The cost of using a Charleston County ambulance is likely to increase by $50, for the second time in two years, as the county raises Emergency Medical Service rates to capture higher insurance reimbursements and pay for rising costs.

The rate increase awaits a final vote by County Council this evening. There was no opposition to the increase during preliminary votes.

The new rates are roughly tied to an increase in what Medicare and private insurance companies are willing to pay, according to county EMS Director Don Lundy.

However, about 30 percent of those served by the countywide ambulance service do not have health insurance, Lundy said.

Like Berkeley and Dorchester counties, Charleston operates a countywide EMS system, and it is the county's ambulances that respond to 911 calls. Charleston County's current rates are similar to Berkeley's and less than Dorchester County's.

A public hearing is scheduled this evening, before the final vote on the new fees. The county previously increased rates by $50 in 2007.

If the council approves the new rates, the minimum charge for transport in a county ambulance would rise to $375 plus $8.50 a mile, from the current $325 and $7 per mile.

The rates for greater levels of medical treatment also would rise by $50, to $425 and $550, depending upon the level of advanced life support needed.

Berkeley County's EMS rates for similar levels of service range from $300 to $500. In Dorchester County, comparable rates are $400 to $1,285.

"Wow, they are giving their service away," said Dorchester County EMS Director Doug Warren.

Lundy said new EMS treatments and equipment are saving lives in Charleston County, but those improvements have been costly.

For example, the county started using a machine called the AutoPulse about two years ago. It's a mechanical chest-compression device that is used to keep a heart pumping, and Lundy said the machine has dramatically increased the ability of EMS crews to resuscitate heart attack victims.

The machine uses an adjustable strap to compress patients' chests, and those straps are designed for one-time use and cost about $100.

A different piece of equipment recently acquired by Charleston County EMS allows ambulance crews to diagnose heart attacks en-route to a hospital and transmit the information to the emergency room, potentially allowing heart attack victims to go directly to a cardiac catheterization lab.

And another piece of machinery allows EMS crews to keep pressure on a patient's lungs to make breathing easier, which can eliminate the need for a ventilator and several days in a hospital, Lundy said, but it all costs money.

"We're mostly (increasing rates) because it costs more to provide the service," he said.

The new rates also reflect increases in Medicare reimbursement rates.

"What we don't want to do is leave money on the table," Lundy said.

For counties, EMS rates are partly a question of how much of the costs should be paid by those who use the ambulances, and how much should be paid by all county taxpayers.

Lundy said raising rates will pass more of the rising costs along to people who use EMS, and their insurance companies, while all county taxpayers will continue to pay the underlying cost of the EMS system.

County Council had rejected the idea of charging higher rates to ambulance clients who do not live within the county.

The hearing on the rate increase is scheduled for 6:55 p.m. in the Lonnie Hamilton III Public Services Building at 4045 Bridge View Drive, North Charleston.