Sierra Madre approves new EMS fees and revamped paramedic subscription plan effective March 1

The Sierra Madre City Council voted Feb. 11 to adopt fee schedule adjustments proposed by the Fire Department, changes city staff said will recover rising operational costs for emergency medical services and broaden a paramedic subscription program intended to reduce residents' out-of-pocket transport charges.

Sierra Madre EMS Captain Kevin Bustillos told the council the city's vendors and dispatch partners charge per-incident costs that the city currently subsidizes. He proposed three fees to be added to the municipal fee schedule at cost of service: an electronic patient care report (ePCR) fee of $4.95 per completed report, a dispatch fee of $84.18 per dispatch (Verdugo Communications), and a first-responder engine-only fee of $189 for calls where the city's ALS engine treats but a separate agency transports the patient.

Bustillos said the ePCR fee is the vendor's per-report charge for the electronic record the department creates for every patient assessment. The dispatch fee recovers the per-call costs the regional communications center charges to member agencies. The first-responder fee reflects increased equipment and supply costs for the city's paramedic engine, which was reclassified as a medic engine in 2024.

The council also approved revisions to the city's paramedic subscription program. Staff said enrollment was about 553 subscribers (roughly 5% penetration) and proposed tiered plans to encourage broader coverage: a single-year plan at $89; a discounted couple plan; a family plan for up to three members at $158 (plus an additional charge for extra members up to five); a business plan for employee groups; and a low-income household rate of $45. Staff said the subscription would continue to waive billed out-of-pocket charges for members when the city bills third parties for transport; according to staff, Sierra Madre's third-party billing historically collects about 79% of billed amounts.

Using historical call volumes and a 79% collection rate, staff estimated the new fees could recover nearly $150,000 annually and push total EMS cost recovery to roughly three-quarters of a million dollars when combined with existing transport billing. Staff recommended implementing the fee changes March 1, 2025.

Council members questioned details of fee calculations, cross-jurisdiction reciprocity and collection practices. Captain Bustillos said the city will still bill insurance for transports; subscription members would be protected from private-balance billing for covered incidents. He said an outside billing contractor (Whitman) handles claims and collections.

Councilman McCoss asked whether recovered funds would be earmarked for fire department needs; staff said revenue would flow to the general fund and be considered during the annual budget cycle.

After public comment (no public speakers for this item), council approved the fee schedule adjustments by voice vote. The motion passed unanimously with one council member excused.

Clarifying details included in the staff presentation: ePCR vendor charge $4.95 per completed ePCR; Verdugo dispatch cost $84.18 per dispatch; a proposed first-responder fee $189; current subscription count approximately 553 members; proposed implementation date March 1, 2025. The council asked staff to return with better enrollment/marketing steps, and staff said online and recurring-payment options are in development to increase subscription uptake.

Votes at a glance

- Motion to approve Sierra Madre Fire Department fee schedule adjustments (ePCR, dispatch, first responder fee) and updates to paramedic subscription program: passed unanimously (4-0; one member excused).