Ambulance fee hike passes Selma council on 3-2 vote

Selma ambulance service user fees nearly double after study finds fees cover only half of total operating costs

Selma City Councilmember Blanca Mendoza-Navarro addresses city staff during the City Council meeting Feb. 5, 2024. (Serena Bettis)
Selma City Councilmember Blanca Mendoza-Navarro addresses city staff during the City Council meeting Feb. 5, 2024. (Serena Bettis)
Serena Bettis
Published March 13, 2024  • 
10:00 am

SELMA – User fees for Selma’s ambulance services are increasing by nearly 100% on April Fool’s Day — and that’s no joke.

The Selma City Council approved the user fee increase by a 3-2 vote at its meeting on March 4, and the increase will take effect on April 1. Selma Fire Chief Jordan Webster said the increase is so steep because the fees were last raised in 2014, and there has been no mechanism used in the last decade to incrementally increase the fees to match rising costs. 

“Without an amendment to the fee schedule, operations within both the EMS division and fire division will not be sustainable in the long term,” Webster said.

Fee increases will only impact individuals using private insurance, workers’ compensation insurance and private pay; those with MediCal or Medicare insurance will not be affected, as those plans pay fixed rates regardless of the fees charged. 

Ambulance services for Selma residents are provided through the Selma Fire Department’s Emergency Medical Services (EMS) Division. As a service that provides limited or no general benefit to the community as a whole, the city sets up user fees to fund the services without using taxpayer money.

Fee increases

The city determined what to increase the fees to based on a study conducted by Willdan Financial Services, which analyzed the total costs incurred by the city in providing ambulance services. 

According to the report, the total costs “included the direct cost of staff and operating costs, a share of department administration support and the cost allocation for city central service support.”

The Advanced Life Support (ALS) Level 1 base and emergency base services fee will increase by $1,194, from $1,200 to $2,394; the ALS Level 2 services fee will increase by $1,393, from $1,400 to $2,793; and the Basic Life Support (BLS) base and emergency base services fee will increase by $995, from $1,000 to $1,995. 

The mileage fee will increase from $31 per mile to $44 per mile and the treatment/non-transport fee will increase from $150 to $299. Fees will also be increased annually on Jan. 1 based on the Consumer Price Index (CPI) to account for increased costs in services, according to the resolution approved by the council.

The report findings said that the cost recovery for service operations was running at 50%, and “as such the fees are being subsidized and would need to be increased by 100% to achieve full cost recovery.”

Cost recovery

Councilmember Sarah Guerra, who voted against the increase along with Mayor Scott Robertson, said that she felt the new rates were too high, especially when considering much of Selma’s population are on fixed or low incomes.

Fire Chief Jordan Webster defended the increase, noting that it aligns with rates charged by neighboring cities. Webster also highlighted that, while some fees are higher than those in neighboring areas, others are lower, making the overall cost comparable.

“Looking at the market rate, just looking at comparables to the area, we’re way behind, and it’s not because the city of Selma costs less to run an ambulance company,” Webster said. “It’s because we just haven’t looked at the changes that are necessary to be able to continue to provide those services.”

Despite concerns raised by Robertson, who asked if the fee increases could be phased in incrementally instead of all at once, City Manager Fernando Santillan clarified that city regulations require fees to cover 100% of ambulance service costs.

“It’s unfortunate that we haven’t made incremental changes throughout the years and this hasn’t been looked at in the past, but we have to make a change going forward in order to be able to sustain as a department and offer those services to our community,” Webster said. 

Webster emphasized the need for the fee hike to ensure the department’s financial sustainability, particularly due to a significant portion of patients being covered by MediCal or Medicare, which pay fixed rates below the fees charged.

He also mentioned impending state legislation that would further limit revenue collection. To mitigate costs for residents, Webster promoted the Tri-County FireMed program, offering no out-of-pocket expenses for emergency services to enrolled residents for an annual fee of $65.

Serena Bettis
General Assignment Reporter