Committee Favors County Getting Back in the Ambulance Service Business

July 14, 2007
Dwayne Page

With less than three months until Sumner Regional Medical Center officially ceases operation of the DeKalb County Ambulance Service, the County's Emergency Services Committee wants to bring the ambulance service back under the county's control.

County Mayor Mike Foster told the county commission last month that Sumner Regional, which has been under contract to operate the local ambulance service for several years, is \"going out of the ambulance business\".

Since then, the county's emergency services committee has been meeting to determine whether or not to contract with another entity to run the local ambulance service.

Foster says the committee met at the courthouse Thursday evening and after reviewing proposals from several companies, including Pro-Med, Pride Care, and Trans-Med among others, decided that the best course would be for the ambulance service to be run by the county. Foster says the most of the companies were primarily interested in only providing convalescent care and one company wanted to take ownership of the ambulances. The current fleet of ambulances is owned by the county. Plus, Foster says the committee felt an urgency to act now with less than 90 days before new management must be in place. \"I had gotten information from about eleven counties on how they were handling their ambulances services. Our options were to contract with one of about six other companies that primarily do convalescent care, or let the county run the ambulance service. I think everybody (committee) is concerned that we maintain the same level of ambulance service that we have and that we take care of the people who work there. We think we have a really good ambulance service and we were well satisfied with the service we were getting. We had some concerns last year about the prices. We talked to them about changing the structure of their prices because we thought they were a little high so they lowered them (prices).\"

\"What the process basically amounts to now is that the county will probably have to subsidize the ambulance service some. We feel like we can have a better service if the county runs it so the committee voted for the county to run it and not contract with some other service at this time. I'm comfortable with their decision. I think the county will do a better job of overseeing it. We already own the ambulances. Basically, what it boils down to is that the ambulance service is not a money making proposition, but we would like for it to break even. We'll try to structure the salaries and fees so that it provides the best service we can to the county while taking care of the people who work for the ambulance service. There are two or three options in the way we will handle billing, either it will be contracted out to a collection agency or it will be handled out of the county mayor's office.\"

Foster says the ambulance service director would be hired by the county and the EMS employees would work under the director. \"The employees will answer to the director and if they have an issue they can't resolve then they would submit their grievance to the county mayor's office. They would not be permitted to submit a complaint to any individual county commissioner or the county mayor. Once a grievance has been filed, the director would be required to respond in writing, then the director and the employee making the grievance would come before the entire ambulance committee. We feel like this is the fairest procedure and will help keep down problems.\"

Foster adds that the county is currently compiling information from the ambulance service and other counties in order to determine what the annual costs will be as well as the local rate structure.\" We've used a lot of numbers from the ambulance service itself, but we're also getting input from White County, Lawrence County, Stewart County, Overton County, and some other counties, to try to average out to about what they're doing. It will also be based on TennCare and Medicare fees. In the past, they have charged twelve or thirteen hundred dollars per trip and Medicare paid maybe five hundred dollars and the rest was written off, which would not serve our purpose. The ambulance service, last year, made over 2600 runs. We feel like we need to charge what is a realistic fee. Of course, we will bill TennCare and Medicare at the rates they will pay. We just don't feel like it's right for an individual to pay considerably more than TennCare or Medicare, especially Medicare. Medicare will probably govern what we do. These rates will apply to everyone equally with no political favoritism. The committee was adamant about that. Everyone will pay the same rates, whether the billing is done in-house or by another billing system. We're guessing that the cost to run the ambulance service will be about $1.1 to $1.2 million dollars a year and the revenues will be around a million dollars right now. These numbers are based on what they did last year.\"

Sumner Regional Medical Center currently operates the ambulance service for $163,000 per year, and the county, which owns the ambulances, buys a new one each year. Sumner Regional rents the ambulance service building on Cookeville Highway for $600 per month.

Foster says a lot of for-profit companies are going out of the ambulance service business because of the ever increasing costs and government regulations. He says many counties in this region are now operating their own ambulance services and most are breaking even.

Whether the county will officially get back in the ambulance service business will probably be put to the county commission for a vote at it's next meeting on Monday, July 23rd at 6:30 p.m.

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