New Augusta EMS provider Central EMS plans to be up and running before the May 8 deadline set by the Georgia Department of Public Health, Central President Gary Coker said at a first meeting with the Augusta Commission Thursday.
“That means we’ve got some work to do between now and then,” Coker said.
Central won the license to run Augusta 911 emergency medical calls in a recent state bid award but hasn’t specified how much, if any, it wants from Augusta to subsidize unreimbursed expenses, only that stockholders expect a 10% return. Nor have the number of ambulances, response time requirements and other details been ironed out.
“We’ve been asked probably about 25 times how much is it going to cost? We can’t really tell you what it’s going to cost until we figure out what you want in an ambulance service,” Coker told commissioners.
They’d be asked at least four more times Thursday.
The price was long a sticking point in contract negotiations with former zone provider Gold Cross, whose decision to surrender its license prompted the award to Central. Gold Cross is now on a month-to-month contract.
After a recent tour, Coker said he determined Augusta’s 911 center, fire department, equipment, staff and chief are in great shape. The department’s ISO rating of 1 is held by less than 1% of departments nationwide, he said.
“But when it comes to ambulances, that might be when you put a report card out and it says, ‘needs improvement,’” Coker said.
An emphasis on ‘transparency’
Bryan Gibson, the president of Central parent company Priority Ambulance, requested the commission create a committee of stakeholders, including fire and 911 officials as well as commissioners to “sit down and design a system that you want with transparency in mind.” The transparency will extend to all areas, he said.
“If you’re willing to do that and have us in true transparency, a sitting-down committee that can give us the tools and the data that we can sit there and analyze and give you transparency. Not only within the expenses – I’m talking transparency at the level of a budget that’s line-itemed out. You want to recruit heavily? You want to pay x dollars for an EMT? You want to pay x dollars for a paramedic?”
“It all translates into we have to have an economic partner in this to be able to make this successful in what we’re paying so therefore you understand exactly what our subsidy would be and how much,” he said.
The transparency would extend to revenue, Gibson said, “so that if there is a subsidy required and how much it is that it’s not just vapor, that it’s not made up, that you truly can see exactly what we’re asking for and why it’s needed.”
Mayor Garnett Johnson asked if Central could estimate a price based on its response to the state request for proposals, which was eight ambulances during peak hours and six off-peak, plus three quick-response vehicles.
Gibson said yes, but the answer would resemble “throwing darts at it.”
Commissioners weigh in
When it was time for questions, Commissioner Wayne Guilfoyle asked General Counsel Wayne Brown if Augusta had to do a request for proposals prior to entering a contract with Central. Brown said no.
Guilfoyle and several other commissioners said they should not serve on the committee. He also had suggestions for the contract.
“I just think we don’t need to be involved in it whatsoever. That’s my two cents. A couple things I would like to see in that contract is No. 1, that if we do business with Central Service and later down the road if we cut ties, that in that contract, it has to state that they have got to give up the zone as well,” he said, adding that Central should use city fleet gas cards, but only for vehicles providing EMS to Augusta patients.
Commissioner Brandon Garrett returned to the topic of Augusta now conducting an RFP, referencing 2019 meeting minutes concerning an RFP the city did while the state zone was open for bids. Gold Cross would obtain an injunction, blocking the opening, which was eventually overturned.
“An RFP is not required here, because they are the zone provider,” responded Nancy Williams, contract compliance administrator for the city procurement office.
“The bottom line here, no matter how long we discuss it is that when you have a provider that is selected by the state, Augusta does not have the jurisdiction to put another ambulance company into that zone,” Brown said.
Garrett asked if Central planned to offer non-emergency patient transport, as it does in other areas and as Gold Cross provides in Augusta.
“The answer is right now, no, we want to make sure the county is set up,” Gibson said. “Yes, we would like to expand our operations post that.”
EMS data ‘tainted’
To a question about the price from Commissioner Alvin Mason, Coker elaborated on why it has specified no amount other than 10%.
“Because we didn’t know the number of calls that were being run to multiply by what we thought we would collect, and we didn’t know what the expenses would be here because we didn’t know how the system would be developed and designed,” Coker said.
Coker said the data it has received on Augusta EMS calls appears inaccurate.
“We think that that is somewhat tainted, because at times it seems to us, on first look, that the routine calls from the hospital transfer, interfacility transfers may be mixed in with the state’s data,” he said. “We don’t know the number of calls that are being run in the 911 system currently.”
Commissioner Sean Frantom warned of commissioner involvement in the process, after “what has happened over the past eight years.” He said what is needed is “a committee that’s not commissioners, and an open forum where commissioners are willing to listen but we don’t bring any input or any speaking in.”
Frantom added that if the subsidy is too high, it may be rejected.
“If we know it’s going to be in the $4 or $5 million range, it’s going to be a tough sell,” he said.
The commission agreed to vote on the committee at a Tuesday called meeting. Johnson said he’d like to see area hospitals that receive the emergency patients to be involved.
