By Serena Vasudeva
Crossville Chronicle
CROSSVILLE, Tenn. — City-owned ambulances were once again front of mind at Tuesday’s Crossville City Council work session.
Several discussions have taken place regarding a city-owned ambulance service. The ambulance service would be part of the fire department.
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During the city council retreat in January, Fire Chief Chris South said around 80% of calls to the fire department are medical in nature.
Offsetting 30-cent tax hike
One concern from the council was how the city would pay for the service. In June, Financial Director Nathan Clouse said a city-owned ambulance service would require a minimum 30-cent raise to the property tax rate to pay for it.
He said he deduced the cost by talking to the billing service the city is interested in working with and speaking to the financial director in Mount Juliet, a city which has its own ambulance service.
Both Mount Juliet and Martin, another Tennessee city with city-owned ambulances, raised property taxes to pay for the service.
The council voted to postpone their vote on a city-owned ambulance service so additional funding options could be researched.
Now, Councilman Mark Fox has come back with possible funding options.
He said that he had made an initial inquiry with the Gary Sinise Foundation. According to their website, they provide homes and mobility devices for veterans as well as first responder support.
“They’re very big on helping emergency services, first responder organizations. And this is grant money,” Fox said.
Turner asked what the application amount was, to which Fox said that there was no limit on what the city could apply for.
“Obviously they may have some internal amounts that they set judgments and awards based on, but there’s no cap. You can request the funding as you can see fit, as you can justify,” Fox said.
Fox said the application requires organizational statistics and size of community served.
The council will vote on authorizing the application Tuesday.
Fox invited freelance grant writer Anna Hamilton to the workshop. She said she has experience applying to federal and private grants, though she hasn’t worked directly with a municipality.
“In addition to grants specifically going to the department, there is the Crossville Fire Rescue Foundation . So, that opens up a whole new plethora of opportunities for us because a lot of grants are specifically notated for 501c3 organizations.”
According to the Crossville Fire Rescue Foundation website, the nonprofit funds rescue tools, protective clothing, maintenance equipment and training courses.
City Attorney Randy York asked how Hamilton was typically paid. She said she has an hourly rate of $65, and will usually work 2-10 hours per week, depending on what grants they apply for.
Fire chief pitches numbers
South provided a presentation on how the new EMS service could be implemented. He said implementation will be split into three phases.
Phase one will involve preparation and certification. During this fiscal year, the service will begin the certification process with the state, the Drug Enforcement Administration and Medicare.
They will also get their certification for basic life support, then transition to advanced life support.
South said phase one will take around six to nine months.
“We would be purchasing a used ambulance initially for that process. We recommend about $120,000 for that process at that time. We would then order three additional EMS units.”
South Siddons-Martin has a three- to four-month delivery for ambulances, and the three additional units would cost $1.3 million.
Modifications to fire station 1 would be required for additional personnel to have bedrooms. The proposed new floorplan will utilize existing buildings with some notifications. Fire Station 2 does not need to be modified. The projected cost is $24,000.
The city would also have to enter into agreement with a billing company, such as AMB Medical Ambulance Billing. AMB is the company Cumberland County EMS uses.
The second phase deals with personnel. January 2026 is when South said they would hire 18 additional employees: nine paramedics and nine advanced emergency medical technicians.
They will also need new fire protective clothing for those employees, which South said will cost $108,000.
Ten weeks of fire training will also be required at $190 per employee. Existing captains will be promoted to battalion chiefs and given raises.
South said the fire department would hire people who are already certified paramedics or certified advanced EMTs to save money and time.
In a slide presentation by South, the fire chief said firefighter paramedics would be paid $70,000, firefighter advanced emergency medical technicians would be paid $59,000 and fire battalion chiefs would be paid $88,000.
The totals with benefits are higher: $104,000 for firefighter paramedics, $94,000 for advanced EMTs and $124,000 for fire battalion chiefs. From January to June 30, 2026, their total personnel cost would be $1,107,000.
“If we’re paying the money like this, they’re coming. I have no doubt in my mind,” South said.
South said during an interview that the majority of their existing staff will also be involved with the city-owned ambulances and are already trained. With the increased job responsibility, almost all personnel will receive a raise.
“It realistically doubles the roles and responsibilities our department will have,” South said. “If they’re going to be doing the job, obviously they should be compensated for it.”
South said rotating staff will prevent burnout.
“The program that we’ve designed will actually accommodate them to be able to rotate from fire apparatus to squad to EMS unit, maximizing these personnel in a way that we can reduce their day-to-day wear and tear and hopefully maximize job happiness and ability to make sure that they are able to perform to the bar that they set.”
Phase two also includes working with Cumberland County 911 on EMS zoning and 911 response.
South estimated they will need $225,000 in equipment.
Phase three is when the program is implemented and will begin transporting patients. South said the timeline depends on the council’s approval and plan, but could begin around July 2026.
“I want you all to be aware, we are thinking this through to the nth degree. When I plan, I try to plan for every possible stipulation,” South said.
South said they will need $225,000 for equipment, which can be purchased outright or purchased and financed over 5 years interest free. Equipment could also be leased.
South said the total cost will ring in at $3.2 million during its first year. The total operating budget increase annually is between $2.6 million-$3 million, while the expected revenue is at the low end of $2.7 million.
During an interview with the Chronicle, South said that he prepared the numbers by working with vendors and human resources.
“I got the Tennessee state rules and regulations for what exactly is required to be on an ambulance and I worked with some vendors to start trying to identify what would be a cost factor,” South said.
He said he may be a little high for the yearly projections he calculated, but that it was ultimately better to be high than to be short of funds.
For salaries, he looked at comparable rates across the Upper Cumberland. Human resources provided the cost of benefits.
South said he did not collaborate with the city financial department.
“My numbers are specifically ours … I think finance provided and did some of their own calculations and stuff like that, but, you know, obviously I tried to stay with what I felt like what was exactly where we needed to be. I tried to make sure it was as close to the exact numbers that I thought we would project.”
Mayor: City would pick up half of county’s $2M loss
After the presentation, Councilman James Mayberry asked what the cost to hire an independent contractor to provide an ambulance service would be. He gave AMR as an example.
“That’s a question I unfortunately can’t answer sir, because I have not looked into that. I was not instructed to do something like that.” South said. “The only thing I can assure you… If you tell me to do it, I’ll make sure it’s done correctly. I think you know that. If you pay someone else to do it, the only thing you’ll be able to hold against them is the money that you pay.”
“It wouldn’t make sense to do an AMR type here. We’re already provided for by the county,” Turner said.
Mayor RJ Crawford said that the county is losing $2 million on their EMS service.
“If 50% of their calls are coming from within the city now … We’re looking at roughly a $1 million loss.” Crawford said.
South said he looked at the county numbers and they collected $4.5 million with a $6 million budget. If they took half, the city could collect around $2.25 million. He said that their costs after startup would be $2.6 million.
South acknowledged there would be a financial burden for the service, but said he believed his numbers were reasonable.
“I spoke to the people we actually purchase from and tried to get as real numbers as I could,” South said.
If city EMS becomes reality, county to pull Crossville units
Crawford said he did not want a situation where the city starts their own ambulance service, causing the county to remove their additional ambulances and leaving the city taxpayers to pay for both services.
The county has already confirmed they will remove the ambulances typically stationed in Crossville if the city has its own service.
Fox said that while those ambulances start their day in Crossville, they respond to calls outside the city. He added that he has urged commissioners not to reduce their ambulance fleet.
“Cookeville does not have a city EMS program, they still use their county. And so, I hate to use comparables to Cookeville because my competitive spirit is to try to outdo them, but they’re a good litmus test to go, ‘are they moving in that direction?’’ Crawford asked. “Why would our EMS get statewide recognition if they weren’t high quality?”
CMC doctor: Fox said ‘I might be the medical director’
Dr. Thomas Allingham, Cumberland Medical Center’s medical director critical care medicine, told council members he is in favor of a city ambulance service.
“I see it as, since Cumberland is the fourth largest geographic county in Tennessee, the county has a large area to cover,” he said. “Fifty percent of the calls apparently come from within the city limits. So I feel that a city EMS program would be very warranted in this situation.”
Allingham said CMC has a stroke program and a cath lab. The Cath lab is under the hospital’s interventional cardiology program and is used to treat heart attacks.
“Rapid response by EMS is critical for those programs to work well,” he added.
Allingham said he and Fox, a surgeon by profession, have been colleagues for close to 20 years.
“[Fox] has requested that if this does come to fruition, that I might be the medical director of that program,” he added. “I am grateful for his trust.”
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