By Brad Hicks
Local officials agree that of the many questions that must be answered before any significant action is taken toward the establishment of a county-operated service, the question of cost tops the list.
While a definitive answer may not come for some time should officials opt to move in this direction, officials should soon have a general idea of the expenses involved in such a venture.
The recently-established Unicoi County Ambulance Study Task Force, formed to explore the feasibility of a county-operated ambulance service, held its first meeting on Wednesday, Oct. 5, at Erwin Town Hall.
Among the officials present for the meeting were members of the Unicoi County Commission’s Ambulance Committee, County Commissioner and Erwin Police Officer Todd Wilcox, Erwin Town Recorder Glenn Rosenoff, Erwin Police Chief Regan Tilson, Erwin Fire Chief Darren Bailey, Unicoi Volunteer Fire Department Chief Robert Adams, Unico1 County Emergency Communications District Board Chairman Bill Hensley, and April Jones with Unicoi County Memorial Hospital.
Also in attendance was John Dabbs, EMS consultant with the Tennessee Department of Health.
The formation of the Ambulance Task Force was discussed during the Aug. 31 meeting of the county’s Ambulance Committee. During that meeting, committee members and other local officials attending voiced their concerns about MedicOne Medical Response, the county’s current ambulance services provider, including a staffing shortage, lack of available ambulance trucks and higher response times.
Discussions during the Aug. 31 meeting led to the formation of the Ambulance Task Force.
Last Tuesday’s meeting of the Ambulance Task Force again opened with officials expressing concerns about MedicOne.
County Commissioner Jason Harris, who chairs the county’s ambulance committee and was appointed during the meeting to chair the Ambulance Task Force, said MedicOne is still one paramedic short of being able to make available during peak times a third ambulance, which the company is contractually obligated to do. Currently, only two ambulances run in the county.
“He’s violated his contract from the time he signed it,” said County Commissioner and Ambulance Committee member Gene Wilson.
Several officials also pointed out MedicOne has not yet constructed a station within Unicoi County, a stipulation of the company’s most recent contract with the county.
“I wouldn’t work for them just for the living conditions,” Adams said.
“From what I gather, they’ve got two years left and I don’t think they’re going to do anything as far as the buildings, renting,” Harris said. “I think they’re going to stay right where they’re at and milk it out there as long as they can.”
Bailey said he has personally seen MedicOne crews in action a number of times.
“My personal opinion, and this is simply opinion based on 30 years experience, there’s some substandard practices and there’s some issues with the way they perform,” Bailey said.
The discussion soon shifted to the costs associated with a county-operated ambulance service and what it would take to make this happen. Hensley suggested that Unicoi County’s three governments split the costs, with each entity paying a portion.
“It’s easier to subsidize a third of something than it is the whole thing,” he said.
Bailey said the first thing officials must determine is where to find the money for the county-run ambulance.
“You’re looking at a year, you’re not going to get nothing,” Bailey said. “You basically have to have the finances to run this thing for a little over a year with no income. In about a year, we will start probably bringing in some money and then, honestly, I think the thing would almost fund itself, depending on salary levels, equipment levels, call volumes, how many ambulances you want and all that stuff.”
County Commission Chairwoman and Ambulance Committee member Marie Rice agreed, stating officials need to get an idea of the startup cost. When asked by Bailey, Dabbs said he did not believe a service could be started to cover Unicoi County for less than $2 million.
There was also some discussion of pursuing grants to establish the service, but Dabbs said the county’s governments may need to have the money in their coffers rather than relying on grant funding.
“I would say that funding for your first year is going to be your biggest item,” he said. “Just guessing, I would say you’d have to find a way to come up with the whole cost yourselves, and if you get other stuff it would help offset that. Then you’d be in good shape.”
Dabbs said he could develop a draft budget for the establishment of a county-operated service to serve as a starting point. He said this draft will include several different service models and could be ready to present in about a month.
That draft budget is set to be presented to the Ambulance Task Force when it next meets on Nov. 7.
MedicOne has served as Unicoi County’s ambulance services provider since 2011, when its initial contract was approved by the Unicoi County Commission. But, as the April 1, 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 service’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 now seeking a $132,000 yearly subsidy. The bid was later approved by the County Commission, and a new four-year contract with MedicOne took effect on April 1 of that year.
Bailey said if the county moves toward establishing its own ambulance service, it would need to immediately bring in a director who understands the billing, financial and medical aspects of the business. He also suggested the county-operated service should be set up as a sort of public utility, similar to the Washington County-Johnson City EMS, with its own independent board of directors.
And while other questions remain, such as how much each entity would be asked to contribute and the number of stations that would be needed, some officials feel the county should begin taking the steps necessary to start its own ambulance service.
“I’m ready to bite the bullet for this county and do it because I’m sick of it,” Wilson said. “And our citizens deserve better than what we’re giving them, because we’re not getting any service.”