Foon Rhee

Sacramento’s ambulance service now comes with higher fees

A man injured by a Sacramento Regional Transit light rail train is taken to an ambulance in April 2016.
A man injured by a Sacramento Regional Transit light rail train is taken to an ambulance in April 2016. Sacramento Bee file

It’s bad enough that Sacramento taxpayers are paying too much for city ambulances because there are two firefighters in each one, instead of lower-cost civilian paramedics.

It’s even worse for those struggling to make ends meet and unfortunate enough to receive ambulance service.


Sara Moore knows this through painful personal experience. On Jan. 19 – her first day on her first full-time job in five years – she fell off her bicycle when a tire got stuck in the light rail tracks near H and 8th streets downtown.

She bruised her knee, and when she briefly passed out, a bystander called 911. A city ambulance crew arrived and took her pulse and blood pressure. She told them she was fine, and signed a form saying she didn’t want to go to the hospital.

Moore, 44, an analyst at the California Energy Commission, put the scare behind her. But in March she got a bill from the city for $283 – a fee for being treated at the scene but not transported. She was especially surprised since she says she wasn’t asked for consent to be treated.

“I thought it was a mistake,” she said. “That’s a lot of money for a blood pressure check.”

What she didn’t know is that last December, the City Council unanimously approved new ambulance fees. As of Jan. 1, base fees rose by 26 percent and a new $283 first responder fee was added. Starting July 1, annual inflation increases kick in.

The city, however, did add a provision to help people with financial hardships with the fees. The fire chief can approve a full waiver, or a reduction of 25 percent or 50 percent, based on income.

Moore says she qualifies for a 25 percent discount, and has been going back and forth with the fire department for more than a month trying to get it.

In a May 24 email to Moore, Assistant Fire Chief Michael Taylor says while the department can waive or reduce the first responder fee, it doesn’t have a similar waiver for the treated but not transported fee.

Moore asks: Why not?

Good question. The city doesn’t have a good answer. A city spokeswoman says the waiver covers all fees, and the ordinance doesn’t make any distinctions. Someone at City Hall should tell the fire department.

While it is still billing Moore the full $283, it has offered her a six-month payment plan. The department cashed her first installment of $47, but she’s holding off on the rest to see if she can get the discount.

Good for her, but she worries that others who end up in a similar pickle and are less assertive will just pay whatever the city bills.

In 2016-17, the ambulance fees brought in $18.4 million, while the fire department’s emergency medical services cost $23.5 million (including $2.7 million in department-wide overhead expenses).

The city adopted the higher fees so that they will eventually cover the entire cost of ambulance service and it doesn’t have to dip into the general fund. Fair enough.

But the cost wouldn’t be so high if the department used at least one civilian paramedic in each ambulance. And just maybe with a lower cost, it wouldn’t be haggling over a discount for people like Moore.

The paramedic issue, however, has been out there for years, and it appears unlikely to change soon. It’s an election year, and the city firefighters union is one of the most powerful players in local politics.

Councilmen Rick Jennings and Jay Schenirer, who are in the most competitive races on Tuesday, have each received the maximum $5,600 from the Sacramento Area Fire Fighters Local 522 political action committee.

City Hall will also be relying again on firefighter support to persuade voters in November to renew Measure U, which brings in $45 million a year and will otherwise expire next March.

So don’t hold your breath for any progress on paramedics this year. But you might want to cross your fingers you don’t need to call for an ambulance.

Foon Rhee: 916-321-1913, @foonrhee