Franklin County Emergency Medical Services is considering charging “repeat users” a fee for responding to certain types of emergencies where the patient then refuses to be transported to a medical facility, the county’s EMS director said.

The fee would be nominal, Nick Robbins, EMS director, said, but charging such a fee hopefully would motivate people to start thinking about treating the underlying causes, rather than waiting until a situation turns into an emergency scare.

“We’re not trying to penalize people to do this as a source of income, since it’s really not that much money,” Robbins said, “but it’s hopefully to encourage people that have these issues to get the [medical check-up] they need.”

Robbins specifically was referring to 58 diabetic emergencies to which the department responded in 2012. Too many of those calls, Robbins said, are from people who repeatedly call EMS for help with symptoms of low-blood sugar. After EMS crews administer a shot of Dextrose 50, or sugar water solution, the patient feels better and refuses transportation to the hospital, he said.

In some cases, Robbins said, his crews see the same patient two to three times a month for the same issues, which could indicate the patient is not telling his or her doctor about health problems or getting needed medical treatment.  

“If we start putting some kind of monetary fee, it might encourage them to find out what’s causing the problem instead of just going with it,” he said.

Robbins did not indicate how much the fee would be, but said a $125 charge, for example, would pay for the medicine, mileage and personnel costs. That fee, he said, would be far more than a $10 Medicare cost for a doctor’s visit.

Healthcare privacy laws restrict EMS personnel from discussing a person’s number of ambulance visits, Robbins said, which means his department cannot contact a repeat user’s doctor and ask about contact.

The average ambulance transport in Franklin County costs the department $528, depending on mileage and the patient’s condition. But it’s not about getting monetary compensation, Robbins said. It’s about helping people help themselves, he said, rather than “just abusing the medical system.”