DOUGLAS COUNTY, Ga. — Douglas County commissioners voted unanimously to impose a $100 fee on 911 medical calls when the patient is treated but not transported to a hospital.
The measure, proposed by Fire Chief Miles Allen, appeared on the March 17 Board of Commissioners consent agenda.
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Chief Allen said the proposal is a cost-recovery measure for EMS calls that use resources but don’t result in a billable transport.
Allen offered two hypothetical examples to show the problem. In one, EMS responds to a patient found unresponsive with critically low blood sugar, administers a $250 dose of glucagon, and the patient regains consciousness but refuses transport. In the other, EMS responds to a cardiac arrest, performs resuscitation using airway devices, IV/IO supplies and defibrillation pads — about $500 in expenses — but no ambulance transport occurs because the patient does not survive.
The chief estimates that roughly one-third of EMS calls, about 5,600 in 2025, do not result in a patient transport. Assuming a 60% collection rate, he said the department could recover about $336,000 in revenue to help offset the cost of pharmaceuticals and disposable EMS supplies now paid through the operating budget.
The fee is intended solely as a cost-recovery measure to offset the cost of consumable EMS supplies and pharmaceuticals used during patient care, not to generate revenue. The proposal also said the practice is common in EMS and that patient care would never be delayed or denied because of billing concerns.
The fee would apply to:
- 911 responses by Douglas County Fire-EMS
- Patients who are assessed and treated
- Patients who refuse transport
The fee would not apply to:
- Lift assists without a medical assessment
- Public safety-only responses
- Incidents that do not involve patient care
The department said billing would be handled by its current third-party vendor, EMS-MC, and the board approved the fee and authorized the commission chair to sign related documents pending legal review.
What do you think: Should departments bill for non-transport EMS calls to recover costs, or does that create risks for patient care?
