By Marina Starleaf Riker

The Bulletin

People who are transported by city of Bend paramedics may see their bills increase by hundreds of dollars over the next three years.

Right now, patients transported by city ambulances pay a flat fee of $928. But by 2019, people who live in the city could see their bills go up by $369, while people who live outside the city limits or in an area served by Bend’s rural fire district, could see a $1,666 increase.

The city council must still approve the increases and that is expected in June.

Bend hasn’t raised ambulance fees in 12 years, but the city has grown by more than 15,000 residents in that time, said Steve O’Malley, who works as the deputy chief for EMS services at the Bend Fire Department. Several other Oregon cities, including Redmond, La Pine and Eugene, currently charge about $1,800, about twice as much as the fee in Bend.

“Our costs continually go up,” said O’Malley. “How do we ensure that we’re still able to do what we’re doing today?”

O’Malley said the increase is necessary to ensure the fire department can keep up with the needs of Bend’s growing population during a time when the city is struggling to pay for things such as road repairs and police services. At the same time, retirees have flocked to Bend — a group that requires more medical attention than younger Bend residents.

“We’ve built a system that puts a priority on emergency medical services, and that costs money,” said O’Malley.

If the new fees are implemented, people who live in the city limits and areas served by the rural fire district could see a gradual increase over the next three years until they’re charged $1,297 — a $369 increase from what they pay now.

But that’s only half of what it actually costs the fire department to transport them — nearly $2,600. Under city law, city residents and people who live in areas served by the rural fire district can’t be charged more than 50 percent of that cost.

People who don’t live in the city, however, could eventually be on the hook to foot the entire $2,594 bill. This year, they could be expected to pay about 80 percent of that cost — about $2,075 — a number that could grow until they’re charged the full cost in 2019.

But Bend councilor Nathan Boddie, a physician who works at Mosaic Medical, warned about passing those costs onto Bend’s sick residents — especially those without health insurance or who are under insured.

“From a physician’s perspective, I want my patients to be able to call an ambulance without having to worry,” said Boddie, who treats many patients who don’t have medical insurance.

Boddie said low-income residents may avoid calling an ambulance — even if they’re experiencing a medical crisis — because they’re scared of the cost. In order to prevent that, Boddie said he’s talked with the fire department to offer a special payment program for uninsured people, who make up only 4 percent of people that EMS serves. The city also offers payment plans with no interest — sometimes for a monthly payment about $10 a month.

“We do have a pretty forgiving policy,” said Boddie. “But if you’re calling an ambulance because you have a chronic disease, you might call the ambulance more than once.”

Even though costs could rise, they generally won’t impact people who have Medicare or Medicaid, programs that generally cover the cost of transport. People who have Medicare or Medicaid make up the vast majority of people EMS serve — about 73 percent, according to the fire department.

­— Reporter: 541-633-2160,