EMS for the Public

The Contra Costa Emergency Medical Services (EMS) agency welcomes comments and concerns about EMS medical issues from the public. Your input helps improve our system. Below are answers to some of the questions and comments we have received.

What is the Emergency Med A or Emergency Med B charge on my property tax bill?

Emergency Med A or Emergency Med B are charges resulting from Measure H, passed by the voters in 1988, which created a countywide parcel charge for enhancements to the emergency medical service system. Med A covers the San Ramon Valley area, and Med B is comprised of the rest of the county. Assessment rates refer to the rate per "benefit unit." Residential parcels are assessed based upon the number of dwelling units, with a single-family residence assessed at one benefit unit. Commercial and industrial parcels are assessed from three benefit units up to 500 benefit units for heavy industry. Rates have been at $3.94 and $10.00 per benefit unit in Zone A and B, respectively, since FY 1996-97. These rates cannot be increased without being approved by the voters.

The enhancements funded by Measure H include increased paramedic service; medical training, equipment, and supplies for the fire service; and upgrades to the County radio system used for paramedic-to-hospital communication.

Why is the cost of ambulance service so high?

The high cost of emergency ambulance service is related to the cost of maintaining a number of ambulance units, staffed by trained paramedic/emergency medical technician crews, available 24/7 at locations throughout the county where a rapid response to a 9-1-1 call can be assured.

While many ambulance transports originating from a 9-1-1 call turn out, retrospectively, not to have been life threatening or to have involved injuries/illnesses that would have been exacerbated by a delay in response, this is usually not knowable at the time of the call or even after paramedic assessment in the field. Emergency medical service systems throughout the county are designed to err on the side of patient safety by rapid response and transport to the nearest appropriate hospital emergency department or specialty care center. Most charges are at the "Advanced Life Support 1 (ALS1) Emergency Base Rate." This is the charge that applies when a paramedic-staffed ambulance is dispatched for an immediate response.

How is it decided where to transport a patient?

Emergency ambulance patients are transported to the nearest Basic Emergency facility or to a hospital of patient/family choice. (A Basic Emergency facility is a facility that is licensed by the state, and has an emergency physician on duty 24/7, and is equipped to treat or stabilize most medical emergencies). However, critical trauma patients are transported to trauma centers, and certain heart attack patients are transported to a hospital with advanced cardiac capability. In 2012 high-risk patients with stroke will be taken to hospitals that have enhanced stroke-care capability.

There are nine basic emergency departments in the county to serve our community. All basic emergency departments are required by law to treat patients regardless of insurance status.

Is it ok to change my mind about being transported once the ambulance arrives?

Yes. When an ambulance is called the patient or his/her guardian (such as in the case of a child) has the option to refuse to be transported. However, emergency paramedics will advise to continue with transport whenever they suspect a significant medical condition. Should the individual choose to have the paramedics discontinue care and not provide transportation to a hospital they will be required to sign a release of liability on the paramedic’s medical report stating that the risks of the decision are understood.