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Ambulance service cost estimated at $2.5M

By Brad Hicks

They now have an idea of the costs involved but, before county officials make any movement toward the establishment of a county-operated ambulance service, they first want to meet with the CEO of the county’s current ambulance services provider.

At its meeting on Monday, Nov. 7, – the second for the panel – the Unicoi County Ambulance Study Task Force unanimously voted to send a registered letter to MedicOne Medical Response CEO Jim Reeves to request that Reeves meet with the Unicoi County Commission’s Ambulance Committee to discuss the issues county officials have with the service being provided by MedicOne.

The letter will ask that Reeves respond within 10 days of receipt to schedule a meeting with the Ambulance Committee and that this meeting be scheduled within 30 days of the response deadline.

This vote was made after the Ambulance Study Task Force heard from John Dabbs, EMS consultant with the Tennessee Department of Health. Dabbs was also present at the Task Force’s first meeting held in early October, at which time Dabbs said he would present to the panel an estimated budget for the establishment of a county-operated service in November.

Dabbs said on Monday a rough estimate of the startup cost would be $2.5 million. This includes the cost of the service’s infrastructure, a facility with meeting space, and four ambulances – two 24-hour trucks, one to run during peak hours and a fourth to be on call.

Dabbs estimated the county-operated ambulance service’s annual budget would be a little more than $1 million. He said if the service achieved a 40 percent collection rate on its transports, it would come close to meeting its budget but some subsidy on the county’s part may be required.

The county-operated service would take a minimum of three months to establish, according to Dabbs.

The Ambulance Study Task Force was formed to explore the feasibility of a county-operated ambulance service. Its formation was discussed during the Aug. 31 meeting of the county’s Ambulance Committee. During that meeting, committee members and other local officials in attendance voiced their concerns about MedicOne, including a staffing shortage, lack of available ambulances and higher response times.

Unicoi County Commissioner Gene Wilson, during Monday’s meeting, reiterated statements he had made in prior meetings. He said MedicOne has been in violation of its latest contract “since day one,” as the company, which runs two ambulances in the county, does not make available a third ambulance during peak times and has not yet constructed a new station within Unicoi County.

“We’re going to have to bite the bullet,” Wilson said.

Others present at Monday’s meeting also expressed their concerns.

“But, regardless, the problem I have is we do not have a service that we contracted to get and one our citizens deserve and what they expect,” Erwin Mayor Doris Hensley said. “As mayor, I have got to make sure that our citizens are protected. So, regardless of the money, what it’s going to cost, we’re going to provide that service for them.”

Hensley also said she is in the process of pursuing grant funding for the establishment of an ambulance service and would be willing to present the matter of an ambulance service operated by the Town of Erwin to the Erwin Board of Mayor and Aldermen for its consideration even if the county was not onboard.

“I want to do it as quickly as I can,” Hensley said in response to Unicoi County Mayor Greg Lynch asking whether the town would wait for MedicOne’s current contract to expire. “I can’t wait around and have something happen to one of our citizens. We have waited at least two hours for an ambulance, and our police officers have had to go sit with them. Police officers have even had to go in the ambulance with them because they don’t have the personnel. We’ve had a police officer to actually pump the IV into a patient because they didn’t have the sufficient equipment to do it. This is not acceptable.”

Several officials said they would favor a county-operated service, even if that means having to cover a subsidy greater than the one the county currently pays to MedicOne.

“If it takes raising taxes to make this thing work, I hate taxes, but I would vote for it to protect the people,” Wilson said.

“To me, I’d as soon do our own and get away from these people from Texas who don’t care nothing about Unicoi County and, if we paid $200,000 a year, we’d have our service and have a lot better service than what we have now,” said Unicoi County Commissioner and Ambulance Study Task Force Chairman Jason Harris.

Hensley said a dependable ambulance service is needed for citizens across Unicoi County “whatever it costs.”

But Lynch said if MedicOne were to pull its ambulance out of Unicoi County before the company’s contract is up, it could prove to be even more costly. He said this would allow the county to “call the bond” on MedicOne, providing the county with $150,000. However, Lynch said it is unlikely that this funding would cover ambulance coverage expenses until the county could establish its own service, as Unicoi County would have to pay Washington County $3,000 per day to provide local coverage.

Lynch suggested that the county’s Ambulance Committee first request a meeting with Reeves so that local officials can air their grievances, possibly discuss the transition and both sides can work toward resolutions.

“We’d have to be up and running pretty fast,” Lynch said. “That’s why, setting aside all the problems we’ve had, I think we’ve got to sit down with the management of MedicOne and see if we can’t, short-term, work it out and, long-term, do whatever you want to do after this contract is over with or as soon as you all can get on your feet with a service.”

Unicoi County Commissioner Marie Rice agreed, adding this should be the first step in the process followed by officials researching how a county-operated service would be financed.

The Ambulance Study Task Force opted to hold off on scheduling another meeting until Reeves is given the chance to respond to the letter.

MedicOne has served as Unicoi County’s ambulance service 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 future of MedicOne 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 county’s 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, the company now seeking a $132,000 annual subsidy. This bid was later approved by the County Commission, and a new four-year contract with MedicOne took effect on April 1 of that year.