A DeKalb County public safety consultant’s statement that ambulance response times have no real consequence on a patient’s treatment and care has alarmed Dunwoody officials as they seek to create their own localized EMS zone to speed up arrival times.
And while Brookhaven officials say they are also concerned about slow EMS response times in the city, they have decided to work with the county to put an EMS post on Buford Highway rather than support the creation of a new EMS zone.
Brookhaven’s stance, announced by City Manager Christian Sigman at the Sept. 20 EMS Council subcommittee meeting, shocked Dunwoody City Councilmember Terry Nall, who questioned the city’s motives as it works out a nearly $200,000 agreement with DeKalb County to put a new EMS station in Brookhaven.
He said there also appeared to be a disconnect between Brookhaven elected officials and city administration.
“Brookhaven City Council hasn’t formally taken a position on EMS, so it’s unclear why its city manager said anything at the EMS Council subcommittee,” Nall said. “It’s clear Christian Sigman spoke without having the policy direction of council, which would be a no-no in Dunwoody.”
Brookhaven City Manager Christian Sigman batted away Nall’s disappointment.
“It is unfortunate that Mr. Nall thought the city of Brookhaven would support the Dunwoody solution before the county could work the issue in a deliberate and holistic fashion,” Sigman said.
The Sept. 20 meeting of the Region 3 EMS Council subcommittee was the third meeting of the group tasked with studying DeKalb County EMS response times and the possibility of creating new EMS zones.
The final meeting of the subcommittee is slated for Oct. 4 when it is expected to make recommendations to the full EMS Council.
Do response times matter?
DeKalb County hired public safety firm AP Triton for $67,000 in June following Dunwoody’s declaration of an “EMS Emergency” in May. The Dunwoody mayor and City Council have complained to DeKalb for several years of AMR’s slow response times.
Scott Clough of AP Triton said at the Sept. 20 meeting there is compelling evidence that “response times have no impact on patient outcome” except for a small number of patients with severe trauma or illness, such as a stroke.
“Response times in all reality are [made] to ensure contractual compliance,” Clough said.
Clough’s statement angered Nall, who has led the city’s effort to create its own EMS zone or at least create a separate EMS zone for DeKalb residents north of I-285 to possibly include other municipalities.
“I’m appalled a consultant hired by this county is saying response times don’t matter,” a visibly frustrated Nall told subcommittee members.
Nall said EMS response times are a public safety issue that Dunwoody elected officials have a “moral obligation” to address to ensure safety of the city’s 50,000 residents and the 150,000 employees working in the state’s “economic engine” of Perimeter Center.
Nall noted that in 2016, it took an ambulance approximately 30 minutes to respond to call of a woman with a head injury on Dunwoody Club Forest.
He said DeKalb firefighters, who are often the first on the scene of an emergency but cannot transport patients to a hospital, were quoted on the scene as saying, “This lady needed to get to the hospital right away. Where is the damn ambulance?”
The woman died at the hospital, Nall said, and it’s not known if she would have survived if an ambulance arrived sooner.
“Response times do matter,” Nall said.
The current performance-based contract with AMR requires ambulances respond to calls in under 9 minutes for 90 percent of calls. Dunwoody and Brookhaven have documented many instances where responses times are longer, with Dunwoody citing some ambulances don’t arrive for 20 to 30 minutes or more. The county has fined AMR nearly $1.9 million for failing to meet the contracted response times.
Sigman also took exception to Clough’s statement that response times don’t matter.
“I don’t buy into that statement about response times,” Sigman said at the Sept. 20 meeting. “We’ll hold the county accountable.”
The county and AMR argue the contract signed in 2013 is a bad one. Right now, for example, the county doesn’t pay AMR at all; instead, the company gives the county money for every response. Dunwoody officials say that set-up is backward and creates the wrong incentives.
The contract expires at the end of this year and DeKalb officials said at the Sept. 20 meeting a new RFP likely would not be ready until early next year when the consultant’s report is finalized. The county is able to extend its contract with AMR on a month-to-month basis.
Nall said DeKalb’s own slow response in waiting to address the bad contract until after Dunwoody declared an “EMS Emergency” is more reason for Dunwoody to have its own EMS zone.
Brookhaven to work with DeKalb and AMR
Sigman announced at the Sept. 20 meeting that Brookhaven was working with DeKalb County and AMR to put a new EMS post on Buford Highway and was not supporting Dunwoody in its quest to carve out more localized EMS zones.
Nall said in an interview he had been told by Brookhaven City Council members Joe Gebbia and Bates Mattison they wanted Brookhaven to be part of Dunwoody’s decision to seek to create a new EMS zone because Brookhaven was also having issues with slow ambulance response times from the county.
Nall added he was “stunned” to hear Sigman contradict what Gebbia and Mattison told him.
“Either they have a problem with EMS or they don’t,” Nall said. “This is no way to be a partner for an adjoining city.”
Gebbia said he and Mattison did discuss EMS response times with Nall in June at the Georgia Municipal Association’s conference in Savannah.
However, Gebbia said he did not tell Nall that Brookhaven wanted to be part of a new EMS zone. Mattison did not return a call for comment.
Instead, Gebbia said, he later learned Sigman was working with AMR and DeKalb to address Brookhaven’s issues with slow response times by putting a new ambulance post at 3292 Buford Highway where a shuttered QuikTrip sits.
Three ambulances are expected to be stationed on Buford Highway by the end of the year, Sigman said. The city purchased the QT site in May for $1.7 million to gain a foothold on Buford Highway and hopefully guide redevelopment there. Gebbia has said he’d like to maybe see a city welcome center there.
The new EMS post would serve all of DeKalb, but is also intended to provide quicker response times to the northern quadrant of DeKalb County, Sigman told the subcommittee.
Brookhaven currently has no ambulance posts in the city. An intergovernmental agreement between DeKalb and Brookhaven for the new ambulance post is slated to be finalized in October.
As part of the IGA, Brookhaven would front the approximate $170,000 cost to build out the former QT building so it can be used as an AMR post and DeKalb will then pay back the cost through a year-long rental agreement, Sigman said.
Nall said he wondered if Brookhaven’s decision to not support a separate EMS zone was because it did not want to interfere with the “money flow” from DeKalb to pay for the new ambulance post.
Gebbia said Nall’s allegation was “irresponsible” and that he understood Nall has spent significant political capital in trying to create a new EMS zone for Dunwoody.
“I think what we have is a very good outcome,” Gebbia said of the Buford Highway post. If after a year the response times are not satisfactory for Dunwoody and Brookhaven, Gebbia said Nall’s option to create a new EMS zone might be more viable.
Sigman said in an email following the Sept. 20 meeting that Dunwoody officials were aware of Brookhaven’s efforts to establish an EMS post on Buford Highway to improve response times in northern DeKalb.
He said the Brookhaven City Council has not provided policy direction to city management to support a carve out for Dunwoody and that the mayor and council were aware of the efforts to establish an EMS post location on Buford Highway.
“Only Dunwoody can decide what is best for their city,” Sigman said. “For Brookhaven, we believe DeKalb County Fire Rescue is working the issue in a professional manner with a deliberate pace.”