The question over whether the county or Gold Cross EMS should be named zone provider for ambulance services in Augusta boils down to one thing: control.
Who gets that control will be decided by the state later this month.
The Augusta Fire Department and Gold Cross have been co-zone providers ever since the city contracted out services to Gold Cross in 2006, the only arrangement of its kind in the state except for a similar joint service between two hospitals in Athens.
Throughout the contract in Richmond County, the Augusta Fire Department has only run two ambulances at the most while Gold Cross handled the majority of calls.
After the regional EMS council reopened the zoning this summer, it voted in November to recommend the Augusta Fire Department, which holds an ambulance license for the city, be zone provider.
Gold Cross CEO Vince Brogdon said he will appeal to the state department of public health, which makes the final decision, at a hearing scheduled for Jan. 13 to try to win control of the zone.
“We feel that we’ve done a great job and we have no reason to not be zone provider in Richmond County,” Brogdon said.
Although he could not give an exact figure, Keith Wages, the director of the state Office of EMS and Trauma, said zones in Georgia are more commonly awarded to a county government that has an EMS license rather than a private company.
This is because as zone provider, the government does not have to run ambulances itself and can contract the service to whichever company it chooses. This gives government officials authority to set standards for service, like minimum response times, and to switch EMS providers if they are unhappy with the service.
In Jefferson County, for example, the local government holds the zone but contracts all services to Gold Cross. The county does not run a single ambulance, but with the zone designation, has the authority to choose which ambulance company works in the county.
County Administrator Adam Mestres said he is satisfied with the service provided by Gold Cross, but that the county would be somewhat trapped if a private company held the zone designation.
“If we did not have the zone provider designation, then that means XYZ ambulance service would have it and if we no longer want to partner with XYZ, no one else could come in and work,” Mestres said. “If we say ‘we don’t want ya’ll anymore, we’re going to bid with ABC company, they can say ‘We own the zone and we don’t want ABC here...Ideally it could create some type of monopoly.”
The state began awarding zones to ambulance services in the 1970s to prevent multiple companies from rushing to a scene at once and causing chaos, said Wages. As zone provider, that service answers all 911 calls for EMS in an area and has the authority to contract services out to another ambulance company.
Columbia County does not have an ambulance license and therefore is not eligible to be a zone provider. Gold Cross holds the zone for Columbia County and has had a contract there since 2001.
Pam Tucker, director of Columbia County Emergency and Operation Division, said she does not see a problem with the arrangement because of wording in the contract that in theory takes the zone away from Gold Cross if the partnership ends.
According to the contract, Gold Cross’ zone provider designation would terminate if the contract were to end or expire and the county would request the state reopen zoning for another provider in the area.
“We would immediately put in a request for the state to open zoning so we could promptly get another ambulance service,” Tucker said.
However Mestres, former director of Aiken Rescue ambulance service, said he would still not be comfortable with a private company holding the zone even with that kind of wording.
The contract is an agreement between a local government and an ambulance service and in no way obligates a state agency to do anything.
“The state might say ‘I don’t care what you have in your contract, we control what’s zoned and what’s not zoned,” Mestres said.
The state will have the final say on who receives the zone in Augusta, but the majority of Augusta Commissioners who responded to requests for comment support the county having the zone.
“If Augusta-Richmond County has to pay for it, we should be able to make our own decisions in what we want to do,” said Commissioner Bill Lockett. “We don’t want to have our hands tied behind our back.”
Commissioner Wayne Guilfoyle said residents would be at risk if a private company held the zone and did not allow the county to decide which services came in to assist in the event of an emergency or natural disaster.
“If we had a major catastrophe and the government had to bring in other ambulance services, (Gold Cross) can actually say ‘no’ at that point,” Guilfoyle said. “You relinquish all control over any kind of ambulatory service.”
Commissioners William Fennoy, Alvin Mason and Corey Johnson also supported the county holding the zone. Mary Davis, Marion Williams and Donnie Smith did not respond to e-mails and voice mails requesting comment.
Commissioners Joe Jackson and Grady Smith are in favor of Gold Cross holding the zone because they said Gold Cross officials are experts in the field and provide top notch service.
“When I’m on that gurney or that stretcher I want someone who knows what to do, when to do it and how to do it,” Smith said. “If the county provides (the service) you don’t know who in the hell is going to be pushing you.”
Jackson also questioned the county’s ability to invest money in purchasing ambulances and hiring more personnel if it were awarded the zone. However there are numerous counties in Georgia that hold the zone provider designation but contract the services out and do not run any ambulances themselves, according to Wages.