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Several months ago, the County Council rejected ambulance fees in the fiscal 2009 budget. One reason: The proposal lacked many key details (such as who would get billed), and council questions went unanswered.

Ambulance fees are now back before the council. County officials have had months to do their homework. Yet, we know as little today as we did six months ago. Given the county executive's propensity to skip over these key details, it's critical for the council to ask the tough questions and get answers before voting. Here are some suggestions:

ïCounty officials say no resident will receive a bill for ambulance service. Yet a county-commissioned report shows revenue of $1 million-plus from "self pay" transports. At $500 per transport and a collection rate of 10 percent (again, from the county's report), 20,000 people will get some type of bill, and 2,000 will pay each year. How does this equate with the "no bill" promise? How will small business owners be impacted (e.g., for non-resident employees and or themselves if they self-insure)? If no one is billed, will county officials reduce their revenue estimates?

ïCounty officials cite Fairfax, Prince George's and other jurisdictions as models. These jurisdictions bill all residents for service; the uninsured can request waivers in an elaborate process that requires the submission of detailed tax and other financial information. Will this process be used in Montgomery County? How can a no-bill policy square with federal law (that allows waiver of co-pays but may not allow routine waiver of fees generally) and insurance policies that exclude coverage in such situations?

ïWe have been assured that fees won't deter calls to 911. Fairfax County imposed its fee in 2005. EMS call volume dropped from 2004 to 2005 (when adjusted for population growth) and has remained below 2004 levels. What analyses (e.g., surveys of impacted populations) have been done to show that ambulance fees don't deter at least some calls to 911?

ïThe county already collects a fire tax from residents (and grants and fees from inspections, etc.). Money is fungible. What guarantees will be in place to ensure that ambulance fees — or current funding — isn't shifted to the general fund? For example, will the county provide a multi-year guarantee of fire/rescue funding that includes all fire tax revenues, grants, and ambulance fees?

ïWhat impact will ambulance fees have on volunteers? The hundreds of active volunteer firefighters, paramedics and EMTs strongly oppose the county charging that we voluntarily — enthusiastically — provide for free. Why doesn't the county look at ways of strengthening volunteer recruitment and retention — which would lessen personnel costs and bolster ties between citizens and their community-based fire/rescue departments.

We respectfully submit that the council should not even consider the ambulance fee legislation until these questions have been adequately addressed and the answers given a full airing with the public.

John Bentivoglio of Bethesda is a volunteer firefighter/rescuer, life member and counsel to the Bethesda-Chevy Chase Rescue Squad.