In an attempt to generate much-needed additional revenues to a financially strapped EMS and at the same time, cease free ambulance runs to those who receive medically related services by EMS personnel, Clinton Fiscal Court has adopted a “Refusal of Services” resolution that puts a fee on individuals who receive medical care without being transported to a medical facility.

The financial condition of the Clinton County Ambulance Service came to light earlier this month at a fiscal court session. During that meeting, it was learned that the county’s Occupational Tax is helping carry the EMS on a monthly basis. Further, runs that are referred to as “signal eight” are costing the ambulance service time and money when an ambulance is dispatched to a location without actually transporting a patient to a medical facility–even though medical services are provided at the scene.

The resolution, adopted by unanimous vote of the court at its’ monthly meeting held on Wednesday, January 19, sets criteria for EMS personnel to follow in determining whether or not such non-transport patients can be billed, as well as setting a fee of $150 for such runs.

Although it was noted that charging persons who receive the medical services without being transported and subsequently billed will not solve the financial woes of the EMS, it is one step in helping generate more revenue for the service, which as in the past, has been lost.

The stated purpose of the “Refusal of Services” resolution is… “to describe the procedure for Clinton County EMS employees to follow in the event a person refuses medical care or transportation and to establish a fee for this service.”

This applies to any member that is an EMT or Paramedic involved in the delivery of medical care. It further states that Clinton County EMS shall offer medical care, assistance and transportation to any person seeking the service.

The Refusal of Services “Treatment without Transport” guidelines spells out what EMS personnel are to do and determine at a scene and criteria for establishing a relationship between the patient/responder.

The document also deals with instances involving minors, those individuals who may have mental problems or impaired persons. It also has criteria set for having to use force in providing care for the safety of others.

The document states in part, “When medical care or transportation is refused by a person, the EMS persons in charge of the incident shall make the following determination:

* Does the person display complaints, signs, and symptoms or have evidence through an examination of the scene to suggest a serious illness or injury exists?

* Is the person posing a threat to himself or others due to a physical or mental problem?

* Does the person appear to be intoxicated or otherwise mentally impaired?

“If the answer to all of these are NO, inform the patient that they will be billed for the services rendered.”

The resolution adopted by the court last Wednesday will officially go into effect next Tuesday, February 1 and reads as follows:

Whereas, Clinton County EMS shall offer medical care, assistance and transportation to any person seeking our services. Clinton County EMS recognizes that according to these guidelines that a patient/responder relationship may or may not be established; and

* Whereas, in cases that this patient/responder relationship has been established and the patient has received medical care from Clinton County EMS, it is essential to have a Treatment without Transport Fee established.

The court set the fee at $150 per run by the Clinton County Emergency Medical Services.

Although it was noted at the first meeting of the year held by the court that these fees alone were definitely not a cure for all the EMS financial problems, it is one necessary step.

Other options as to how the county will deal with the EMS budget–whether cutting back or increasing revenues sources–is likely to be the topic of discussion and debate as the 2011 year progresses.