CITY AMBULANCE FEES MAY RISE : 15% INCREASE WOULD BRING RATES CLOSER TO THOSE IN COUNTY.

Byline: Steven J. Gorman Daily News Staff Writer

The Los Angeles City Fire Department is proposing a 15 percent increase in the amount it bills residents for ambulance and paramedic service, a move that would bring the fees more in line with county ambulance rates.

The proposal, approved in May by the Los Angeles Fire Commission and backed by the Mayor's Office, would boost the fee charged for paramedics to treat and take a patient to the hospital by about $50 a call to $388, said Assistant Fire Chief John Ware.

That's still cheaper than the maximum fee of $402 that private ambulance companies serving Los Angeles County are allowed to charge for advanced life-support transport services.

The actual rates charged by county-contracted ambulance companies generally run lower than the maximum for competitive reasons, said Darlene Isbell, assistant director of emergency medical services for the county.

Under the city's proposed fee increase, ``I suspect L.A. city will be right in there with what companies are charging,'' she said.

If approved by the City Council, the increase would be the first of its kind in four years and would generate at least $2 million a year in added revenue for the Fire Department, Ware said.

The proposed city fee of $388 to treat and transport one patient covers the basic cost of paramedic service and medications. Separate fees are charged for mileage and such supplies as backboards, splints, bandages, dressings and oxygen masks. Those fees also would go up by 15 percent.

The council's Public Safety Committee took up the fee plan Monday and passed it on to the Budget and Finance Committee without taking further action, said Diana Brueggemann, an aide to Councilwoman Laura Chick, who chairs the Public Safety Committee.

Ware said he hoped the new rates would go into effect by September.

Like many fire departments nationwide, Los Angeles city's recoups a portion of its emergency medical service costs by billing individual patients or their insurance companies.

The cost of serving ``medically indigent'' patients - those who lack insurance and are too poor to pay - is absorbed by the city, Ware said.

While city ambulance fees have remained constant since 1992, inflation, budget constraints and a growing population have made it more difficult for the department to maintain adequate service to city residents, Ware said.

In particular, escalating salaries have combined with the rising cost of medical supplies and equipment to drive up the expense of providing life-support services.

At the same time, a growing portion of the department's budget is devoted to handling emergency calls from the poor, who increasingly rely on city ambulances and paramedics for such primary care services as rushing expectant mothers to the hospital.

``In some of the poorer areas of the city, we've become the delivery service for babies,'' said Fire Chief William Bamattre. ``It raises the whole cost of health care services across the board.''

All this comes as the city Fire Department faces a $5 million reduction in its budget, a cut that will be absorbed mostly in its enforcement programs for hazardous materials and underground storage tanks, Bamattre said.

The department collects $15 million to $16 million in ambulance fees each year, which covers less than half the cost of providing emergency medical service, Ware said.

The fee increase, combined with plans to upgrade the department's fee collection system, would boost revenues to about $18 million next year, he said.