Public response led the Cherokee County Board of Commissioners to rescind the citizen assist fee for Emergency Medical Services on Monday night.
“I’ve been contacted by several residents of the county, and in particular a few veterans, who have asked if this board would consider waiving the $100 citizen assist fee for the veterans of the county,” Commissioner Jan Griggs said.
Commissioner Randy Phillips made a motion to waive the fee for all residents. Assistant county manager Maria Hass said the board likely needed to go that route, as opposed to attempting to waive it for only one group of people. Commissioner Cal Stiles later suggested reimbursing any residents who have already been charged. The board also unanimously approved that motion, which was made by Griggs.
Before that move, the county’s EMS fee system was a bit complicated.
When the board of commissioners voted in June to add a charge for Emergency Medical Services service calls that require a citizen assist – even those that didn’t result in hospital transport – with the 2022-23 fiscal year budget, they may have underestimated the aftershocks felt in the community.
First, there was some confusion around just what service is attached to what charge. Robin Caldwell, director of the county’s emergency services, cleared that up right away.
“There is not a charge for 911 calls for any reason. Anyone can call 911 at any time for an emergency,” she said. Under the now former policy, “If someone calls 911 for a citizen assist, this will constitute a charge of $100.
“Citizen assist means a non-emergency service requested by and provided to a citizen.”
However, it wasn’t quite that straightforward. Local resident Paul Goings required a citizen assist when he fell out of his chair and required assistance to get off the floor. He received a bill for $100 per fall.
The charges took effect July 1, so Goings’ 911 citizen assist call in June was free. However, when he fell multiple times in August, he began accruing charges totaling $500 before he understood what was happening.
Goings called 911 and asked for assistance, EMS personnel arrived and provided that assistance, so he was charged $100 under the new budgetary requirements. But things get complicated when the charges start fluctuating.
Changing charges
Local resident Vivian Greene said she made the very same call to 911 that Goings did.
“I got tangled up in my kitchen stool, and I went one way it wanted to go the other,” she said.
Greene landed on the floor and her son, afraid to move her in case she broke her hip, called 911 for a citizen’s assist. EMS personnel arrived and helped her walk to her chair. She didn’t it yet know it, but that call was meant to cost her $100. Except that it didn’t.
Greene was charged $360 for her assist. The difference with her fall and Goings’?
“The EMS guy touched my hip to see if it was broken,” she said. It was not. That one assessment increased her charge for the service call by $260.
Caldwell explained some of the costs involved with a simple assist 911 call.
“[Each call] requires an ambulance with medics to respond, thus incurring costs,” Caldwell said. “Cost factors include the ambulance, maintenance, fuel, two certified personnel, etc. Citizen assist may not need medical care or treatment, but they are receiving a service from skilled and trained personnel.”
Greene is less concerned with details than intent.
“This is all politics; they want the money they lost in the lawsuit,” referring to the recent settlement against the county for $48.5 million.
However, Caldwell shared that “citizen assist calls have more than doubled since 2018. They consist of over 10 percent of call volume.”
People who need help
Mark Ripplinger, like many others in Cherokee County, was startled to receive a bill for $535 for his 911 call for a citizen assist for his wife.
“She had a little episode, and I thought I better call an ambulance,” he said.
Ripplinger is man who would know when to make that call. As a retired firefighter, nurse and paramedic, he has experience about how these things work.
“I understand there are expenses. It’s scary how much stuff costs,” Ripplinger said, “But you can’t charge for a refusal [for transport to the hospital] for a 911 call.”
When the paramedics arrived to his house, his wife was stable and in bed. They checked her blood pressure, monitored her heart and placed an oversized paperclip-looking apparatus on her finger to check her oxygen levels.
His wife’s numbers were steady enough to refuse transport to the hospital. After the paramedics left, he decided to take his wife to the hospital on his own.
The whole experience was so relieving, and the conduct of EMS personnel so professional, that Ripplinger wrote a note to Caldwell, praising her for the efficiency and courtesy of her staff. Then the bill arrived.
“Two weeks later, I got this bill for $535,” he said. Like others before him, he was shocked.
“You can’t charge for a refusal,” he said. So he wrote Caldwell another note, this one with fewer accolades.
“I bit my tongue and tried to be as nice as can be, telling her that this is how you get people not to call 911. Do cops charge for a call about a prowler?” Ripplinger said.
A 25-year veteran of the fire department, he said his department never charged for a call. He’s also confused that if 35 percent of Cherokee County’s population is within the age range that may require more medical assistance, “Why would we expect to pay for an ambulance? These are the people who need the help.”
Another tension point for those charged centers around why they weren’t informed of the budget changes, but Caldwell believes the public was properly notified.
“The board of commissioners had not increased our EMS billing rates since 2018, while the cost of providing the service has risen significantly,” she said.
Still, this doesn’t assuage Ripplinger.
“I pay taxes,” he said. “It should cover a refusal. The EMS system is there to protect citizens; if you are afraid to call them for fear of the money, it leads to injuries or death.”
Editor Jared Putnam contributed to this report.