County OKs patient charges

Clark County now can be reimbursed for up to 1,000 patients transported by firefighters a year.

Commissioners on Tuesday signed off on a code that will go into effect in January. It calls for the county to charge patients the Medicare rate of $628 to $728 when firefighters take them to a hospital.

Rescue teams transport an average of 350 patients yearly when private ambulances are delayed or unavailable.

The county was paid nothing for the service before. Both the cities of Las Vegas and Henderson are reimbursed for such transports.

"We're already transporting," Commissioner Chris Giunchigliani said. "We're the only ones who don't get to collect."

The county firefighters union lobbied lawmakers for the code change earlier this year. Because the change was a legislative action, county leaders had no choice but to enact it as a local code.

Money received for the transport service will go into the county's general operating fund. Fire officials said they expect the patient volume to stay at about 350 a year.

Last year, county firefighters received 122,111 calls. Of those, 88,234, or 72 percent, were medical, while 3,515, or less than 3 percent, were fires, according to county data.

Being first on the scene, firefighters sometimes cannot wait for a private ambulance if the person's life is in danger, said Ryan Beaman, president of the International Association of Firefighters Local 1908.

"Time is critical for those patients," Beaman said.

Commissioner Steve Sisolak repeated his concerns that the provision could lead to firefighters being paid bonuses for transporting patients.

He pointed to a clause in the labor contract that calls for the county to negotiate with firefighters for extra pay when an emergency transport program is created.

"Are we not calling this a program?" Sisolak said.

Firefighters, who are among the highest-paid county workers, have been criticized for not making contract concessions during the budget crunch the way other local unions have.

Beaman insisted he had no intention of pushing for bonus pay.

"We're not opening our contract to increase our pay," he said. "There's no change in our transport practice."

Beaman said he will not ask for bonus fees when the county and union start bargaining in the spring to renew the labor contract.

An insurance representative told the commission that industry-wide, a firefighter typically can receive $30 to $80 to move a patient. Two or three firefighters are usually involved in a medical transport.

Fire Chief Steve Smith and a county attorney both assured commissioners that the new code will not automatically trigger labor negotiations for bonus pay.

Giunchigliani agreed, saying that just because the two sides are allowed to bargain doesn't mean they will.

"I don't support paying bonuses," she said.

Officials at American Medical Response, which provides ambulance service to the county, worry that the firefighters' transport program will escalate, cutting into their business.

"We're afraid this will cause a real, real slippery slope," said Al Martinez, president of the Service Employees International Union Local 1107, which represents AMR.

Las Vegas launched a modest patient-transport service in much the same way the county is doing, and the volume grew, especially when firefighters began getting bonuses, said Alex Ocampo, an AMR paramedic.

"The city and the county tend to mirror each other," Ocampo said. "The contracts the unions generate, they reflect each other."

Medical transports will be tracked to see how many patients were moved and how many were able to pay for the service, Deputy Fire Chief Russ Cameron said.

County firefighters take one or two of the 150 patients transported each day in the valley, Cameron said, adding that he did not expect that number to rise.

"I don't think anyone up here would want to impact someone's job," Commissioner Lawrence Weekly said.

Contact reporter Scott Wyland at swyland@reviewjournal.com or 702-455-4519.