Some Dunwoody officials are questioning the response times for critical and non-emergency ambulance calls included in a bid for an ambulance provider that are slower than response times the city and county contractually agreed to last year. The county’s five-year contract with American Medical Response expired Dec. 31 and is being extended on a month-to-month basis.

DeKalb County put out its bid for an ambulance provider this week that includes mandated response times ranging from under 12 minutes for critical emergency calls to less than 30 minutes for non-emergency calls. But in a memorandum of understanding the county and the city agreed to last year, response times in Dunwoody are designated at nine-minute or less for 90 percent of the response times for critical life-threatening calls, and 15 minute or less for 90 percent of the response times for basic life support calls.

Dunwoody City Councilmember Terry Nall, who has led the effort to have Dunwoody break off from DeKalb County to create its own EMS zone, said the bid “violates the Dunwoody/DeKalb MOU.”

“Our MOU says the [request for proposal] must be materially the same as the MOU,” Nall said, adding the bid is “problematic and unacceptable.”

Mayor Denis Shortal acknowledged he was also concerned about the different response times listed in the bid and MOU. Shortal said he has been assured by DeKalb CEO Michael Thurmond that the MOU continues to remain in effect for Dunwoody during the bid process. The MOU is effective for one year and is automatically renewed for future annual terms.

“Nothing has changed,” Shortal said. The RFP is one thing, Shortal added, and the final contract is a separate agreement, but “basically the MOU stays in effect.”

“The MOU doesn’t say anything about the RFP … it states what is about being in the contract,” Shortal said.

DeKalb County did not return a request for comment about the different response times. In a news release announcing the national search for an ambulance provider, DeKalb CEO Michael Thurmond said the new proposal will improve patient care and countywide ambulance response times.

“The RFP also gives municipal leaders within DeKalb County the flexibility to enhance levels of service by creating designated service areas within their jurisdictions,” Thurmond said.

The request for proposal for an ambulance provider was posted to DeKalb County’s website March 11. The county’s five-year contract with American Medical Response expired Dec. 31, but the county has extended the contract until a new provider is hired. AMR is expected to bid on the new contract.

As part of its contract extension, AMR can charge higher fees for transport and medical services. Cities can also pay $145 an hour to station an ambulance in their jurisdiction for “enhanced” service as part of the contract extension.

Other provisions included in the ambulance provider bid:

  • The county will permit the creation of service areas with the option to purchase supplemental services for those municipalities or other portions of the county that desire additional service.
  • The contractor shall have a signed agreement with a secondary ambulance service to serve as a back-up transport service.

Last May, the Dunwoody City Council declared an “EMS Emergency” with state officials seeking immediate relief for slow response times they said were putting resident lives at risk. The declaration followed years of complaints to DeKalb officials about ambulance response times.

That declaration led the Region 3 EMS Council, which advises the state Department of Public Health about setting ambulance contracts and zones, to form an ad hoc committee to study DeKalb’s EMS services and study Dunwoody’s request to create its own EMS zone.

At a Feb. 7 ad hoc committee meeting at Dunwoody City Hall, City Manager Eric Linton told committee members the city still had “grave concerns” about response times and wanted to ensure the under nine minutes and under 15 minutes would be included in the request for proposal. “That is our number one priority,” Linton said.

AMR recently went through a similar situation in south Fulton County. Leaders there asked the state Department of Public Health to open up its EMS region to competitive bidding due to slow response times from AMR. The state agency eventually awarded the south Fulton EMS bid to Grady EMS over AMR.

Terence Ramotar, regional director for AMR, has said that one reason for slower response times is extended “drop time” that keeps ambulances off the roads. Drop times are the time it takes for an ambulance to transfer a patient to a bed in an emergency room. Historical drop times are in the 15-minute range while DeKalb County’s is an hour, he said.

Traffic congestion also plays a role in slow response times, according to Fullum.

The next meeting of the EMS ad hoc committee is slated for April 18 at Dunwoody City Hall.

This story has been updated with comments from the DeKalb County CEO.

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