Vashon Island Fire & Rescue (VIFR) plans to start charging Islanders for non-emergency ambulance service, a move that could bring as much as $100,000 a year to the department, commissioners say.

In a four-to-one vote, the fire department’s five commissioners decided at its meeting last week to order the department to begin charging Islanders for what’s called basic life support transportation — where patients need the aid of an emergency medical technician or EMT but are not in a life-threatening situation. There will be no charge for transporting advanced life support patients, a service covered by King County Medic One.

The exact fees are still being determined but will likely be between $200 to $250 for an on-Island transport and $400 to $450 for transport to an off-Island hospital — charges that will be covered by people’s private insurance plans, Medicaid or Medicare, the commissioners said. People who are uninsured or can’t pay will not be turned away, said Ron Turner, who chairs the fire department’s commission and who spearheaded the effort.

“No one’s going to be left on the curb,” he said.

But some questioned the timing of the commissioners’ decision, noting that it comes months after Vashon’s only private ambulance service, Island Emergency Care (IEC), went out of business. That service folded in part because of a long-simmering dispute between its owner, Jolene Lamb, and the fire department.

Earlier this year, after a particularly tense interaction between Lamb and members of the fire department, the department said it would not use Lamb’s company if Lamb was a part of the call. According to Lamb, that decision put her small company out of business.

“If they were a private entity, the attorney general would be coming down on their heads for illegal business practices,” Lamb said. “You curtail someone’s busithen when that business is gone, you start charging? That’s anti-trust. That’s racketeering, in my opinion.”

Keith Yamane, the fire department’s outgoing chief, said the fire department tried to work out its issues with Lamb and is not the reason for her company’s demise. But he declined to elaborate on the dispute between Lamb and the department, saying Lamb has threatened to sue VIFR.

“The fire department understands the need for a private ambulance service on the Island. … It keeps personnel on the Island if we have multiple calls. During a disaster, we’d have extra people to help,” Yamane said. “We did not try to put IEC out of business.”

This is not the first time the fire commissioners have called for fees for ambulance service. Three years ago, the commission passed a similar resolution, Turner said, with an eye towards implementing the new fees in January 2005. The department even printed a color brochure explaining its rationale, describing some of the financial challenges behind the decision and laying out the new fee structure.

But for reasons Turner and others say they don’t fully understand, Jim Wilson, the department’s chief at the time, chose not to implement the new program. Turner, sounding frustrated, said it’s now time.

“You’ve had two years. Now get going with it,” he said, describing his message to VIFR.

Turner said that the district’s failure to charge fees for ambulance transport is in effect “subsidizing the insurance companies,” which routinely reimburse policyholders for the service. What’s more, he said, the district needs more revenue if it’s to address concerns about the district’s response time to the Island’s outlying areas, and this is one way to bring in more money.

“We have to improve service somehow,” he said. “This is the only way we can do it without raising taxes.”

The decision to begin charging the fees came at the same time the district’s commissioners passed VIFR’s 2008 budget, a $4 million spending plan that reflects a 7 percent increase over the current budget.

The commissioners chose, however, not to increase the tax rate by 1 percent, a proposal that was on the table. The additional revenue in next year’s budget comes largely from last month’s passage of the Medic One levy.

The budget does not include the $100,000 that Turner says he believes the district will recoup by charging for ambulance service. Those funds, once they get built into an updated budget, will likely be earmarked for the district’s reserve funds, which stand at around $1.7 million, VIFR officials said.

Turner said he hopes the additional funds will enable the district to purchase a house in an outlying area that could be used to station a volunteer medic and firefighter — a so-called “residents’ program” that some small fire departments use in other parts of the country.

“At some point, the Island’s going to need a new fire station,” he said. “Well, you can’t build a fire station tomorrow. But you can buy a house tomorrow.”

The issue of whether to charge for ambulance service is one that has come up in small districts throughout the region over the last several years. Increasingly, districts are opting to pass on such costs to the users, since insurance companies routinely pick up the tab, said Roger Zegers, president of Systems Design Northwest, an ambulance billing company in Silverdale.

King County has long been an exception, however, because of the popularity of Medic One and the fear that people might not support the highly acclaimed emergency response service if they are also paying for non-emergency ambulance service, he said. What’s more, King County has plenty of private ambulance companies that can handle the basic life support calls for a fee, he said.

But that’s beginning to change as some of the small cities and towns within King County grow and find their fire departments are handling a growing number of basic life support calls, Zegers said. Maple Valley’s fire department, for instance, just began billing for such services, he said.

“Everyone else wants to step back and let others be the first ones to charge,” Zegers said. “But now it’s really beginning to happen” in King County.

Within Vashon’s fire commission, the one opponent to the plan is Commissioner Gayle Sommers, who said she has already asked for the resolution to be reconsidered at the commission’s next meeting. Like Lamb, she believes it doesn’t look good to begin charging shortly after the one private company went out of business.

“Now all of a sudden the fire district doesn’t have any competition, so we’re free to charge because we’re a monopoly?” she said, sounding a note of incredulity.

She said she also worries about the impact this could have on people who are uninsured and low-income or those who may not realize the costs will be covered by their insurance companies.

“It may cause people to think twice about calling 911,” she said.

What’s more, Sommers said, it’s possible insurance premiums could go up due to rising ambulance fees.

“And there are already an awful lot of people who are uninsured on Vashon,” she said.