The Cameron Park Community Services District Board of Directors approved the implementation of a First Responder Fee to help offset the increasing costs of providing paramedic-level emergency medical services on all fire suppression units within the District. Each year, Cameron Park Fire Department staff review the actual cost of delivering this advanced level of care and recommend any necessary adjustments for the upcoming fiscal year to ensure the fee reflects true cost recovery.

You received a First Responder Fee because you were the patient in an emergency medical incident—such as a vehicle accident, traumatic injury, technical rescue, or medical complaint—and a Cameron Park Fire Department engine company provided an assessment, treatment, or other medically necessary intervention in accordance with El Dorado County Emergency Medical Services protocols.

The current First Responder Fee is:

$215.00

This fee is calculated using methodologies documented in the xxx, 20xx First Responder Fee Analysis found here:

First Responder Fees are fully or partially covered by most medical insurance carriers.  If you receive a First Responder Fee bill, use the contact information provided on the invoice to submit your insurance information for billing.

The Cameron Park Community Services District Board of Directors adopted the First Responder Fee following a formal public review and approval process. The ordinance establishing the fee was introduced and read at a publicly noticed Board meeting, and was unanimously approved at a subsequent meeting in accordance with legal requirements for adopting local fees and charges.

To ensure the fee reflected only the actual cost of providing advanced-life-support emergency medical services, the District engaged DTA, a qualified third-party consultant, to conduct a detailed Cost of Services (Use Fee) Analysis. This analysis used the District’s operating budget, four years of historical call data, and operational information provided by Cameron Park Fire Department staff. The purpose of the Analysis was to identify the appropriate fee level needed to recover the true costs of delivering paramedic-level first responder services.

The ordinance adopting the First Responder Fee, as well as the full Cost of Services Analysis, are available for public review:

• First Responder Fee Ordinance – Adopted Version
• First Responder Fee Cost of Services Analysis (DTA)

Yes.  The implementation and collection of First Responder Fees has become an industry standard to fund the enhanced paramedic level of service provided by fire district resources and their staffing.

(a) A district board may charge a fee to cover the cost of any service which the district provides or the cost of enforcing any regulation for which the fee is charged.  No fee shall exceed the costs reasonably borne by the district in providing the service or enforcing the regulation for which the fee is charged.  A district board shall not charge a fee on new construction or development for the construction of public improvements or facilities or the acquisition of equipment.

The El Dorado County EMS system is designed around the fact that there are far more fire engines available than ambulances. Fire engines are strategically located throughout the county and are staffed with highly trained EMTs and Paramedics who can arrive quickly—often several minutes before an ambulance. Because early medical intervention saves lives, sending both resources ensures rapid assessment, treatment, and safe transport.

Many medical emergencies require multiple trained personnel to provide effective care. Time-critical conditions such as cardiac arrest, respiratory distress, strokes, heart attacks, seizures, traumatic injuries, and opioid overdoses often require simultaneous interventions that cannot be performed by a single provider.

In most cases, a Cameron Park Fire Department engine company will arrive first and begin care:

• A lead EMT or Paramedic begins assessing the patient and initiating treatment.
• A second responder obtains vital signs, prepares equipment, or assists with initial procedures.
• A third responder gathers information from family members or bystanders, collects medications and medical history, and obtains patient demographics.
• Fire personnel must carry all medical equipment—bags, airway kits, trauma supplies, cardiac monitors, and medications—into the scene.

When the El Dorado County Emergency Services Authority (EDCESA) ambulance arrives (typically a two-person Paramedic team), they assume patient care and prepare the patient for transport to the hospital. Because many patients in our community are older adults or have mobility issues, additional responders are often needed to safely lift or move the patient to the gurney.

For the most critical emergencies, additional personnel may be required to staff roles such as:
• CPR compressor(s)
• Airway manager
• Defibrillator/monitor operator
• IV/IO access and medication administration
• Team lead
• Time recorder and data manager
• Safety officer

In some cases, a Cameron Park Fire Department EMT or Paramedic may accompany the ambulance to the hospital to continue hands-on care.

After transferring patient care, engine companies work to return to service as quickly as possible so they can be ready for the next emergency—whether it is another medical incident, a fire, or a vehicle accident.

Cameron Park Fire Department engines carry both Basic Life Support (BLS) and Advanced Life Support (ALS) equipment, similar to what is found on a medic unit, ensuring rapid and effective treatment before and during ambulance arrival.

Local fire agencies have far expanded their original duty of fighting fires and responding to emergencies. Originally, only basic medical services were provided (splints, CPR, etc.). Today, more than 70% of all calls the fire district responds to are for advanced life support, including intubation and the use of defibrillators. The challenge for fire districts is to ensure revenues match the increasing expenses for providing this essential public service. This change in balance from traditional fire suppression to medical services has shifted the rationale for financing fire district operations toward a combination of general fund revenues and user fees, instead of solely from general fund revenues. This combination will create a more sustainable funding source by providing revenues beyond property tax assessments.

If you have received an invoice, please use the contact information provided on the invoice to submit your insurance information.  If you do not have insurance, use the contact information provided on the invoice to let our billing service know. 

Pre-hospital care is considered to be a critical component of the healthcare system, saving lives. Most medical insurance carriers cover First Responder Fees.

If you have questions about your First Responder Fee, please know that we will always attempt to bill your auto or medical insurance first, if that information is available to us. If we do not have your insurance information, you will receive a billing notice from our billing division requesting copies of your insurance card, confirmation of group or policy numbers, and basic demographic information. This helps verify that Cameron Park Fire Department provided medical care to you or to someone you are responsible for.

All billing communication will come by U.S. Mail and will direct you to respond to:

Cameron Park Fire Department
PO Box 296110
Sacramento, CA 95826-9110

For questions or assistance, please call:
1 (866) 385-6552

Checks and credit cards are accepted.

Please note: The Cameron Park Community Services District and Fire Stations 88 & 89 DO NOT accept in-person payments.

If you believe you received a First Responder Fee in error, or if you have questions about the charges, you may request a review of your bill through our billing division.

To begin the dispute or review process:

1. Contact the billing office listed on your statement:
   Phone: 1 (866) 385-6552
   Hours: Monday–Friday, 8:00 a.m. to 4:30 p.m. (PST)
2. Provide the required information, which may include:
   • Your invoice number
   • The date of the incident
   • The patient’s name
   • Any available insurance information
   • A brief explanation of why you believe the bill is incorrect
3. The billing representative will review the incident report and insurance details to confirm whether the fee was applied correctly.
4. If additional information is needed—such as proof of insurance, clarification of who received care, or details about the incident—you may be asked to provide documents to support your dispute.
5. After review, the billing office will notify you in writing of the outcome and any necessary corrections.

Please note:
All dispute and billing inquiries must be directed to the billing office. The Cameron Park Community Services District and Fire Stations 88 & 89 DO NOT handle billing disputes or accept payments in person.

Yes. The Cameron Park Community Services District has a compassionate billing policy that allows for the waiver or reduction of the First Responder Fee in cases of verified financial hardship. Individuals who are unable to pay the fee may request a review through the billing office, which will provide the necessary forms and documentation requirements.

For assistance, please contact the billing office at 1 (866) 385-6552.