DeKalb officials approve new contract with troubled ambulance provider

Ambulances are lined up at Grady Memorial Hospital. Photo: JOHN SPINK/JSPINK@AJC.COM

Ambulances are lined up at Grady Memorial Hospital. Photo: JOHN SPINK/JSPINK@AJC.COM

A nine-month process to hire DeKalb County’s ambulance provider for the next five years came to a close Tuesday, as commissioners voted to continue contracting with the company that paid nearly $2 million in penalties for its slow response times.

American Medical Response, a Colorado-based company, will respond to emergency medical calls in DeKalb through 2024, according to the agreement unanimously approved by the commission.

AMR has faced complaints about its response times since taking over ambulance services for the county in 2013. CEO Michael Thurmond acknowledged last month that the old contract was weak, poorly constructed and difficult to enforce.

County officials said the new contract will have additional oversight and more specific penalty provisions. In a request for proposals issued in March, the county listed detailed calculations for penalties if the ambulance provider does not meet the required performance standards. It also mandated that the company provide detailed monthly and yearly reports.

The county has not released a copy of the proposed new contract with AMR.

Previously, AMR was tasked with responding to 90% of calls within less than nine minutes. The company repeatedly failed to meet that standard, according to statistics provided by the fire department. But the contract was so vague that at one point AMR declined to pay the penalty fees.

“This is completely different than it was for the past five to six years, that’s what folks need to understand,” AMR Regional Director Terence Ramotar said after the vote.

The new response times are loosenedbut more detailed. For critical calls, like heart attacks and seizures, the response times must be within 12 minutes. For issues like animal bites and eye injuries, the expectation is under 15 minutes. And in the least serious emergency category, including headaches and situations involving minor bleeding, AMR must arrive within 30 minutes to stay in compliance with the contract.

“I feel confident that we can work with the provider to create a system that our citizens can be proud of, and one that will be totally integrated with the fire department,” DeKalb County Fire Rescue Department Chief Darnell Fullum told the commission.

The agreement comes at no cost to the county. Instead, AMR will collect fees from clients, insurers, Medicare and Medicaid. The county said the proposed fee structure will be included in the contract, but has not released what those fees will be.

An AMR ambulance leaves Grady Hospital on Thursday May 9, 2019. JOHN SPINK/JSPINK@AJC.COM

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In March, the county asked for bids for a new ambulance contract. AMR was one of two companies judged and scored by an evaluation committee. AMR scored an 85 out of a total 110, while the other bidder, PatientCare Logistics Service, scored a 78.

While the procurement process was underway, the county extended its contract with AMR several times, frustrating some commissioners.

Thurmond gave a presentation to the commission last month championing a “re-envisioning and revamping” of the county’s EMS system. Over the past year, DeKalb has invested more than $5 million in new fire department vehicles that can respond to medical calls, fire stations and fire department paramedic positions.

Despite the complaints about AMR’s service, Thurmond said he is confident they will provide improved service to residents. He said he was encouraged by AMR’s settlement with the county.

AMR said it also added additional ambulances at stations around DeKalb and implemented a GPS system that identifies the closest ambulance to an emergency situation when a call comes in.

In January, DeKalb implemented a new model that judges response times based on the first emergency response unit that arrives on scene — whether that be a firetruck or ambulance. The latest data released by the county shows that fire department units respond faster on average than AMR ambulances.

All firefighters are trained emergency medical technicians, and about 14% are trained paramedics.

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