Board introduces ordinance to raise County Fire, EMS and CSA 17 fees; public commenters warn of burden on residents and businesses

The San Diego County Board of Supervisors on April 22 voted to introduce an ordinance revising fees for County Fire, the Emergency Medical Services (EMS) Office and County Service Area (CSA) 17. The changes were presented by County Fire leadership and staff and include adjustments to fire marshal fees, EMS credentialing and ambulance transport rates for CSA 17.

Why it matters: Staff said the fee updates are intended to reflect current labor and operational costs, improve cost-recovery compliance with board policy and ensure the financial sustainability of ambulance services in CSA 17, which serves several coastal and unincorporated communities. Public commenters said the increases could be steep for residents and small businesses.

What staff presented

Jeff Collins, Director of County Fire, explained that fire marshal fees and inspection rates have not been revised since February 2021 and that negotiated labor-cost increases and updated staff time estimates justify changes. Staff proposed new hourly and stand-by rates for special-event staffing and recommended charging businesses for previously free inspections on a prorated-hourly basis.

For EMS, the presentation described the second year of a three-year phased fee increase that better aligns credentialing, ambulance permitting and hospital specialty designation fees with the staff time required. Staff described ongoing oversight of private ambulance providers and hospital designations and said the office inspects about 500 ambulances per year.

For County Service Area 17, staff recommended consolidating three separate transport fees (residents, nonresidents and out-of-county patients) into a single rate aligned with County Fire’s ambulance rate so CSA 17 remains financially sustainable; staff said patients remain responsible only for copays and deductibles and that Medicare/Medicaid rates remain fixed.

Public comment and concerns

Five speakers addressed the item. Public commenters raised the scale of some proposed increases and questioned whether the staff justification was adequate. Concerns included potential effects on small businesses, elderly residents in coastal and unincorporated communities, and environmental considerations related to disposable vape waste (raised by another commenter in the consent-discussion earlier). Several commenters characterized the increases as inflationary and called for more transparent justification and attachments in staff materials.

Board action and next steps

The board introduced the ordinance and approved staff’s request to proceed to adoption on May 6, 2025. Staff also asked the board for a CEQA finding of exemption and a waiver under board policy (B-29) to phase increases consistent with the auditor-controller’s guidance. The board voted to introduce the ordinance and to set adoption for the May 6 meeting.

Key details (from staff presentation and public record)

- Fire marshal program: proposed changes to residential and commercial plan review and inspection fees, new standby apparatus/personnel rates, and charging businesses for inspections with hourly prorating. - EMS: second-year phased increases for personnel credentialing, ambulance permitting and hospital specialty designation fees (part of a three-year phased approach). - CSA 17: proposed increase consolidates three transport fees into a single fee aligned to the county fire ambulance rate; increases affect commercial insurance billing, not Medicare/Medi-Cal fixed rates. - Staff recommended CEQA exemption for the fee updates and identified stakeholder outreach conducted to advisory boards, hospitals, ambulance providers and business groups.

Speakers (excerpted)

- Jeff Collins — Director, San Diego County Fire (presentation lead) - Andrew (county staff) — presented fee analysis and outreach summary - Public commenters: Consuelo; Audra; Mark — raised concerns about scale and fairness of increases

Actions

- kind: ordinance_first_reading motion: "Introduce ordinance amending County Fire, EMS and CSA 17 charges and fees, find the project exempt from CEQA, and set the ordinance for adoption on May 6, 2025." mover: "Vice Chair Tara Lawson Reimer" second: "Supervisor Monica Montgomery Steppe" outcome: "approved" notes: "Board approved introduction and set adoption hearing for May 6, 2025; staff to return with final ordinance and CEQA findings."

Clarifying details

- Staff said fire marshal fee schedule had not been revised since February 2021 and proposed increasing 10 fees, decreasing 1 fee, and adding 14 new standby rates; precise line-item amounts and full fee table are in the staff report and ordinance attachments. - CSA 17 proposed change consolidates resident, nonresident and out-of-county transport fees into one rate; staff emphasized patients would be responsible only for copays/deductibles and Medicare/Medi-Cal remain unaffected.

Provenance

- transcript_segments: [ {"block_id":"seg_10783","local_start":0,"local_end":96,"evidence_excerpt":"...request to update the fees charged for certain services within County Fire, the Emergency Medical Services Office, and County Service Area 17...","reason_code":"topicintro"}, {"block_id":"seg_11832","local_start":0,"local_end":64,"evidence_excerpt":"Vice Chair Lawson Reimer, that motion passes unanimously, with all supervisors who are present voting aye.","reason_code":"topicfinish"} ]

Searchable tags: ["fire_fees","EMS","CSA17","ambulance_rates","CEQA"]