Ambulance service in Morgan County is under scrutiny from several residents who worry just two ambulances cannot sufficiently handle the medical needs of the community after personally experiencing long wait times during dire emergencies.
Since November of 2017, Morgan County Dispatch called out-of-county ambulances a total of 88 times to respond to emergencies when Morgan County’s two designated ambulances from National EMS were either tied up on other calls or needed more assistance on the scene. After two recent controversial cases, one in which a woman died after waiting nearly a half hour for an ambulance and another in which seven injured car accident victims waited while bleeding on the side of the road for almost an hour before an ambulance arrived, several local citizens are asking for a third ambulance to be added in Morgan County.
Ambulance service in Morgan County is currently contracted out to a private company, National EMS, recently bought by Priority Ambulance. National EMS has been Morgan County’s ambulance provider since 1988. The county pays $289,000 a year for two ambulances that operate 24-hours-a-day, 7-days-a-week, mandating that the ambulances respond to Priority One calls in less than 9 minutes and 59 seconds, 90 percent of the time. Both officials from the county and National EMS claim two ambulances are adequate to handle the vast majority of emergency medical needs in Morgan County, a community of more than 18,000 people. The addition of a third ambulance would cost the county $500,000 extra per year—a cost that would most likely be passed on to the taxpayers, according to County Manager Adam Mestres.
“A half a million dollars would amount to a half mil increase to the millage rate,” said Mestres. “Ultimately right now, based off the data in their contract with us and the analytics they send to the county quarterly, National EMS is meeting, on average, those response times, for both Priority 1 and Priority 2 calls,” added Mestres.
“We are meeting that threshold,” said Huey Atkins, National EMS Director of Operations for Morgan County. According to Morgan County Dispatch, the average response time for Morgan County ambulances were: 8 minutes 58 seconds in 2017, 8 minutes and 55 seconds in 2016, and 9 minutes 28 seconds in 2015.
Atkins did, however, concede, that mutual aid, calls for out-of-county ambulances that happen when Morgan County ambulances cannot respond at all, are not factored into National EMS’ review of ambulance service. “If we can’t respond, we can’t factor that in to our response times,” said Atkins.
Two recent cases in Morgan County did not negatively affect National EMS’ calculated response time averages, because National EMS couldn’t get there at all, point out critics advocating for more ambulances.
The death of a Madison woman in July first raised the question if two ambulances are enough for Morgan County.
Donna Martin, a 73-year-old Madison resident who succumbed to complications after a wasp sting, waited a harrowing 28 minutes for an out-of-county ambulance to arrive after her family called 9-1-1 when she collapsed on July 21. Although an 18-year-old volunteer firefighter, Curry Wadsworth, arrived on the scene within 12 minutes after the initial call for help, he could only perform CPR, but could not administer anaphylaxis drugs or other lifesaving medicines to counteract cardiac arrest. Once an ambulance from Greene County arrived, Martin was transported to Morgan Memorial Hospital where she was later pronounced dead.
“I think it is only fair to ask the community – is this okay? If this were your loved one, would a 28-minute response time in a life-or-death situation be acceptable?” said Ellen Sims, Martin’s daughter. “You put your faith in the system. You entrust that calling 911 is your best bet for life-saving care. Our mother was a tax paying citizen of our county for 35 years, and our local EMS failed her…we had to wait 28 minutes for Greene County’s EMS team and ambulance to arrive. Morgan County’s ambulance system never came.”
Sims, and the rest of her family, is asking for change.
“What our mom needed was a ‘Plan D,’ something we know other counties have in place in the event of a ‘perfect storm,” said Holly Martin Garcia, Donna Martin daughter and practicing nurse in Athens. “A ‘Plan D’ should have been experienced back up medics on call to receive any critical calls. If she would have received this treatment, CPR with the addition of life-saving drugs, she possibly might still be here today.”
“Our mom was the most important woman in our lives and she deserves a better response to this tragedy than people just telling us it was ‘unfortunate’ and that it was ‘just the perfect storm.’ Those responses alone are just not good enough. What is ‘unfortunate’ is that our current system in place failed her, and we need a community that stands with us to effect change. Our loved ones deserve such change, and so do yours,” said Sims.
Just last week, another incident drew the ire of a local nurse, who happened to drive by a serious accident in Morgan County and waited with injured victims for nearly an hour before an ambulance arrived.
On Tuesday, Oct. 9, a two-car crash on Highway 83 between Bostwick and Madison left seven people, including a teenager and an infant, on the side of the road waiting for an ambulance for 58 minutes before an out-of-county ambulance from Greene County finally arrived. Beth Hallman Herring, a nurse at Piedmont Athens Regional Hospital Medical Center, happened to drive past the accident and stopped to help. Herring noticed the adults and teenager from the first car were holding their arms and necks and the teenage boy was bleeding from his nose and forehead. The infant had no visible injuries, but she feared there could be internal injuries. “I was worried about internal bleeding for him and for the baby,” said Herring. Herring became most concerned for a young college girl, the driver who accidentally crashed into the other car, who was bleeding from her stomach while lying on the side of the road, unable to stand up.
“She said she couldn’t get up and was seeing stars,” said Herring. “She was complaining of abdominal pain. She laid there so long, ants started to crawl all over her.”
Herring waited with the accident victims. A first responder also happened to drive by and stopped at the scene. Police officers and other first responders with medical bags showed up on the scene, but all Morgan County ambulances were tied up on other calls. Initial calls for mutual aid from surrounding counties were also denied because of other emergencies.
The initial 9-1-1 call was made at 4:32 p.m. When one Greene County ambulance arrived at 5:30 p.m., there was not enough room to transport all seven victims to the hospital.
“I couldn’t believe what was happening,” said Herring. “Greene County was told there was only two victims injured. This isn’t a fluke. This is a serious problem in our town and in our county. What if these were your children laying on the asphalt for an hour, possibly bleeding to death, and being eaten by ants?” said Herring, who claims other law enforcement and medical officials at the scene admitted to her that this was not a rare occurrence.
“One of them said to me, you’d be surprised how often stuff like this happens, where we are on the side of the road just waiting and waiting for an ambulance,” remembered Herring. “I was born in this town and I love Madison. I support it in every way. I think it’s great we have a new hospital and new schools, but what’s the point of having a new hospital, if people die before they can get there? It doesn’t make sense.”
Herring plans to use her voice to lobby for a third ambulance in Morgan County.
However, officials with Morgan County and National EMS argue that these cases are rare and not reflective of a broader problem that would warrant the addition of a new ambulance. According to Atkins, the number of ambulance needed in a county is based on several factors, including population, emergency medical call volume, current average response times, and financial considerations.
“I live in Morgan County, and I do think two ambulances are enough, but we have committed to looking into adding more with the new hospital opening. We will look at adding additional ambulances,” said Atkins. “If the county wants it, and the people are willing to pay for it, we will provide as many ambulances as desired…You don’t even want to say you have to discuss money when it comes to this, but unfortunately, that’s what it comes down to,” said Atkins. “We will do whatever the county commissioners want us to. If they want, three, four or five ambulances, we would provide it. But the volume is just not there long-term to offset the cost.”
Mestres, too, noted the cost of a third ambulance would more than double the county’s current budget for ambulance service and would most certainly translate into a property tax increase.
“Based on an average fair market value house of $225,000 a resident could expect to pay an extra $67.50 per year to help fund EMS. This does not include buying or building a station, maintenance, or other reoccurring costs. Of course, we have a lot of people in the county that have houses valued much higher than that as well,” said Mestres. “We do have an obligation to provide the best service possible within the means of what the county can afford—what the taxpayers are willing to pay for.”
The Morgan County Citizen reached out to surrounding counties to understand how different communities measure the need for ambulance service in their communities and how it compares to Morgan County. Morgan is one of the few counties in the region with only two ambulances.
Morgan County’s population is estimated to be 18,412 residents, spread out across 347.35 square miles. Morgan averages around 2,500 emergency ambulance calls per year. National EMS handles emergency medical calls as well as hospital transfers from Morgan Memorial Hospital. According to Amanda Proctor, director of Morgan County Dispatch, the number of emergency calls requiring ambulances is on track this year to outpace last year’s numbers. So far, in 2018, there have been 1,969 calls for ambulances. “We have had more calls than this time last year,” said Proctor. In 2017, there were 2,557 calls for ambulances, 2,436 in 2016, and 2,655 in 2015.
Upon examining ambulance service in Greene, Putnam, Oconee, Oglethorpe, Rockdale, and Hancock counties, Greene County, which runs three 24/7 ambulances plus a private service handles hospital transfers, bears the most similarity to Morgan County’s makeup.
Greene County’s population is about 1,000 less than Morgan County’s, with 17,281 residents spread across 387.44 square miles. Greene County averages around 2,900 calls for ambulances per year since 2016, a reduction from previous years since Greene County EMS stopped handling non-emergency transfers between hospitals.
“Our 9-1-1 coverage was suffering,” said Greene County EMS Director Jeff Smith. “Our mission is to truly provide for our citizens pre-hospital emergent care, as we are the sole pre-hospital provider here. “We want to make sure our 9-1-1 coverage is handled and dealt with first, so we had to give up hospital to hospital transfer to ensure optimal emergency 9-1-1 coverage.”
While Greene County runs the ambulance service in house, their budget is three times greater than Morgan County’s ambulance budget, coming in at $965,361 annually.
Putnam County, which has a larger population than Morgan County, coming in at 21,218 residents spread across 360 square miles, according to the last census, also runs three 24/7 ambulances with a much larger annual budget of $1.7 million annually for ambulance service, according to Finance Director Brad Murphy. Putnam County averages 2,800 calls for ambulances per year.
Oglethorpe County, with a population of 14,875 spread across 439 square miles, runs two 24/7 ambulances with a third on stand-by in case of multiple emergencies. Oglethorpe fields an average of 2,100 calls for ambulances per year and pays about $900,000 annually for ambulance service, according to Finance Director Josh Hawkins.
Oconee County, which also employs National EMS for ambulance service, is more complicated because of the county’s overlapping service with Athens/Clarke County. According to Don Cargile, with National EMS, there are usually three ambulances running at any given time in Oconee County, but Clarke County’s nearby ambulance stock of up to 13 ambulances, are readily sent to Oconee County when needed. The two counties share the cost, with Clarke County paying $300,000 and Oconee paying $100,000. According to National EMS, because Athens has a much higher volume of calls and therefore more patients to bill, it offsets the cost to Clarke and Oconee counties more than it does in Morgan County. Oconee’s population is far greater than Morgan County’s coming in at 38,028 spread across 184 square miles. According to Cargile, Oconee and Morgan have similar emergency call volumes for ambulances. “Oconee and Morgan are about the same, averaging about 2,500 calls per year,” said Cargile.
Hancock County is the only nearby county with less ambulances than Morgan County. Hancock runs one 24/7 ambulance and one day-time truck. But there population is about half of Morgan County’s, coming in at 9,402 spread across 471 square miles. Requests for call volume and budget information were not returned as of press time on Tuesday, Oct. 16.
Mestres and Atkins say they are open to the idea of adding a third ambulance, but worry about economic feasibility and also caution citizens that another ambulance might not prevent unavoidable tragedies.
“Two ambulances is adequate for the number of calls we have, but is that to say that we would not benefit from a third ambulance? I think the answer to that is that, yes, we could benefit from a third, fourth, or even fifth ambulance,” said Mestres. “But that wouldn’t guarantee these tragedies would never happen again…That’s an unfortunate reality of emergencies, no one schedules when they are going to have an emergency, they just happen. And when unpredictable emergencies happen at the same time, even with more ambulances, we could find ourselves with the same problem.”
“But if the numbers overall were to dictate the need for a third ambulance, the county would support that despite the tax burden,” said Mestres.
“The problem with Morgan County, is we can go two or three days and not run one ambulance call at all and then it’s like someone rings a dinner bell and we have four or five calls at one time for an ambulance,” said Atkins, who encouraged citizen to reserve ambulance calls for true emergencies. “It’s something you just can’t count on. You can always say you need more ambulances, but the volume is not there on average. In instances when we can’t respond, we rely on mutual aid and we also give mutual aid and we count on our first responders. We all help each other,” said Atkins.
However, Sims, Garcia, and Herring are hoping to convince the county to follow suit with surrounding counties.
“We’ve been told there is just not enough ‘business’ for a third ambulance, that it’s just a ‘money thing,’” said Sims. “And to that I say, if it is a ‘money thing,’ why are we spending $35 million on building a new hospital when there is not a rock-solid plan in place that meets the 100 percent threshold of getting our citizens there? We gave our county-contracted ambulance company ‘business’ that day, and they were not able to meet our needs.”
“If this situation happened to any elected official in Morgan County; his wife, his daughter, his grandchild, I can only imagine they would use their platform for change to occur, whether it be the addition of a third ambulance, pushing to have a non-privatized EMS service like in Greene County, or having a plan in place such as Jackson County EMS where trained medics can drive to the location with their medical box and begin treatment until EMS arrives,” said Garcia.
“This situation truly scares me and frightens me,” said Herring. “I feel I need to sound the alarm and spread the word about the ambulance situation in Morgan County. I encourage all Morgan County Citizens to get involved, because I don’t want something terrible like to happen to my family or to anybody else’s family.”