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FLAGPOLE
CLASSIFIEDS
T he bicyclist was Struck from behind as
he rode down Milledge Avenue in the
early morning hours of Feb. 15. The
truck continued another two blocks, dragging
the bike with it according to police reports,
before the driver turned around, called 911
and administered CPR to the rider.
- National EMS, the official ambulance ser
vice for Athens-Clarke and Oconee counties, •
was notified of the accident at 2:48 a.m.
and arrived on the scene at 3 a.m., accord
ing to the accident report. The cyclist arrived
at Athens Regional Medical Center, less than
two miles away, at 3:14 a.m. A week later,
he remained in a coma from an accident that
took place five blocks from Athens-Clarke's
Fire Station No. 3 on South Milledge Avenue.
But because firefighters don't respond to
emergency medical calls, it was only the
National ambulance, responding from
the company's main office on Macon
Highway about three miles away, that
could come to the cyclist's aid.
The incident underscores what
some say is a basic design flaw in the
county's emergency management sys
tem. Historically a task split by Athens
Regional Medical Center and St Mary's
Hospital (and even before that, by
local funeral homes), the ambulance
service was contracted to the family-
owned National EMS in 2009. As a
result the private company operates
its own fleet of ambulances from five
locations across Clarke and Oconee
counties. It is the only ambulance ser
vice in the two counties authorized to
respond to 911 emergency calls, but to
help offset its costs, National also may
pick up non-emergency transports when
an ambulance crew isn't on a call.
The original three-year contract
officially rolls over into its one-year
extension on Mar. 1. The coming year,
hospital and local government officials say,
will likely bring an examination of the EMS
services—although there are no plans, at this
point, to make any changes.
"We have a model in place that has worked
for decades, and we're trying to utilize the
best components of that going forward," said
Athens-Clarke County Manager Alan Reddish,
citing the role the two hospitals have had in
running EMS services. "From a local govern
ment perspective, that has worked well. To
assume there should be a dramatic change in
that structure relative to the services that are
being provided would not be [correct]. We are
happy with the process that's in place."
David Brooks, an Athens resident who runs
the long-distance medical transport company
Ameritrans, said he's concerned about the
county's ambulance service simply because he
has kids who may one day rely on the service.
His company does not compete with local
medical transportation companies, he said,
. but he's spent decades working in the field
[ and was familiar with the county's ambulance
service when it was run* by the hospitals. There
are three main types of EMS service that can
be provided, he said: a separate county-run
emergency service, an EMS that's combined
with fire services, or a private company.
"Or then, you have what we had for yeare,
with the two hospitals running a service; they
were private but they had trucks dedicated to
emergencies," he said. "There's nothing wrong
with a private company making a profit... but
now, the scary thing is, the citizens have no
idea what the response times are or when they
run out of ambulances."
Officials with National said they haven't
received any major complaints from the local
EMS oversight committee, made up of a collec
tion of representatives from the two hospitals
and the county. That has a lot to do with the
company's average response time of less than
seven minutes per emergency call, said Robby
. Atkins, National's director of operations. In
Athens-Clarke County, the company is required
to have an average response time of less than
eight minutes, 59 seconds; in Oconee, the
average time needs to be less than 12 min
utes, 59 seconds.
When the hospitals ran the EMS service,
they only responded to emergencies; any
non-emergency medical transport—from the
hospital to a home, or from one hospital to
another, for example—was handled by other
medical transport companies. National, which
responded to 16,191 calls in Clarke and
Oconee counties last year, also performed
2,691 routine or critical care transports,
according to Don Cargile, National's director of
marketing and himself a veteran of St. Mary's
Hospital's former ambulance service. It's those
non-emergency transports that keep the busi
ness model working, National officials say,
because the 911 calls don't pay the bills.
"Thirty percent of all 911 calls we respond
to, we do not transport," Atkins said. "So,
that's 30 percent extra resources we have to
have available 24/7. That's across the board,
across the state—the more urban you get, the
higher [non-transport rate] you get. We have
'frequent fliers'... who may be 1 to 2 percent
of our costs."
Because of the expense involved in
responding to 911 calls—not to mention
equipping trucks with medical gear—National
receives a subsidy from the two hospitals
based on its losses. The subsidy started at
$400,000 per year, split between the two
hospitals, according to Dee Burckett, vice
president for professional services at Athens
Regional Because National reported greater
losses in the years since its contract took
effect, that subsidy has risen to $440,000.
But that loss does not reflect any income gen
erated from non-emergency calls.
Burckett said when National's contract goes
into its one-year extension, it will be a time
for the county and the hospitals to reassess
the service. Unlike fire and police protection,
there is no state mandate for a county to
provide EMS service. Georgia's Department of
Public Health oversees an Emergency Medical
Services Division that regulates licensing and
training of EMTs and first responders, with the
mission to '"encourage, foster and promote...
an optimal system of emergency medical and
trauma care." With no specific mandate, new
options could come to the table when the
contract expires next year.
"The question before us now is whether we
continue to stay involved, or terminate the
contract and let the Georgia EMS system take
over," Burckett said. "We haven't reached a .
decision yet as to what the future will look
like. Athens-Clarke and Oconee have a tradi
tion and it is unusual for a hospital to provide
the service."
The fire department is called in cases of a
known cardiac arrest, said Assistant Fire Chief
Kyle Hendrix, or the fire department will arrive
to assist EMTs in the rescue process.
"We're really the back-up to them, but we
also respond when they have cardiac arrest,
car wrecks, anything involving drowning,"
Hendrix said. "If we have a confirmed cardiac
arrest, we go, because we might [be able to]
get there quicker. But other than that, we're
really the back-up to them."
Reddish said combining EMS with fire
services, or bringing it in under the wing of
the county, is out of the question unless the
public is willing to have a serious discussion
about money.
"You don't just take the number of fire
fighters you have and train them," he said.
"This could require additional staffing and the
purchase of very expensive vehicles. We would
have to get into a very large capital program
to do that; employ additional staff to do that.
We would have to house them somewhere,
and our fire stations were not built to house
another EMS service. If circumstances change,
we'U look at the most viable options we have.
We certainly would look at all the options,
should we be required to do so. But right now,
we like what we have."
But Brooks said he thinks it can be better.
"The best solution, as far as safety, is for the
fire department to take it over," he said. "But,
obviously, we'd have to pay for that."
Kristen Morales
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8 FLAGPOLE.COM • FEBRUARY 29,2012