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The Price of Paramedics: Murrieta Fire Chief Provides Update on Fee Program

A program to recoup costs incurred when the Murrieta Fire Department responds to emergency medical situations has proved more successful than expected, according to Murrieta fire Chief Matt Shobert.

“Twenty-five percent of our community has subscribed,” Shobert said. “Usually, they say in similar programs you will get about a 10-percent buy-in,” he said, of figures consistent in other southern California cities such as Corona, Anaheim, Burbank and Santa Ana.

In Murrieta, more than a year has passed since the Emergency Medical Services subscription program went into effect in January 2013. Murrieta City Council approved it in August 2012 despite some community outcry calling it a tax. Councilman Randon Lane had agreed with that sentiment and said it should have been put out for a public vote.

Shobert maintains that funding the department receives from property taxes—roughly $40 per single-family household—is strictly for fire suppression and protection. On the other hand, the $48-per-household annual EMS subscription helps offset the costs of equipment and maintenance, disposable supplies and annual paramedic training, he said.

“Quite frankly, it is something we should have implemented 12 or 13 years ago when we started our paramedic program,” Shobert said. Prior to that, since the department was founded in the mid-1900s, its sole purpose was fire service.

The only city in Southwest Riverside County with its own fire department, Murrieta sends an engine with paramedics aboard when a 911 call comes in indicating a medical emergency. American Medical Response is contracted countywide to also send an ambulance. Whoever arrives to first to the scene immediately provides care.

Murrieta’s EMS subscription remains voluntary, but if someone who is not subscribed receives legitimate emergency medical care from Murrieta firefighter/paramedics, they are subject to a $350 bill. “As we sit today, we have roughly 8,200 subscribers,” Shobert said. “Our initial estimates put us at 2,500 to 3,000 for the first year.”

That is expected to calculate out to approximately $300,000 in net revenue for the first year, including what was collected through those billed at the full rate of $350, he said. Low-income residents, senior citizens and those with government-subsidized health care may subscribe for $24 annually.

The majority of subscribers are elderly, he said, while the business community has been slow to come on board. Business subscriptions are charged on a sliding scale, from $75 to $300 annually, depending on the number of employees.

“Certainly a lot of the senior care facilities—the higher users of our system—have bought into it,” Shobert said. “And some of the larger businesses, some of the health-care-related businesses have jumped on board. But in general terms, the numbers for mom-and-pop type places have been really low.”

This may be because ultimately, it is the person having the medical emergency who would be held responsible for the bill—not the business, he said. In some cases, Shobert went on to say, health insurance providers have submitted payment for the unsubscribed.

“Not across the board, but some are paying it,” Shobert said. “So that is an added benefit, and it validates our care. We do arrive on scene promptly but historically we haven’t had the opportunity to get compensation for that.”