San Jose council endorses studying first‑responder EMS fee; chief says ability to treat won’t change
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Summary
After months of developing a proposed first‑responder fee, the council accepted staff’s plan to pursue a fee and compassionate‑billing program and directed future review of ordinance and budget treatment; staff estimated up to $4 million annually under assumptions.
The City Council voted March 25 to move forward with development of a San Jose Fire Department first‑responder fee program and related compassionate billing policy, directing staff to return with an implementing ordinance and budget language later this year.
Fire Chief Robert Sapien and his team told council their preliminary model estimates an initial per‑incident cost basis that could translate to about $4 million a year in gross revenue under national payer‑mix assumptions, while the department emphasized that “ability to pay will never be a factor in patient treatment.”
Why it matters: the proposal would bill insurance payers for advanced life‑support care delivered by fire department paramedics at 911 scenes; staff said the city would adopt a compassionate billing approach with waivers, payment plans and forgiveness programs for uninsured or hardship cases so that treatment remains unconditional.
Council members pressed for safeguards and clarity on likely revenue, impacts on low‑income residents and how proceeds would be allocated. Councilmember Candelas urged that proceeds eventually be considered to support ambulance‑adjacent emergency response work such as Med 30; others asked that any general‑fund treatment be spelled out in the budget process.
Council action: by unanimous vote council approved the staff recommendation to finalize details and return with an implementing ordinance and recommended fee schedule for council review in June 2025; staff said implementation would not change medical protocols.
What’s next: staff will complete a compassionate billing policy, come back with an ordinance and proposed fees and charges in June, and run a public information campaign explaining waivers and protections for uninsured or hardship cases.
