Grady EMS may get south Fulton ambulance service after response issues

A regional board has recommended Grady EMS provide ambulance service in the south part of Fulton County. AJC FILE PHOTO

A regional board has recommended Grady EMS provide ambulance service in the south part of Fulton County. AJC FILE PHOTO

Cities in south Fulton County, which have complained about dangerously long ambulance response times, should ditch their current provider and go with Grady Emergency Medical Services instead, an arm of the state public health department recommended Tuesday.

A committee of the metro Atlanta regional EMS council opted to recommend Grady EMS over the only other bidder, current provider American Medical Response. A vote of the full regional EMS council will take place Thursday.

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Grady EMS, in its bid for the service, promised an average response time of nine minutes for emergencies and 20 minutes for non-emergency calls.

Terence Ramotar, AMR’s regional director, said his company’s average response time in the area is now about 14 minutes, with the fastest service in East Point and College Park. AMR does not prioritize emergency over non-emergency calls, Ramotar said.

AMR said it could improve to average 12 minutes for emergencies and 15 minutes for other calls. Even better service could be provided, the company said, if officials want to pay a subsidy.

Ramotar said he thought south Fulton’s sparse population and wide geography made Grady’s proposal impossible.

“If any ambulance provider can provide nine-minute service on average in south Fulton, it would have happened a long time ago,” Ramotar said. “We were all sitting there shocked. It’s like two plus two equals five.”

Bill Compton, the senior vice president of emergency services at Grady EMS, said his estimates are an "educated projection," and he would do whatever it takes to provide the service promised, even if that means increasing the number of employees or ambulances.

“Grady looks at opportunities. South Fulton is next to central Fulton,” where Grady also provides EMS service, Compton said. “If it was two counties north of here, it wouldn’t be an opportunity for us.”

Both providers said a large portion of 911 calls in south Fulton are not true emergencies and don’t require ambulance transport. But they differed in how they plan to handle those non-emergency calls.

AMR, in its pitch, proposed taking more residents to urgent care facilities instead of hospitals and using a nurse call-line to keep some people from calling 911. Grady plans to handle some incidents by sending nurse practitioners to scenes in vehicles other than ambulances to take care of minor injuries and provide basic treatment, like sutures. That would keep more ambulances in circulation and save time on transporting patients, Compton said.

Compton said there’s no need to “run lights and sirens for toothaches and belly aches and stubbed toes.” Sending medical care to residents wouldn’t eliminate the number of non-emergency calls that receive ambulances, but would certainly reduce it, he said.

It was that innovation, of taking help to residents, that won over some members of the board. One board member, Patrick McDouglas from Gwinnett County, said the integrated model that Grady EMS recommended had the potential to change the way care is provided.

The Grady Health System EMS patch on Gail Stallings’ shirt. JASON GETZ / SPECIAL

Credit: Jason Getz

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Credit: Jason Getz

Henry Argo, the Palmetto fire chief, said that he thought the recommendation would be good for residents, who can now wait 20 minutes for ambulance service in his city. If patients are transported faster, he said, they are more likely to live, and ambulances spend more time in service. Because Fulton County is already giving money to Grady Memorial Hospital, Greg Brett, the fire chief in Chattahoochee Hills, said he and others feel that they already have a more “intimate relationship” with Grady than with AMR.

Before the vote, the mayors and fire chiefs in south Fulton sent a letter saying they preferred Grady.

“Taxpayers already paid for it, in a way,” Brett said of Grady EMS. “We all like the idea of improving a system that seems to have some deficiencies. Grady seems to be a visionary.”

The Region III EMS Council will vote on Thursday on the committee’s recommendation. If Grady EMS gets the service, AMR will have a chance to appeal the decision to same council.

Both providers expect ambulance transport to cost a bit less than $2,000 a ride, but not as much for low-income residents. Pete Quinones, chairman of the committee that recommended Grady, said ambulance service is essentially a loss leader; Ramotar said AMR lost $300,000 last year providing the service.

“If Grady gets it, their feet are going to be held to the fire to get that nine minutes without a subsidy,” said Quinones, president and CEO of Metro Atlanta ambulance service.

Ambulance response time in south Fulton County

Current average, with American Medical Response: 14 minutes

Proposed average, with American Medical Response: 12 minutes for emergencies, 15 minutes for non-emergencies

Proposed average, with Grady EMS: nine minutes for emergencies, 20 minutes for non-emergencies