Port Fire Depart. proposes billing users of its medical services

Port Fire Depart. proposes billing users of its medical services
The Port Washington Fire Department is proposing a cost recovery program, the first time patients' insurance would be billed for the department's emergency medical service. (Photo by Cameryn Oakes)

The Port Washington Fire Department is proposing a new cost-recovery program for the emergency medical services they provide, marking the first time the department would bill patients for ambulance transportation and medical care.

The announcement was made by the department’s Board of Directors chairman, Christopher Bollerman.

The program, which would require the approval of village contracts, would also be supplemented by “compassionate billing” to serve Port Washington residents and to ease financial hardship associated with the new billing structure.

On April 9, Gov. Kathy Hochul enacted legislation that allows fire departments previously not permitted to bill for ambulance services to begin doing so for a four-year period. This will begin July 8.

New York previously was the only state that prohibited fire department billing for ambulance services, Bollerman said.

The patient’s insurance providers will be billed for the costs recovered from the fire department.

The cost recovery plan outlines four charges that patients utilizing the department’s medical services may have to pay: basic life support services, advanced life support emergency, advanced life support 2 emergency and transportation per loaded mile.

Basic life support services would cost $1,500, advanced life support would be $2,200, advanced life support 2 would cost $3,000 and transportation per loaded mile would be rated at $35/mile.

The first three charges are determined by the type of care the patient requires during transportation. Every patient will be charged with a singular fee depending on which of the three medical supports they need, but every patient will also be charged for the loaded miles.

Advanced life support 2 is typically for people experiencing cardiac arrest, which requires an “explicit amount of procedures that have to be performed,” Bollerman said. The department expects less than 1% of patients to be in that category because of the close proximity to St. Francis Hospital.

The transportation per loaded mile is the transportation fee calculated by the distance from the scene where a patient is picked up to the hospital that receives them. Patients will not be charged for the distance the ambulance drives to the scene. The distance is rounded to the nearest tenth of a mile.

The Port Washington Fire Department has adopted “fair and reasonable rates” based on the costs of providing the service, according to Bollerman

This new cost recovery program is intended to combat some of the economic hardships the department has faced in recent years.

For the fifth straight year, the Port Washington Fire Department is the busiest volunteer fire department in Nassau County, according to Bollerman. In 2022, the department responded to 2,580 EMS calls and 1,471 fire calls in Port Washington.

But Bollerman said volunteerism is on the decline nationwide, including in Port Washington.

To combat this, the department has been supplementing their volunteer force during business hours with paid, “career personnel,” Bollerman said.

The department has 29 part-time employees who are managed by two full-time employees. They are paid at an hourly rate.

“The fire department expends hundred and hundreds of thousands of dollars to pay them,” Bollerman said.

The new cost recovery is intended to aid in this by “[lessening] the burden” of the salaries of career employees, filling nighttime hours services with advanced life support providers and purchasing better emergency medical equipment. The funds recovered from emergency medical services are only allowed to fund those services specifically, barring it from being spent on other expenses such as fire protection services.

“No member of the Port Washington Fire Department will receive any benefit or any gain with the fire department enacting cost recovery,” Bollerman said. “The people are the only ones that gain.”

Through the cost recovery program, the department is aiming to get the funds to buy more emergency medical equipment and hire more medical personnel without increasing taxes, as it is “being funded by the people utilizing the service,” Bollerman said.

While patients may soon have to pay for the medical services the Port Washington Fire Department provides, the department is also proposing a “compassionate billing” program to combat the effects on Port Washington Residents.

Compassionate billing includes three aspects.

First, if the department responds to an emergency and the patient’s home address is located within the seven municipalities the department services, then that person’s copay will be automatically waived.

“Whether their copay is $0 or $400, we are going to waive it,” Bollerman said.

In lieu of residents paying taxes for the infrastructure of the fire department that provides medical services to them, the department would waive their copay, Bollerman said.

“Sick or injured persons who reside in the geographical area of responsibility of the Port Washington Fire Department, that are transported to local hospitals, that have any applicable insurance copayments will have this charged automatically waived due to the assumed payment of town/village real estate and/or personal property taxes,” Bollerman said.

Second, if the costs of utilizing their emergency medical services will lead to financial strain, then the fee will be waived.

So if you have a high insurance deductible for the medical services you receive, you can work with the department’s third-party billing company, of which the department has engaged proclaim services with, to express a financial hardship and the costs will be waived.

The Port Washington Fire Department will not implement a sliding scale based on income or payment plans.

The department will not require authentication or documentation of why you can not afford the services if you request a waiver of cost due to financial hardship. The patient will receive forms from the third-party billing company to document it.

“When it comes to waiving costs, when it comes to who decides, it’s all part of the compassionate billing program,” Bollerman said. “The decisions about someone’s financial status and can they pay or can’t they pay is not made by the fire department leadership. It is made through policies and procedures established with the third-party biller. So myself and any of my cohorts are not going to be privy to anyone’s financial means.”

The third aspect of compassionate billing is that the fire department is barred from recovering costs from an uninsured person.

“So anyone that is uninsured or lives in the shadows, they need not worry about calling for an ambulance,” Bollerman said. “We are forbidden from charging them and we will give them the same level of care as someone with the greatest insurance.”

Bollerman said that non-Port Washington residents will be responsible for paying the costs recovered from utilizing their emergency medical services but can still request cost forgiveness due to financial hardship.

“There’s true compassion,” Bollerman said.

If a patient refuses treatment from the department, or if they are treated at their home and not required transportation to a hospital, there will be no cost, Bollerman said.

At a March 1 meeting, the Town of North Hempstead voted to adopt the new fire contract that included cost recovery fees and the compassionate billing program.

“The fire department is the backbone to our community,” town Councilwoman Mariann Dalimonte said. “[The contracted money] is providing the resources needed to protect the community.”

Dalimote said that she ultimately voted to approve the contract for the town because she “knew it would be beneficial to the community [she] represents” and provide the support the fire department needs.

Since 2017, the leadership of the fire department has been meeting with all of the elected officials on the Port Washington peninsula to brainstorm how they can provide “a better emergency medical service to the residents of the peninsula” utilizing cost recovery programs, according to Bollerman.

The town constitutes half of the fire department’s contract and services, which are provided to seven municipalities.

The other six municipalities include the villages of Manorhaven, Plandome Manor, Flower Hill, Sands Point, Point Washington North and Baxter Estates.

As the department is an independent entity from the town and the villages, they provide contractual services that are renewed yearly.

Contracts signed by the seven municipalities for the services of the Port Washington Fire Department include fire protection, emergency medical services and LOSAP, an equivalent to a retirement pension.

The fire department’s overall budget is about $4.5 million, broken into $3,528,914 for fire protection and $569,777 for emergency medical services, and the yearly LOSAP total is $460,000. The town pays for about half and the other six municipalities pay the combination of the other half.

Despite being the busiest volunteer fire department in the county, the total department budget ranks 12th in all of Nassau county, according to Bollerman.

“We’re very proud of that, but we need all the funding that we can get,” Bollerman said. “And we firmly believe that the funding we can get from cost recovery will help us take a great service and make it even better. We’re doing one hell of a job to stretch [$4.5 million].”

When all the money from the seven municipalities is pooled, that adds up to the entirety of the department’s budget.

The percentage of which each municipality pays the department’s total budget is established by the Nassau County Department of Assessment. The department gets the total assessed value of each municipality, which is then added together and divided by each municipality. The department apportions its budget annually by the total assessed value of each municipality, which establishes who pays what amount.

When the Town of North Hempstead approved the fire contract, they agreed to pay $2,082,545 for the services and $233,726 for LOSAP.

Bollerman said he delayed the contract from being established in January because they wanted to ensure the new contract language was adequate and that it “[served] our people best.”

The contract will not be enacted unless all seven municipalities have voted on implementing it. Bollerman said there will also be a thorough public relations campaign to ensure the residents fully understand before the cost recovery services are implemented.

In March, Bollerman said he will be meeting with the villages of Baxter Estates, Plandome Manor, Port Washington North and Manorhaven. Flower Hill and Sands Point don’t do an annual contract with the department, rather it starts on June 1 for the village budget cycle year, so they will be met with later in the year.

No bills will be sent until the contract has been voted on and approved by all seven municipalities. Fire protection and emergency medical services are still being offered despite the contracts not being fully finalized yet.

Bollerman said that since the town has already approved the contract, the department has the ability to begin sending bills to residents utilizing their emergency medical services, but they are making to decision to not send bills until all seven municipalities have adopted the new contract.

Bollerman said the target date for implementation is June 1, but it could be sooner or later.

While the proposal of charges for utilizing emergency medical services may be a change that sounds unfavorable, Bollerman, who is a lifelong Port Washington resident and has been in the department for 38 years, stressed that nobody will be hurt by the new program.

“I care about the people,” Bollerman said. “We are going to think of the people first, and I pledge that to them.”

Bollerman said that residents will not notice any difference in the services provided by the fire department if this is implemented fully, beyond an increase in the ability to provide emergency medical services.

The fire department is in the process of developing its public relations campaign for the new billing program, pending the adoption by the remaining municipalities. Bollerman said an FAQ about the changes will be posted on the department’s website potentially on Wednesday.

“The experience has been eye-opening,” Bollerman said. “It’s been a long time in the works. It’s been challenging in the aspect of bringing seven municipalities and the fire department all together. There was a lot of give and take and we worked collaboratively together. It was always putting the residents of Port Washington first. I believe we designed a plan that will compassionately deal with the finances involved and still provide the funding to provide a superior medical service to the people of Port Washington.”

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