State Law Threatens Paramedic Fee Scales

Residents in Anaheim, Fullerton, Orange and possibly San Clemente who subscribe for paramedic services may see hikes in their annual fees unless the cities obtain an exemption from a state law, fire officials say.

Under a subscriber program, residents pay an annual fee of $12 to $24, which covers any paramedic calls for that household. Those who do not subscribe must pay $75 to $125 for each call.

But under an 11-year-old law known as the Knox-Keene Act, paramedic programs that charge subscriber fees qualify as health-care plans subject to licensing.

The law, passed before paramedic services existed, requires that any person or government agency that “undertakes to arrange for the provision of health-care services to subscribers or enrollees . . .” must be regulated by the state Department of Corporations, George Crawford, the department’s senior counsel, said.

‘Devastation’ Seen

As the law reads now, it could “devastate the city as far as the city’s (paramedics) program is concerned,” Fire Chief Martell Thompson of Orange said.

When Orange was notified earlier this year that it was apparently in violation of state law and subject to new licensing as well as penalties, the city moved to lobby for a new law to exempt such programs.

This week, such a bill, by Assemblyman John R. Lewis (R-Orange), is scheduled to come up for a vote in the Assembly.

But if Lewis’ bill hits a snag, the current law could slap cities that have paramedic fee programs with an initial one-time registration fee of $2,500, an annual assessment of $500 and a percentage of what the fire departments net from the subscriber fees (cities would give the state up to 26 cents per family unit), according to Warren L. Barnes, supervising counsel of the health-care service plan division for the Corporations Department.

According to a report to the Anaheim City Council last week, Fire Chief Darrell Hartshorn said the cost to Anaheim would be about $16,000 in fines and other expenses.

Primary Objection

Stan Getty, Fullerton Finance Department revenue manager, said the city’s main objection to falling under state licensing procedures is the added cost. “We would have to pass on the cost to subscribers,” Getty said.

Fullerton and Anaheim charge $24 annually per household, while Orange charges $12 per household.

San Clemente levies a $25-per-household fee to cover ambulance or paramedic transportation, not paramedic services. San Clemente Fire Chief Tom C. Dailey said his city’s program is not subject to the Knox-Keene Act. But other fire chiefs say it is.

If Orange is found to be in violation of state law, Thompson said, officials may be forced to reimburse residents who have paid the annual $12 fee for the past three years. Thompson said about half of the city’s households are enrolled in the program.

Crawford, the state official who will be handling the case, said such a penalty is an option but an unlikely choice. Orange officials said they are baffled as to why their program, which has been operating for three years, was singled out while similar programs in Anaheim and Fullerton have gone unnoticed.