ANNAPOLIS – Down the road, Maryland’s more than 4 million vehicle owners may be facing another fee increase to pay for the rising cost of emergency services, even though vehicle registration fees have risen by $5.50 since 2002, according to a legislative analysis.
EMS fees increased $8 to $11 in 2002, then rose again to $13.50 in 2003.
The fee covers a variety of services under Maryland’s Emergency Medical Services System, including MedEvac helicopters, ambulances, fire equipment, rescue squads and trauma units, according to the Maryland Department of Motor Vehicles web site. Of the current surcharge, $11 funds the EMS system and $2.50 funds the Maryland Trauma Physician Services Fund.
But EMS board decisions, increased expenditures and the possibility of replacing helicopters have put a strain on the cost of operating the EMS system.
“We’ve always been on the cutting edge in terms of EMS,” said Dr. Robert R. Bass, executive director of the Maryland Institute for Emergency Medical Services System at a Joint Legislative Committee Meeting Wednesday.
The State Police Aviation Division is supported by the EMS fund, which may be needed to replace as many as 12 helicopters at a cost of $6 million to $7 million each, according to a Department of Legislative Services budget forecast.
After MedEvac helicopter crashes in 1972, 1973 and 1986 that left six people dead, the state, in 1998, purchased Dauphin helicopters, twin-engine helicopters that were safer and more reliable.
The new helicopters have had more than 70,000 accident-free flight hours to date. The institute conducted five in-house helicopter studies and concluded that if properly maintained, the helicopters could be replaced on a 17-year cycle beginning in 2007.
The legislative budget analysis did not take into account any helicopter replacement that may be necessary as early as 2006. Even without the helicopter replacement, EMS would operate with its current funding until 2018.
In 2002, 345,000 of the 682,000 EMS calls resulted in transports. Two-thirds were medical transports and one-third were injury transports. MedEvac transports accounted for 5 percent of all injury transports, totaling 5,070.
“Maryland is recognized as having one of the best comprehensive trauma care systems in the country,” said Bass. “Our aviation program gets them to a facility where they can intervene rapidly.”
The institute oversees and coordinates the EMS system and has an 11-member board. Expenditures from the fund increased 50 percent through this fiscal year and not all is attributed to inflation. The board made the decision to increase available grants from $5 million per year in 1999 to $7.5 million dollars in 2000 and then to $10 million since 2000.
The R. Adams Cowley Shock Trauma Center, operated by the University of Maryland Medical System, also receives funds from the registration fees and has been held to an approximately 3 percent annual increase due to inflation since 1999.
It is unclear if the increase will continue, legislative analysts said. Money allotted for replacement and modernization of medical equipment is also not included in the budget forecasts beyond fiscal year 2005.
Other sources of funding besides increased vehicle registration charges or changes to current expenditures were discussed briefly.
“The federal government set up EMS, but no funding except for homeland security,” said Bass. “There is no dedicated funding in the federal government right now for EMS.”