Ambulance Services & Fees

Training for: Legal Notes

Question: Must municipalities provide ambulance services, and if they do so, may they charge ambulance fees?

Answer: There is no legal requirement that municipalities provide ambulance services. But municipalities are expressly authorized to raise and appropriate public funds to operate a municipal ambulance service or support a separately incorporated ambulance service (see 30-A M.R.S.A. § 5725(9)). A municipality may charge an ambulance fee if it operates a municipal ambulance service but not if it merely provides financial support for a separate service.

Ambulance fees are not imposed by state law. In order to charge a fee for a municipal ambulance service, a municipality must establish a fee by “home rule” ordinance (see 30-A M.R.S.A. § 3001) enacted by its legislative body (town meeting or town or city council). The fee should be proportionate to the actual cost of providing the service, should be imposed only on those who actually receive the service, and should be imposed on all similarly situated persons equally. The fee cannot be used to raise general revenue or to fund other services or general government.

It is probably permissible to charge an ambulance fee to non-residents but not to residents of the municipality. There is a rational basis for this distinction because non-residents do not pay local taxes to fund a municipal service, whereas residents do (see generally Baldwin v. Fish & Game Comm’n of Montana, 436 U.S. 371 (1978)). It is probably not permissible, however, to charge only those with insurance because it would be difficult to demonstrate a rational basis for this distinction.

Ambulance fees that are collected must be deposited and may disbursed by the municipal treasurer in accordance with the laws governing municipal funds. If a fee is not paid voluntarily, a municipality may go to court (Small Claims Court if the fee does not exceed $6,000) to collect it. If the person billed has insurance, their plan may cover the fee, but a municipality should not bill the insurer directly because there is no legal relationship between the municipality and the insurer. Instead, the person billed should be instructed to submit the claim to their insurer if they have one.

For more on fees, see our “Information Packet” on Fees, User Fees, Impact Fees, Service Charges and PILOTS, free to members at www.memun.org. (By B.N.G.)

Question: Must municipalities provide ambulance services, and if they do so, may they charge ambulance fees?

Answer: There is no legal requirement that municipalities provide ambulance services. But municipalities are expressly authorized to raise and appropriate public funds to operate a municipal ambulance service or support a separately incorporated ambulance service (see 30-A M.R.S.A. § 5725(9)). A municipality may charge an ambulance fee if it operates a municipal ambulance service but not if it merely provides financial support for a separate service.

Ambulance fees are not imposed by state law. In order to charge a fee for a municipal ambulance service, a municipality must establish a fee by “home rule” ordinance (see 30-A M.R.S.A. § 3001) enacted by its legislative body (town meeting or town or city council). The fee should be proportionate to the actual cost of providing the service, should be imposed only on those who actually receive the service, and should be imposed on all similarly situated persons equally. The fee cannot be used to raise general revenue or to fund other services or general government.

It is probably permissible to charge an ambulance fee to non-residents but not to residents of the municipality. There is a rational basis for this distinction because non-residents do not pay local taxes to fund a municipal service, whereas residents do (see generally Baldwin v. Fish & Game Comm’n of Montana, 436 U.S. 371 (1978)). It is probably not permissible, however, to charge only those with insurance because it would be difficult to demonstrate a rational basis for this distinction.

Ambulance fees that are collected must be deposited and may disbursed by the municipal treasurer in accordance with the laws governing municipal funds. If a fee is not paid voluntarily, a municipality may go to court (Small Claims Court if the fee does not exceed $6,000) to collect it. If the person billed has insurance, their plan may cover the fee, but a municipality should not bill the insurer directly because there is no legal relationship between the municipality and the insurer. Instead, the person billed should be instructed to submit the claim to their insurer if they have one.

For more on fees, see our “Information Packet” on Fees, User Fees, Impact Fees, Service Charges and PILOTS, free to members at www.memun.org. (By B.N.G.)