By Ben Benton
Chattanooga Times Free Press
Copyright 2007 Chattanooga Publishing Company
SEQUATCHIE COUNTY, Tenn. — The cash crunch at the Sequatchie County Ambulance Service illustrates how hard it is to keep such services going, area operators say.
Whether they’re county-owned, like most in Southeast Tennessee, or contracted as in many Northwest Georgia counties, operators say emergency medical transport is a costly endeavor.
“The cost of running an ambulance service or an emergency medical service is incredible. Today’s average to start a paramedic level ambulance is about $420,000 just in the start up,” said Scott Radeker, EMS director at Hutcheson Medical Center in Fort Oglethorpe, Ga.
“Mismanagement” forced Sequatchie County leaders to bail the service out to the tune of $115,000, but aggressive debt collection will get the service back on its feet in a few months, officials said.
Sequatchie commissioners are reviewing a couple of proposals for private service, but a county-owned service gives government leaders and citizens “some say-so if there is a problem,” said county budget committee member Michael Griffith.
“People in my district want us to keep ownership,” he said.
Georgia’s Catoosa, Dade and Walker counties pay subsidies for service contracts with nonprofit Hutcheson Medical Center’s EMS department, records show.
Mr. Radeker, who also once worked in Erlanger hospital’s EMS department, said Georgia services face a shortage of paramedics and the closure of training facilities. Those problems add to financial challenges like Homeland Security grants that help fire departments more than they do emergency medical services, he said.
But “economies of scale” mean larger services like those at Hutcheson or Erlanger can offer lower rates than can county-owned departments, Mr. Radeker said.
McMinn County, Tenn., officials switched from an ambulance service operated by the county-owned hospital to the private company Med-Trans to cut costs, said Joe Guy, assistant to the county mayor.
“Because our county ambulance service was tied to Woods Hospital when it was going to be sold, we felt it was in the best interest of the citizens that we put it out for bid,” he said.
McMinn’s contracted service reduced costs and provided more ambulances, Mr. Guy said.
A county-owned service gives local government “more control” but a private service “is profit-driven and (private companies) are much more likely to reinvest in the service,” he said.
Whitfield County, Ga., has contracted with Hamilton Medical Center’s Whitfield Emergency Medical Service for years, County Administrator Robert McLeod said.
“The county must continually evaluate each of its contractual services,” Mr. McLeod said. The county is negotiating a new contract with Whitfield EMS, he said.
Contracted services lighten the burden on the county, but “with a contractor, it is more difficult for the county to assess patient quality of service and matters related to vehicles, equipment and maintenance,” Mr. McLeod said.
Still, a private company can play an important role in an area with existing service, according to the owner of Catoosa County-based Angel Emergency Medical Services.
Dewayne Wilson said Angel EMS provides 911 service in Catoosa but also provides non-emergency transport services through a state contract in Whitfield, Dade, Walker and Chattooga counties. Angel ambulances transport an average of 125 patients a day, he said.
In a community with only one service , response times may lag if ambulances are already busy, he said.
“We decided to be competitive partners (with Hutcheson) and work together,” Mr. Wilson said. “That way we wouldn’t have to worry about citizens not being covered.”
But call volume isn’t as important as collections, he said.
Rising costs could spell a trend toward more publicly owned ambulance services because private companies are finding it harder to remain profitable, Mr. Wilson said.
“You have stay on top of your collections. You have to make sure you manage your company where it’s profitable,” he said.