Information for Residents

The total cost of ambulance services rendered will depend on the level of service provided appropriate to the person’s needs, as judged necessary by the paramedics on the scene in consulting with the nearby hospital’s emergency room physician.

Individual fees for materials or services rendered during an ambulance call will be itemized and provided to the insurance company along with the invoice. Although the ambulance fees assessed to residents do not cover the cost of services provided, the published fee schedule as provided by Medicare and Medicaid is used as a guide in order to minimize the cost to residents who contribute to the fire district through real estate taxes and donations.

Real estate tax proceeds only provide a portion of the revenue needed to provide our residents with professional fire, medical and rescue services.

We are very fortunate to have these full time professional services in a community our size, especially since we are an average of 15 – 20 minutes from the nearest hospital.

Many of the surrounding fire departments, as well as the private ambulances have an ambulance service fee in place.

Communities have realized the value of assessing this user fee as a means of defraying the costs of providing the highest quality emergency medical care to you and your family.

After you have received ambulance service, Andres Medical may contact you to obtain specific insurance information.

Your insurance carrier (or Medicare, if applicable) will be invoiced for the ambulance service. You will receive an Explanation of Benefits (E.O.B.) from your insurance company explaining the portion of the ambulance service fee that they will pay. Any portion of the ambulance service fee in excess of the cost paid for by your insurer will be considered a co-payment amount.

Ordinance 2022-002 was passed establishing a fee of $2,000.00 for basic life support (BLS) ambulance calls and $2,150.00 for ALS calls. These fees only apply to those who are transported by the Manteno Community Fire Protection District to the nearest hospital.

Advance Life Support (ALS) ambulance service fee calls, those requiring more extensive emergency care, are $2,150. Along with the ambulance service (transport) fees, the following itemized expenses may be applied if applicable to the emergency response:

• Mileage – $30.00 per mile
• Oxygen – $20.00

These fees will be billed and collected by EMS/ME (Andres). Most insurance companies (Medicare and non-resident Medicare providers) have agreed to pay out benefits on behalf of their customers in order to cover the cost of pre-hospital emergency care (ambulance service). We provide the following non-transport services free of charge to residents:

• Diabetic Emergencies ($250.00 for non-residents)
• Lifting Assistance: After the 10th call of the calendar year: $100 per assist.
• Refusal of Treatment
• Good Intent Calls

We always encourage residents to call 9-1-1 for emergency help!

Residents who do not benefit from privately held health care insurance, and do not qualify for medicare or medicaid, will be assessed the Ambulance Service Fee as per the ordinance.

Please call Chief Scott O’Brien (815) 468-7100 with insurance concerns or questions about payment if you do not have insurance, medicare or medicaid.

Your emergent call may have been one of many during a given period, which exhausted the availability of our ambulances and paramedics. We assist our neighboring communities when they request assistance and in turn they assist us when we are in need of additional resources. As such, you will receive an ambulance bill from that respective fire districts billing agency.

Our full-time firefighters & officers are also paramedics and can respond to medical emergencies when the other ambulances are not available due to multiple calls. Or the nature of the call may warrant additional assistance and the engine will follow the ambulance to assist with patient care. The Engines and Command Cars are equipment with medical equipment to assist the paramedics in providing EMS care until an ambulance arrives to transport.

The property taxes collected are not sufficient to fund all of the services that are being requested of the fire district. And each year, the demand for emergent services increases as does overall costs.

The Manteno Community Fire Protection District works with the Village of Manteno, the Village of Bourbonnais, and Kankakee County (Depending on where you live) to ensure the requirements are followed for the safety of all!

Effective January 1, 2023, a new Illinois law went into effect that requires any new smoke alarms installed in a single or multi-family home to have a 10-year sealed battery.  Battery powered smoke alarms currently existing in homes may remain in place after January 1, 2023, until they exceed 10 years from their manufactured date, or they fail to respond to operability tests or malfunction in any way. When these units expire or fail, a replacement unit must have a 10-year sealed battery. This applies to residents that are still using alarms with removable batteries or alarms that are not hardwired.

We strongly recommend using the 10-year life sealed battery smoke alarms; however, as long as your current 9- volt battery powered smoke alarms are working, and are less than 10 years old, there is no need to replace them currently. When these units fail or have reached a life of 10 years old or more, the new law requires them to be replaced with a 10-year sealed battery unit.

There are a few exceptions to this law, which include: homes that were built after 1988 that already have hardwired smoke alarms, in addition to homes with wireless integrated alarms that use low-power radio frequency communications, Wi-Fi, or other Wireless Local Area Networking capability.     

For more information, or if you have questions, please call Battalion Chief Adam Hartman at 815-468-7100. To view the new law in its entirety, please visit www.IFSA.org/smoke-alarm-law.

CO Presentation

It is recommended every 10 years for smoke alarms and 6 years for Carbon monoxide alarms, and at least once a year for the batteries in those alarms.

The Illinois Environmental Protection Agency has a schedule for collection dates and a listing of collection facilities in Illinois.

This fee has become necessary as the frequency of non-emergent lift assist calls has greatly increased.  We have residents who call 9-1-1    20+ times a year. They were not injured, they just needed help up. This is not what the 9-1-1 system was designed for!

We will continue to provide lifting assistance, but with the limited resources available during a given day, the call for a lift assist may cause a delay to an emergent situation. An average lift assist consumes 20- 30 minutes (response time to and from the scene, patient care & documentation). If we received one call at a time, this would not be an issue.  But we regularly experience multiple calls (36% of the time), thus creating a possible delay to the next emergent call that occurs.  This is the situation we are trying to avoid.

We recommend working with social services and other local assistance organizations to find the right level of affordable care.

For Fire District Residents, please inquire about complimentary safety inspections, smoke detectors, carbon monoxide detectors, weather radios and rural address signs.

Contact Battalion Chief Adam Hartman

You must be at least 18 years of age, in good physical condition (able to pass a medical test and physical agility test) and live within the fire district. Once you have completed the application process, passed the background and physical requirements, you will be placed in an orientation program.

Please contact Battalion Chief Richard Petersen for further information.

Daily care and attention by our firefighters, as well as the fire district prioritizing the maintenance and care of the units, as safety and reliability are very important in providing an emergent service to our community.

Tower Ladder (T79) – 25 years old.
Squad (Sq. 78) – 31 years old.
Engine E75 – 15 years old.
Engine E76 – 19 years old.
BT72 – 11 years old.
T74 – 10 years old.

In the administrative functions, it is run like a business as we maximize efficiencies, minimize expenses, seek additional sources of revenue and utilize data to make informed decisions. But operationally, this is more difficult. Here are a few examples:

1. Emergencies can’t be scheduled – we receive numerous emergent calls in a close time frame which deplete our resources for the next call. It’s easier when 911 calls are one at a time, but many times this is not the case. If the public could schedule emergencies, then we could better prepare for the demands in the most efficient method possible. It is common during each day for 2 or 3 of our ambulances and 6 of our paramedic/firefighters to be on calls and not available for the next call. One 911 call does not wait for the next call. The 911 calls tend to arrive in bunches. So how do you plan for the efficient use of resources when you don’t know what is needed at what time of the day? We utilize our mutual aid (neighboring districts/departments) for redundancy, with the hope they are not busy at the same time. This creates a better utilization of resources while lowering the costs necessary to staff at the needed service level. And we reciprocate to make it work for all of us. When others can’t reciprocate, the system is not efficient. With reduced staffing, busier call volumes and underbudgeted districts/departments, this is becoming a growing problem.
   
   
2. We must respond to a broad category of incidents, not just the ones that have revenue streams attached. Business would focus on optimization and delete the non-performing/non-optimal items. When you call 911, anything not an initial crime, traffic issue or business check mostly gets a fire response. Examples of a fire response – building fire, vehicle fire, field fire, motor vehicle accident, gas leak, carbon monoxide poisoning, structural collapse rescue, machinery entrapment…. Or an ems call such as cardiac arrest, difficulty breathing, feeling ill, stroke, diabetic emergency, allergic reaction and the list goes on. Therefore, we train every day!
   
   
3. Availability – availability is ensuring we are ready to respond to the next call at a moment’s notice.

   Redundancy – is having the resources in place to quickly respond to the next emergency.

   Both terms involve being prepared with the proper equipment and necessary training. We have heard the comment “the firefighters are just hanging around.” This is a good thing as it means we are available for your emergency. And with the demands of preparation (mandated training, maintaining proficiency & ensuring the equipment is ready) and on-going calls, they don’t just hang around much anymore. In business, availability represents under-utilized resources and would be adjusted to be maximized as they would seek out the identified opportunity. A business has hours of operation, our is 24/7.  And we must be able to respond to an emergency that we don’t know about until it’s called in. A business has planned production. If the public would schedule their emergencies, it would make our ability to respond more efficient.

   Availability is also determined by the distant to respond and the distance to the hospital. The further away the emergency from the fire station, the longer it takes for the resources to get back into service after the calls completed. It costs more money when we place stations, equipment and firefighters equally across an area.  And in a less densely populated area, there probably would not be enough tax revenue to cover the costs. A business would consolidate locations and equipment, but in doing this would create a longer response. In addition, when we are 20-25 minutes away from a hospital, it takes the ambulance crew longer to complete the call. So additional resources are needed to meet the demand. It would be more efficient if we were 5 minutes from the hospital. A call for us is not the same as a call for a fire district in closer proximity to the hospital.

   Availability is also affected by our neighboring districts/departments staffing levels, call volume and budgets. Our system has worked well as one helps the other when one is busy, it is hoped we are not all busy at the same time. This reciprocation allows us to operate in a smaller capacity vs. operating at the projected maximum community service need.

   Redundancy provides us with the ability to handle more than one call at a time. When we run one call, 36% of the time we will run another and another. This has occurred up to 9 calls at a time, but many times it 2, 3 or 4 calls in a row. We staff three ambulances, so we can handle three in a row, if we are not responding to an MVA, structure fire or other manpower intensive incidents. When we don’t have the necessary staffing & equipment to handle the requested volume, we ask our neighbors for assistance. And when they incur an increased service demand, we reciprocate by helping them too. This practice works as our peak demands don’t usually occur at the same time. Without this redundancy, we would need 9 ambulances and 54 paramedics to meet that call volume demand vs. the 3 ambulances we do operate and 22 paramedics that we employ now. If we lose this redundancy, the wait times for the next available ambulance may be 30-45 minutes.

   We must remember that redundancy is the enemy of efficiency in the business world, and it is what cost cutting & consolidation efforts focus on to justify the savings. It may be a savings, but is it worth the cost? Many medical emergencies require (such as CVA’s and traumas (falls, MVA’s) required quick responses.  Brain injury occurs within 5 minutes of reduced or no oxygen. The first 911 caller receives the service they expected, but what about caller #2, #3, etc.…  And is the Fire District fulfilling their mission at this point?

4. Proximity – “Time is Life”
   
   Placing resources in a central location sounds great from an expense perspective, but if your ambulance and/or fire engine is 20 minutes away, it’s a long way away when you want a quick response. Especially when tissue death can occur within 5 minutes of a heart attach or not breathing, or when a fire doubles in size every 17 seconds with modern materials. We have placed our resources in 2 locations, which maximizes our ability to respond quickly to most of our residents & businesses within our 96.3 square mile district.

   Proximity, redundancy, and availability are key to optimizing an emergency response, this is counter to corporate resource efficiency.

5. Efficiencies- we seek efficiencies within our scope.:
   1. Responses -Auto aid, mutual aid, MABAS, Haz Mat Team, Fire Investigation Team, CART Team, TRT Team.
   2. Sharing of Resources – testing equipment, instructors, training-academy, computer systems.
   3. Cooperating in equipment utilization & purchasing.
   4. Protecting 96.3 sq. miles with full-time staffing.
   5. Utilizing technology to improve emergent response, patient care and training.
      
      We help our neighboring communities when they are busy and they reciprocate when we are busy, but many times when one fire district/ department is busy so are the others. This may mean the nearest ambulance or fire truck may be up to 30 minutes away! It is not always as simple as it appears.
      
      
6. We respond to non-emergency calls where there is no funding available, and no one else will do it or is not available to do it – lift assists, rescue a pet… Businesses look for ways to maximize revenue and decrease costs, they would not take on these tasks. We provide services when it does not make a business sense to provide the service. We provide fire, rescue & ems services for the Common Good of all, not just a targeted segment of the community. The 911 needs and/or demands of our community are beginning to stress our ability to provide the services being requested.  The funding provided by real estate taxes & fees allocated for those services are not keeping pace with the community’s demand for services. And no one wants to pay more – the taxpayer (real estate taxes, fees), the government (Medicare & Medicaid, inadequate social services), the insurance companies (private medical & auto insurance).  If it was looked at as a business, they would abandon the business. To us, this is not an option.
   
   
7. We do not balance bill our residents for ambulance calls. This means that we don’t ask our residents to pay the remainder of the ambulance invoice that is not covered by their insurance. If a neighboring district/department or a private/hospital ambulance responds, you may be asked to pay the remainder owing. This is a big benefit for the residents of our community as we plan to best meet the needs to the community through proper staffing, equipment levels and revenue/cost management.

To discuss & develop sustainable solutions, we must understand the mission of our fire district and the daily demands placed on us to achieve the mission for our community. Although we have provided several examples of why we perform the way we do, it is not all encompassing. We encourage you to contact Fire Chief Scott O’Brien to discuss any issues, questions, or concerns about our service delivery model that we utilize to meet the needs of our community.