By Tia Lynn Ivey
Just when Morgan County was accelerating the search for a new ambulance provider, county officials were forced to slam on the brakes.
“Here I thought the county was in control,” said County Commissioner Donald Harris. “Today I found out, that’s not the case.”
Ambulance service in Morgan County has been under scrutiny in the last year, after several instances of citizens with severe medical emergencies endured extraordinarily long wait times for an ambulance to arrive.
County officials have been pressed by residents to either enhance the current ambulance service by adding more medical response vehicles and personnel or switching ambulance providers altogether. County Manager Adam Mestres was about to put ambulance service out to bid, as part of the county’s research on how best to proceed, when Huey Atkins, director of National EMS, the current ambulance provider, told him not so fast.
Atkins informed Mestres that the National EMS, now owned by Priority One, is designated as the official and sole ambulance provider for Morgan County’s zone. “They effectively own this zone,” said Mestres to the Morgan County Board of Commissioners (BOC) on Tuesday, Oct. 1. The commissioners were shocked to learn they had no control over which company provides ambulance service in Morgan County.
“The only way to change ambulance service providers is through gross negligence, if National EMS significantly fails to meet the terms of our contract or if National voluntarily gives up its designation as zone providers,” continued Mestres. “They meet our standards, but even they didn’t, we would have to take it before the Region 10 Council and they would decide whether or not to replace National EMS.”
According to Mestres, while the county has no control over who the ambulance provider for Morgan County is, the county has control over renewing a contract with National EMS, but that option poses its own set of drawbacks and unintended consequences. The county’s contract with National EMS is set to expire on Oct. 31. The county pays National EMS $289,000 annually for two ambulances plus fuel costs.
“We do not have to renew our contract with National EMS and they would still be required to provide ambulance service in Morgan County,” said Mestres. “We have an option not to renew the agreement, but we don’t have an option to change providers
However, should the county forgo renewing a contract with National EMS, there is the risk of a reduced level of service at stake.
“Without a contract, National EMS would only have to provide the state standard level of service,” said Mestres. “Our contracts mandates a higher level of service. I don’t know that National EMS would reduce the quality of service, but the potential is certainly there for that to happen if we don’t have a contract with them and they lose funding from us.”
Mestres learned that designated zone providers were established in multiple counties and cities across that the state in the early 1990s, due to a situation in Atlanta.
“Atlanta was just flushed with ambulances from different providers and it created a problem with ambulance competing to beat each other to calls, it caused accidents and such, so designating a zone provider came about as a solution to that,” said Mestres.
National EMS has been Morgan County’s zone provider for nearly two decades, but the county officials were unaware that they were powerless to change that if they wanted. National EMS currently provides Morgan County with two ambulances to cover a population of nearly 19,000 spread across 350 square miles.
“Let’s just say we had a few million dollars to invest and open up our own county ambulance service,” imagined Mestres. “We could buy the trucks, staff them up, put them in our firehouses, and the state would come in and say, ‘hey, you can’t do that.”
Mestres praised National EMS for their quality of emergency medical service.
“As you know, all of this came about due to response times and not the actual quality of medical service National EMS provides,” said Mestres.
This brought the commissioners back to discussing how to enhance ambulance service through options available from National EMS, such as adding a third ambulance to the county or some other emergency medical response vehicle to provide better coverage across the county and quicker response times.
Mestres cited a few current statistics for the commissioners.
“I did some digging from this year’s numbers—from July, August and September of 2019, compared to the same time in 2018.
According to Mestres, for the third quarter of 2018, there were 697 calls for ambulances across all four priority categories. Eight mutual aid calls, which are calls for out-of-county ambulances to respond to a medical emergency, were requested for Priority 1 cases. In the third quarter of 2019, 675 calls for ambulances were reported, with 10 mutual aid requests made for Priority 1 cases.
“Out of those 10 mutual aid calls, six of them resulted from our ambulances being on a transport,” said Mestres. Metres stressed that the contract with National EMS stipulated they must respond to Priority 1 calls within 9:59 seconds at least 90 percent of the time.
“They actually go over that,” said Mestres. “But what we hear is that 90 percent of the time just isn’t enough.”
“This has never been about the quality of medical service National provides. They do an excellent job,” said Mestres. “This all started because of concerns over response time, not the level of care given once they arrive.”
Citizens have complained about National EMS conducting non-emergency transport when Morgan County only was two designated ambulances to cover medical emergencies.
Paula Sellers, whose husband Scott Seller suffered and medical emergency a few months ago and couldn’t get a Morgan County ambulance, brought up this point during Tuesday’s meeting, slamming Atkins for allowing hospital transports.
“He has a good milk cow and he sure is milking that cow for all it’s worth,” said Sellers. “If they are going to have transfers they get paid for, can we not ask or put in the contract that they have one of their ambulances from Watkinsville able to cover while they are making money off our two measly ambulances we have here?”
Now that bidding out ambulance service is off the table, County Commissioners plan to review options from National EMS on the costs of providing another ambulance or other emergency medical services. A third ambulance, running 24 hours a day, 7 days a week is projected to cost the county another $500,000. The county is looking other options including running a third ambulance only during high volume hours, or getting a quick response emergency medical vehicle that does not have transportation capabilities.
“There are actually a wide variety of options we could pursue,” said Mestres.
“We have a lot to look over in the next couple of weeks,” said Commissioner Chairman Ron Milton.