Calif. City Ponders 911 Charge on Care Facilities

Aug. 24--Roseville senior homes may soon have to pay $225 an hour if they rely on firefighters to help residents who fall out of bed.

The Roseville City Council is considering an ordinance that would impose a fee on so-called "lift and assist" requests that involve no medical care. The move is necessary, officials said, because the calls are taxing the response ability of emergency personnel.

The care facilities are "using us essentially as a part of the staff," said Roseville Fire Chief Marcus Reed. "It's a private business using us to come pick these folks up, when in fact they have people there who could do that."

The proposal pits the city against about 100 licensed care facilities operating within Roseville -- mostly catering to senior citizens -- that would be subject to the ordinance. Officials emphasized that the $225 per hour fee would be charged to the facility, not the patient.

But Steve Weinroth isn't convinced. The executive director at assisted living community Sierra Pointe in Roseville suggested that the ordinance wouldn't change long-standing industry practices of calling 911.

"Right off the bat, (care facilities) will figure out a way to pass the cost to the resident," Weinroth said. "That's my guess."

He added, "An assisted living community is entrusted to care for its residents. This is not going to prevent us from making the call that has to be made."

The City Council had been scheduled to take up the ordinance Wednesday, but city officials abruptly canceled the vote at the last minute. Megan MacPherson, Roseville's chief spokeswoman, said the city needs to conduct more outreach.

"We realized that contact with the care facilities had not occurred," she said.

Roseville Mayor Susan Rohan did not respond to a request seeking comment.

From 2012 to 2013, the Roseville Fire Department responded to about 630 lift and assist calls at licensed care facilities. The city expects to net $70,875 annually from the fee, though Reed said it isn't meant to be a revenue generator.

"If those facilities have skilled nurses and people who can ... put them back into bed, that's a better utilization," Reed said. "We want to allocate the appropriate resource to the appropriate call."

He said the calls typically take about 35 minutes to resolve, with the city dispatching three or four firefighters on an engine or truck company and, in some cases, an ambulance.

The ordinance would not apply to lift and assist calls from private citizens.

Sally Michael, president of the California Assisted Living Association, said the ordinance would put operators in a bind, explaining that assisted living communities are not health facilities with medical personnel on site.

"State regulations require us to call 911 if there's an imminent threat to a resident's health," she said. "Sometimes that's hard to assess. When a resident has fallen, there can be injuries that aren't necessarily evident."

"As far as the department is concerned, dialing 911 and getting emergency personnel there is important" when a resident is injured, said state Department of Social Services spokesman Michael Weston, noting that facilities could be cited for failing to comply.

Skilled nursing facilities, also subject to the Roseville ordinance, wouldn't be affected by the added cost, according to one industry group.

"We have people that should be able to help patients up," said Deborah Pacyna, spokeswoman for the California Association of Health Facilities. "A skilled nursing facility is one level below a hospital. Nurses (and) frequently doctors are on site to move patients in and out of bed."

Several fire officials in the region said they do not bill for lift and assist services.

Neighboring Rocklin, with 22 assisted living facilities, has the ability to charge for "excessive" service calls, but the city has never done so in almost three decades, said Rocklin Fire Chief James Summers. The Folsom Fire Department does not charge for lift and assist calls but does bill for medical care, according to division chief Calvin Howard.

In Sacramento, home to 195 assisted living facilities, the city Fire Department does not charge for public assistance calls like a lift and assist. Roberto Padilla, a Sacramento fire spokesman, called the requests "a common occurrence."

"We don't have a problem with it, but we would like them to understand that if you call 911, there's a good chance we're going to send everything your way," he said.

Roseville officials said they will have workshops and send letters to care facilities before rescheduling a City Council vote.

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