
Public safety agencies have increasingly turned to user fees in the past decade, often to cover costs in times of shrinking budgets. Many agencies have rightly faced pushback for charging for core services such as responses to motor vehicle accidents. Taxpayers already are paying to keep public safety agencies staffed and ready to respond to emergencies, so charging fees for services that tax dollars already are funding constitutes “double taxation” for a public service.
In Bangor, the fire department is proposing to charge fees for services that fall outside its core mandate. The department, therefore, is using the fees to assert its core mission to Bangor’s taxpayers and discourage the public from abusing the services it offers. The fee is worthy of serious consideration by the City Council, and it helps that the council won’t have to consider it as part of a proposal to fill a budget gap.
The Bangor Fire Department has faced a growing call volume in recent years, so it needs to use its resources judiciously. The department responded to 41 percent more calls in 2015 than it did in 2009, and emergency medical calls accounted for much of the growth, according to department statistics. The department doesn’t separately track the type of calls that would trigger a fee under its proposal to the City Council.
“When we’re at a home doing home health care, basically, we’re not available for an emergency,” Higgins said.
Of course, fees on their own won’t address the underlying issues that cause people to make excessive and unnecessary use of emergency medical services. As part of instituting fees, the fire department and city staff should continue reaching out to nursing homes, assisted living facilities, home health care agencies and family members to determine how they can play a part in reducing call volumes. In addition, the fire department sometimes has to make the first call to help someone with limited mobility find a more appropriate living situation. Public education also should be a major part of this effort, and the department needs to be transparent so residents are aware that a bill might be on its way.
It’s in everybody’s interest to reduce unnecessary use of fire department resources, and fees can be part of a well-rounded approach to accomplishing that.
