Montgomery County officials are planning to spend almost $1 million to start a program to charge ambulance fees.

The program, in which insurers will be charged for residents to use county ambulances, is expected to generate $18 million for the county each year. It will start in the spring and will be run through the county's Fire and Rescue Service, said Assistant Fire Chief Scott Graham.

The county is creating four positions to handle the program and is planning to contract with a third-party billing company to charge the fees.

One of the new positions is a "patient advocate" who will field questions and complaints from residents, as well as help patients who are eligible for a waiver if they don't have insurance to pay the fee.

County spokesman Patrick Lacefield said he doesn't foresee many residents complaining about the program or the process, but the position was created in response to council members and residents who were worried there would be no support if residents had questions.

"It's an additional person who can be an advocate [for patients]," Lacefield said.

The patient advocate will make almost $75,000 a year with benefits, he said. Because the county doesn't expect many complaints for the patient advocate, the position will be placed in the county's Office of Consumer Protection and will help with the workload in that office.

"If there's additional time [after the work from the program] -- [OCP Director] Eric Friedman has assured

me they will have plenty to do," Lacefield said.

County officials predict there will be about 64,700 ambulance rides in fiscal 2013, increasing to about 68,000 in fiscal 2018. An ambulance ride costs between $300 and $800 depending on the type of service provided, with an additional cost of $8.50 per mile.

The funding for the staff positions will come from the revenue from the ambulance fees. The positions will cost a total of about $335,000 a year total. The remaining revenue will go to Fire and Rescue Services to buy equipment and cover personnel costs, Graham said.

The county has discussed creating a similar program since 2005. In 2010 county voters shot down a referendum to enact the ambulance charge.