By Brad Hicks
Members of the Unicoi County Commission’s Ambulance Committee and other local officials over the past two months have not seen the improvement from MedicOne Medical Response they had hoped to, and more insight into the future of the county’s current ambulances services should come by the end of this month.
The Ambulance Committee met on Tuesday, Jan. 17, to hear the steps MedicOne has taken since November to meet the obligations outlined in its most recent contract with Unicoi County and continue its discussions of the company’s local performance.
Last week’s meeting served as a followup to a Nov. 16 meeting of the Ambulance Committee, during which local officials provided MedicOne CEO Jim Reeves the opportunity to address issues officials have stated exist with the company’s Unicoi County operations, including a lack of available ambulances, staffing shortage and the company’s lack of movement toward the construction of a new station.
The Ambulance Committee in November opted to provide MedicOne with additional time to address these issues and work to comply with the obligations outlined in the company’s current contract with Unicoi County.
The committee was set to again meet last week with Reeves to ascertain information on the progress made, but Ambulance Committee Chairman Jason Harris said Reeves had advised he was unable to attend. Ken Tipton, local operations manager for MedicOne, acted in Reeves’ stead and told county officials MedicOne’s inability to meet the stipulations of the contract boils down to a shortage of staffing.
“There’s just nobody to hire,” Tipton said.
And while MedicOne recognizes the problem, a solution is elusive, Tipton said. Tipton told officials MedicOne has increased its advertising of available positions, upped its sign-on bonus from $1,500 to $3,000, offers pay comparable to or higher than surrounding counties, and has offered to cover relocation costs for employees. Still, Tipton said applications are sparse, and Harris said MedicOne is currently two paramedics short in Unicoi County, doubling the number the company was short when the Ambulance Committee last met in November.
This staffing shortage, Tipton said, has hindered MedicOne’s ability to consistently keep a third truck running in Unicoi County. Harris previously said the county’s contract with MedicOne stipulates that the company is to staff two advanced life support paramedic ambulance units 24 hours per day. The third truck, a basic life support unit, is to be available during high volume call periods.
During the Jan. 17 meeting, Harris asked Tipton what he thinks could be done to increase staffing so that a paramedic is staffed on every ambulance and to get the third truck running consistently.
“I honestly don’t know what the resolution is,” Tipton responded. “I post ads everywhere. I don’t know how to get employees. I don’t.”
Part of the staffing issues may lie with the state’s more stringent regulations pertaining to ambulance employee education, Tipton said. In November, Reeves told the Ambulance Committee it now takes around 300 hours of core education for someone to become an advanced emergency medical technician. Reeves said the state of Tennessee now requires ambulance employees to have at least this AEMT certification, something Reeves said takes one year of full-time education to achieve.
“It’s not just a Unicoi problem. It is a statewide issue,” Tipton said of the staffing shortage.
MedicOne’s most recent contract with the county also stipulated that the company was to operate from a centralized station located within one mile of Exit 36. Instead, the company has since worked from property owned by Unicoi County Mayor Greg Lynch. The company previously purchased property along North Main Avenue to construct the station, but Reeves said previously that bringing this site up to regulations was not feasible for MedicOne.
Tipton said last week that MedicOne had located property in Erwin for its Unicoi County station, but he said it will likely be April before the move could take place.
Around 30 minutes into the nearly one-hour meeting, Erwin Mayor Doris Hensley queried the Ambulance Committee on how much longer officials can ask the same questions of and receive the same responses from MedicOne, further asking if fellow officials were going to continue with the company as is or explore an alternative “to provide adequate service for our folks.”
“All I’m hearing is why they’re not able to fulfill their contract,” Hensley said. “I haven’t heard a plan B.”
Hensley has previously stated that the town of Erwin is willing to establish its own ambulance service without the county’s involvement if the service offered to the town’s residents does not improve. She has also applied for a grant that, if awarded, would allow the purchase an ambulance. Officials discussed the possible pursuit of additional grant funding during last week’s meeting.
And other officials present also voiced frustration concerning the process to this point.
“I think we’re wasting our time,” said Unicoi County Commissioner Kenneth Garland. “I think we need to go with plan B and discuss it.”
Harris said he is in favor of further exploring the feasibility of a county-operated ambulance service.
“For now, until we can get moving forward on that, we need to try to find a way to get this back up to the way it’s supposed to be, at least by what the contract says,” Harris said. “I know last meeting we said we’re going to look two months from now, but we ain’t in no better shape two months ago than we are now. Really, actually, we’re probably a little bit worse than we were two months ago. On the shortage of paramedics, we were short one and now we’re short two. The call volume, where we’re having to get ambulances out of Washington County or Carter County, seems like it’s picked up even more in the last two months than what it has in the past. I heard that they’ve been running routine calls over here now to the nursing homes and stuff like that.”
Harris added the benefits offered by a government-operated ambulance service could help draw employees, helping to address the staffing issue.
Unicoi County attorney Doug Shults interjected, advising officials that their discussion was sounding like “deliberation.” Last Tuesday’s meeting was originally advertised to be held at Unicoi County Courthouse, but the venue was changed to Erwin Town Hall. Shults suggested that another meeting be scheduled, with the time and location advertised.
“At this point in time, before you begin the actual deliberation, I think we’ve probably got some notice issues because, as I understand it, the notice was for a different venue and now we’ve moved the venue and, really, we shouldn’t be deliberating as a committee because we’re not in the place we gave the public notice we would be,” Shults said.
This led to discussion of when officials should next meet to continue talks concerning MedicOne. Harris proposed an early February meeting of the Unicoi County Ambulance Study Task Force, a separate entity from the county’s Ambulance Committee formed in August to explore the feasibility of establishing a county-operated ambulance service. Some officials expressed their desire to see discussions resume sooner.
“I think it’s urgent that we get on with this,” Hensley said.
A meeting of the Unicoi County Ambulance Study Task Force was then scheduled for Jan. 31. That meeting will begin at 2 p.m. and will be held at Erwin Town Hall. Several officials said they would like the Task Force next week to decide on how to proceed.
The urgency officials feel the situation warrants primarily has to do with the status of MedicOne’s contract with Unicoi County. The contract is set to expire in 2019, and Hensley said if local officials decide to establish a government-operated ambulance service, the venture could take around two years to get started.
“If the problems get, I mean, they seem like they’ve got a little bit worse, but if they keep going the way they’re going, we’re going to have to move forward before this two years is out,” Harris said.
MedicOne has served as Unicoi County’s ambulance services provider since 2011 when its initial contract was approved by the Unicoi County Commission. As the April 2015 expiration of this contract approached, county officials began meeting to discuss the company’s future in the county, with some officials expressing concern that the county could no longer afford the company’s $180,000 annual subsidy.
In January 2015, the Ambulance Committee recommended putting the county’s ambulance services contract back out for bid. MedicOne was the only company to submit a bid by the February 2015 deadline, with the company seeking a $132,000 yearly subsidy from the county. This bid was later approved, and a new four-year contract with MedicOne took effect on April 1, 2015.