DeKalb County’s ambulance provider must meet strict response time requirements under the terms of an agreement reached Tuesday, but residents experiencing a medical emergency will be expected to pay much more for the service.
The county’s six-month contract extension with American Medical Response requires ambulances to arrive at the scene of serious incidents within nine minutes and to respond to all other calls within 15 minutes. Whenever those targets aren’t met, the company will pay a $1,000 penalty. The new fees kick in Jan. 1.
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In return, AMR will be allowed to collect higher fees from patients, sometimes double the current rate. The company has argued that the fees currently collected in DeKalb are not high enough, causing it to spend $4 million each year underwriting services in the county. CEO Mike Thurmond’s administration and AMR officials said the new prices are in line with market rates for ambulance services in Fulton and Cobb counties.
“Looking forward, we will continue to work closely with county officials, and all interested parties, as we continue to develop a world-class EMS system for the citizens of DeKalb County,” AMR Regional Director Terence Ramotar said in a statement.
DeKalb Fire Rescue Chief Darnell Fullum said the contract extension closely mirrors a memorandum of understanding that the city of Dunwoody and AMR signed in November. Dunwoody officials had threatened to pull out of the county's ambulance contract after growing criticism of response times.
“We are taking what was agreed upon in Dunwoody and spreading that across the county,” Fullum said.
Commissioners have criticized the CEO's office for waiting so long to iron out new terms with AMR, a company that provides a crucial service but has been accused of spotty performance over a five-year tenure.
The old contract was set to expire at the end of the month, but Thurmond’s administration said more time is needed to finalize documents that would allow for a complete restructuring and rebidding of the ambulance service contract in 2019. That is why the contract extension had to be approved on Tuesday, the Board of Commissioners’ final meeting of the year.
Commissioner Nancy Jester said she didn’t get details about the agreement until a packet was passed to her moments before Tuesday’s vote. She felt she had no choice but to sign off, despite having little time to review it.
“I’m not happy with having to vote under duress to get this done,” Jester said. “We have to extend it.”
Thurmond's office said the initial agreement signed in 2013 was inadequate, and the terms approved Tuesday will ensure that ambulance services can continue in DeKalb while a Request for Proposals document is finalized.
“Service has improved, and we are excited about the opportunity of issuing an RFP that will put this embarrassing episode behind us,” Thurmond said. “We are happy that this board spent the time today to adopt the amendment that ensures a high quality of emergency response service to our citizens.”
Under the agreement, the most serious calls are categorized as Advanced Life Support procedures and AMR can now charge patients $1,725, a 109 percent increase from the old rate of $825. Basic Life Support calls will now cost $1,453 instead of $750, a 94 percent hike. For each mile residents ride in an ambulance, they will be charged $29.50, a 181-percent increase from the old fee of $10.50 a mile.
When an ambulance arrives at a call, but the patient doesn’t require a ride anywhere, the customer will pay $125 instead of the old rate of $75, a 67 percent hike.
DeKalb officials said they called other counties and municipalities to compare rates and found that the old fee schedule was much lower. For example, in South Fulton Advanced Life Support calls carry a fee of $1,750, Basic Life Support calls are $1,715 and the mileage rate is $28.25.
The contract extension requires AMR to create a “compassionate care program” to help patients who are uninsured or cannot afford to pay their ambulance bills. But no details were provided about how that program would operate.
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