Less then 36 hours after implementing fees for ambulance service, Vashon Island Fire & Rescue’s commissioners voted last week to halt the program until they can resolve several questions about the impact such fees could have on both Islanders and the department.

The move took place on a three-to-one vote with one abstention at the commissioners’ meeting last Tuesday night.

Neal Philip, the newest member of the five-person commission, said he offered up a resolution to suspend the fee-collection effort after it became apparent Tuesday night that several questions lingered. It’s not clear, for instance, whether Medicare or private insurance plans will cover on-Island transport fees, where the destination is a health clinic rather than a hospital. Concerns were also raised, he said, about the impact such fees could have on people with limited incomes.

“If they get a bill from the fire department, are they going to throw it away or go without to pay that bill?” Philip asked.

“I wasn’t prepared to move ahead on it without more information,” he added. “There was some understandable frustration. But it’s a serious enough issue that I think it warrants another look.”

Ron Turner, a commissioner who was on the board when it first voted to have the department charge such fees four years ago and who led the effort to resurrect the issue again last fall, criticized his colleagues for what he called “chickening out.” The fees are needed, he said, to bring in more revenue to the department, which wants to build additional fire stations to more quickly respond to calls from some of Vashon’s farthest reaches.

“They’re afraid someone won’t call because they’re afraid they’re going to get a bill,” Turner said. “Well, maybe. But the simple reality is that in order to expand the service, you have to raise more money.”

Turner voted against Philip’s resolution. Commissioners Gayle Sommers and Jan Nielsen voted for it. David Hoffmann abstained.

“I’m disappointed,” Turner added. “Once again, they backed down.”

The commissioners first told the department four years ago to charge fees for ambulance service, a program that never went into effect, despite the production of a color brochure explaining the new fee structure; Turner said then- Chief Jim Wilson, who opposed the effort, never got around to implementing it. The board again voted to launch such a system last November, this time giving the department until April 14 to contract with a firm to develop a billing system and work out any other issues.

According to the plan that briefly went into effect last week, Islanders were expected to pay $200 when an aid car took them to a health clinic on the Island and $450 if they were transported off-Island, costs the commissioners believe most insurance companies would cover.

The charges were for ambulance service that provides what’s called basic life support — or non-emergency transports. Advanced life support ambulance service is covered by Medic One.

But despite a six-month lead time, some issues remained unresolved as of last week, in part because of Vashon’s unique situation as an Island, the complexities of administering the new system and personnel changes that took place in the wake of former Fire Chief Keith Yamane’s departure.

Brett Kranjcevich, the department’s acting chief of operations, said VIFR administrators thought everything had been figured out four years ago, when the program was established but not implemented; it was only when he got more deeply involved in the process that he realized some critical questions — such as whether the Vashon Health Center and other clinics would be considered a “receiving institution” under Medicare regulations — had never been resolved, he said.

What’s more, several of those who work on the front lines at the fire department oppose the new fee system, in part because they fear it will result in some Islanders not calling for an aid car when they in fact should.

Steve Palmer, who heads Local 4189 of the International Association of Firefighters, which represents Vashon’s firefighters, said there are several Islanders who call when they’re not critically ill but need assistance to get to the Vashon Health Center. They dial 911, he added, because that’s what the health center instructs them to do. Some might turn to the fire department for help five or six times a year.

If Medicare doesn’t cover such expenses — it’s not clear yet if Medicare will or won’t — those Islanders could end up with $1,200 in bills by the end of the year, Palmer said.

“We’re concerned that they’ll be a lot less likely to call 911 if they have a stack of bills from the fire department on their kitchen table,” Palmer said. “The union’s main concern is for people’s health and safety.”

The union did not present an official position of opposition to the new fee structure, he said, because it appeared the decision was irrevocable. But Tuesday night, when he realized some issues were still unresolved — would the department send a bill, for instance, even if administrators knew insurance would not cover the costs — Palmer, representing the union, asked for some clarifications. That, in turn, ultimately led Philip — who joined the board in January — to make a motion to suspend the service until some of these questions can be resolved.

“It’s been four years,” said Philip. “What’s a couple more weeks?”

But Palmer said he and other firefighters hope the temporary suspension becomes permanent.

“I believe there’s a lot of support now for discontinuing the process,” he said.