KNOXVILLE, Tenn. — Knox County will contribute $2.1 million each year to the county's EMS system under a proposed contract with AMR, an email sent from Knox County Chief Operating Officer Dwight Van de Vate to county commissioners shows.
American Medical Response said it's currently funded through reimbursements from when people call the ambulance. However, a consultant's review of emergency management in Knox County showed the current funding model was not sustainable without county help.
"The costs far surpass the revenue coming in, and so the subsidies are needed," said Brett Jovanovich, the AMR Regional Vice President. "That comes in terms of additional wages, it comes in terms of additional training investments."
The email from Van de Vate to county commissioners shows several other changes to the county's contract with AMR.
The proposed contract would move EMS dispatch from AMR dispatchers to Knox County Emergency Communications District dispatchers. Under the current contract, county dispatchers forward EMS calls to AMR dispatchers.
Brad Anders, the Knox County 911 Director, said he requested the change from the mayor's office. Anders said it would allow for uniform computer systems and would reduce the number of failure points in the dispatch process.
The proposal emphasizes mobile health and community medicine initiatives too. Jovanovich said AMR may roll out a "quick response vehicle" to an area that consultants call the "Mission District," located on Broadway. It's an area where a large population of people experiencing homelessness gather.
AMR said about 1,300 calls from that area are described as "Priority 1" calls every year, but fewer than 50 of the patients end up going to the hospital. Jovanovich said stationing a quick response vehicle in that area with a paramedic may help cut down on the number of calls and free up resources.
"We could potentially avoid responding with an ambulance altogether, which creates the availability of the ambulance vehicle for more serious calls," Jovanovich said.
The proposed agreement would also create an EMS Medical Director position within the Knox County Health Department, funded by AMR. It would change the way AMR is evaluated by the county, focusing less on wait times and more on clinical performance.
The Knox County Commission has to approve the contract and the selection of AMR as the vendor.
"The last few years have been rough with AMR as our ambulance provider," said Commissioner Larsen Jay in a text message statement to 10News. "AMR still has a record they need to defend and ultimately convince the Commission that, if awarded another term as our provider, they are going to be able to improve on service to the citizens of Knox County."
Jovanovich said the current contract, executed in 2013, created challenges for AMR in Knox County in a changing medical environment. Knox County Commission will hold a workshop on Thursday to discuss the proposed contract.
Jay's full statement is available below.
"I have received the recommendation and will be reviewing all the ambulance service proposals along with the selection committee’s scoring guide to better understand both how this recommendation was made and what was proposed by AMR.
We’re only half way through this process and nothing is guaranteed. I anticipate having a robust workshop where we examine the process to date and have an opportunity to question the heath department, executive branch leadership team and AMR. There are a lot of unanswered questions and past promises made that need to be discussed in a public process.
The last few years have been rough with AMR as our ambulance provider. While I understand the nationwide challenges in emergency services and difficultly with staffing shortages, AMR still has a record they need to defend and ultimately they have to convince the Commission that, if awarded another term as our provider, they are going to be able to improve on service to the citizens of Knox County.
As this process continues, the Knox County Commission will have to determine what’s best for our citizens. We can award the contract as recommended, demand certain conditions in the final contract, or reject the recommendation outright and start over.
I promise the people of Knox County I will do my homework, ask the tough questions, and give every effort to making the best decision. Everyone in Knox County should have an excellent emergency ambulance provider they can count on."