Tuesday, March 25, 2025
San José City Council
Fire Department Emergency Medical Services First Responder Fee Program March 25, 2025
Presented by:
Robert Sapien, Jr., Fire Chief, Fire Department
Steve Boughey, Deputy Fire Chief, Bureau of EMS and Training Evolution of Fire and Rescue Services
2 Tuesday, March 25, 2025
San José Fire Department "All Hazards" Response
Emergency Medical Services
• First Aid "Resuscitator Calls“
• Basic Life Support /
Emergency Medical
Technician (EMT
Certification created in
1970)
• Advanced Life Support /
Paramedics (1995)
Fire Suppression & Rescue
• Fire (wildland, high-rise,
residential, commercial, etc.)
• Rescue (vehicle extrication,
water, confined space, high
angle, etc.)
• Multi-Casualty
(transportation, active
assailant, etc.)
Evolution of Fire and Rescue Services
3 Tuesday, March 25, 2025
San José Fire Department "All Hazards" Response
Emergency Medical
Services 1995-2000
• First Aid "Resuscitator Calls“
• Basic Life Support /
Emergency Medical
Technician (EMT
Certification created in
1970)
• Advanced Life Support /
Paramedics (1995)
Emergency Medical
Services
2000-Present
• Field 12 Lead Acquisition
• Advanced pharmacology
• Advanced Life Support
Interventions
• Lucas Devices
• "Community Paramedicine"
Evolution of Fire and Rescue Services
4 Tuesday, March 25, 2025
San José Fire Department Incident Type Distribution
68,410, 62%
12,241, 11%
6,079, 6%
1,264, 1%
11,206, 10%
6,493, 6%
4,562, 4%
Medical Only Other SJFD Calls (Unclassified)
No incident, wrong location, cancelled en route False Alarm / False Call Good Intent or Service Rescue, Haz-Mat, USAR & Non-Fire Hazards Fires
5 California Lawful Billing Legislations
Tuesday, March 25, 2025
• California Constitution, Article XI, Section 7: Grants charter cities the authority to have “police powers” to create and enforce local ordinances and regulations, such as police, sanitary, and medical response, so long as they do not conflict with general laws. • California Health & Safety Code Section 13916(a): Jurisdictions are permitted to charge a fee to cover the cost of any provided service or enforcing any regulation for which the fee is charged.
• Proposition 26 amended California Constitution, Article 13A, Section 3(b)(2): Allows for a fee to be imposed for a specific government service provided directly to the payor that is not provided to those not charged and does not exceed reasonable costs for providing the service. Examples include user fees for utilities, public records copying fees, emergency medical care and ambulance transport service fees, recreation classes, and transit fees to name a few.
California Fire Agency Fee Comparisons
6 Tuesday, March 25, 2025
Agency Population Fee
First
Responder
Fee
Vehicle
Collision
Response Fee
Folsom Fire Department 84,782 $225 Y
Long Beach Fire Department 449,468 $250 Y
Sacramento Fire Department 526,384 $321 Y
Napa Fire Department 77,492 $338 Y
Roseville Fire Department 159,135 $386 Y
Alameda Fire Department 78,614 $393 Y Y
Proposed: San José Fire Department 969,655 $427 Y Y
Anaheim Fire and Rescue Department 347,000 $439 Y Y
Vallejo Fire Department 122,807 $561 Y
San Francisco Fire Department 843,071 $567 Y
Fee Calculation and Estimated Revenues
7 .
Tuesday, March 25, 2025
Fee Types Payer
Qty. of EMS
Responses
Billing
Rate
Potential
Annual
Revenue
Anticipated
Collection
Rate
Estimated
Annual
Revenue
First Responder
Fee
Commercial
Medical Insurance 7,725
$427 $3,298,575 80% $2,638,864
Private Pay 6,695 $427 $2,858,765 3% $85,763
Vehicle Collision
Response Fee
Commercial
Automobile
Insurance 3,968
$427 $1,694,339 80% $1,355,471
Estimated Projected Annual Revenue $4,080,098
Year One Prorated Starting January 1, 2026 $2,040,049
Fee Administration Process Flow Map
8 Tuesday, March 25, 2025
EMS
Incident Response
Medical Care
Provided?
Yes
Vehicle Involved?
Yes
Vehicle Collision Response
Fee Segment Applied
(Automobile Insurance
Collection)
No
First Responder Fee
Segment Applied
(Medical Insurance
Collection)
No
END
(No Fee Applied)
9 Compassionate Billing
Tuesday, March 25, 2025
• Financial Hardship Criteria
• Charity Care Policies
• Transparency Requirements
• Prohibition of Discriminatory Practices
• Patient Rights and Protections
10 Next Steps and Closing
Tuesday, March 25, 2025
Action Item Completion Timeframe
Communications Plan (Phase 1): Public Announcement and Information Dissemination March – April 2025 City Council Approval: FY 2025-2026 Operating Budget and Fees and Charges June 2025 City Council Approval: Medical Emergency First Responder Services and Fee Collection Ordinance June 2025 First Responder Fee Program Effective July 2025
Communications Plan (Phase 2): Community Education and Internal Training July – October 2025 Communications Plan (Phase 3): Final Preparations December 2025 First Responder Fee Program Implementation (First Responder Fee & Vehicle Collision Response Fee) January 2026
Communications Plan (Phase 4): Implementation of First Responder Fee Program January 2026 Questions?
Robert Sapien, Jr., Fire Chief
Fire Department, Office of the Fire Chief
Steve Boughey, Deputy Fire Chief
Fire Department, Bureau of EMS & Training
11 San José City Council
Fire Department Emergency Medical Services First Responder Fee Program March 25, 2025
Tuesday, March 25, 2025