By Linda A. Moore
The Commercial Appeal
SHELBY COUNTY, Tenn. — The Shelby County Commission will address on Monday resolutions to create a fire department-based ambulance service, after a presentation on Thursday to its public works committee explaining details of the $3.9 million proposal.
The county began considering its own service after ambulance contractor American Medical Response notified officials that it needed more money or it would exercise its option to exit the contract.
After the committee meeting, AMR contended county officials were off base with their estimates for starting ambulance service and the price tag “will be significantly higher” than the $3.9 million estimate.
“We strongly disagree with the County Administration’s assertion that a County Fire EMS system can be provided at a lower cost than AMR,” Jeff McCollom, the company’s regional chief executive officer, said in a prepared statement. “As a national leader in the EMS industry and the provider for the last three years, we have a very clear understanding of the costs associated with providing a responsive, high-quality EMS service for Shelby County.”
At Thursday’s committee meeting, county Fire Chief Alvin Benson and Tom Needham, director of public works, presented the proposal, which will require a 12 percent increase in fire fees, or about $4 a month for the average homeowner.
The expense includes the purchase of 12 ambulances, equipment and the hiring and training of additional staff. That money will be borrowed from the county’s general fund and paid back through the fire fees.
“One of the big things I’m going to take a look at is what should we respond to and what shouldn’t we respond to,” Benson said. “What are those non-emergency type of calls that perhaps we can send someone else to.”
Dealing with the “frequent flyers” who abuse the 911 system has become a nationwide issue, he said.
Benson told the commission that they expect 10,000 calls a year, a transport rate of 65 percent, will bill $1,150 per transport and expect to collect 33 percent of that money, which in many cases is reimbursable through Medicare or private insurance.
The expected response time is nine minutes in the municipal areas and 10.5 minutes in the unincorporated areas.
And the average response time for the fire-based EMS fire trucks is now less than six minutes, Needham said.
None of the eight commissioners in attendance spoke against the proposal, but they did question the processes.
“If I’m in the county and I’m paying fire fees, why am I get billed for transport?” said East Memphis Commissioner Steve Basar.
Commissioner Mark Billingsley noted that he’d just talked to an emergency room doctor about people who abuse the system and said the county could expect expensive abuses if the service were free.
“We’re wasting a lot of time on misuse of public safety,” Billingsley said. “I think the fees being charged are appropriate.”
After the meeting, Benson also said fire fees are similar to insurance, which citizens pay for whether they use it or not. But when they do use it there are still other costs, such as deductibles, attached.
Ambulance service is probably something government should provide, but experience has taught that the devil is in the details, said Commissioner Heidi Shafer.
“I want to see a few more things fleshed out because I want to make sure that we’re protecting the fee payers. I also want to make sure that this does not in any way ever get spread over the entire tax base,” Shafer said.
The ambulance service will serve the unincorporated areas of the county, Arlington, Lakeland and Millington. Arlington would pay $308,000 a year, Lakeland $346,000 and Millington $539,000. Arlington and Millington will move foward with the county, but officials in Lakeland are also looking at their options if they contracted with AMR.
Commissioners were assured that it could be in place by Jan. 1. If not, AMR would rent the county ambulances, which would be staffed by county personnel, at a cost of $110 an hour per ambulance. The county also has an option to lease ambulances from another provider, Needham said.
This will the be the commission’s only opportunity for input in how the service operates, said Commissioner Terry Roland.
Once the ambulance service is approved, state law dictates that as part of the fire department it is managed by the public works director and the commission will not have oversight, Roland said.
The full commission will vote on the ambulance service resolutions at its next meeting at 3 p.m. on Monday.
Copyright 2016 The Commercial Appeal