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Gold Cross contract back up for commission consideration

Gold Cross EMS changes up for review

Monday, Aug 5, 2013 9:02 PM
Last updated 9:18 PM
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Proposed changes to the city’s new contract with provider Gold Cross EMS are up for consideration today by the Augusta Commission, but some in the business say they might not go far enough to protect residents.

The key terms, presented by City Administrator Fred Russell last week, provide for Gold Cross to maintain in Richmond County 10 staffed ambulances from 8 a.m. to 8 p.m., with six equipped for Advanced Life Support, and six ambulances from 8 p.m. to 8 a.m., with four equipped for ALS.

Charles Masters, the vice president of the Augusta Firefighters Association and one of numerous city firefighters who moonlights for an ambulance company, said the number of ambulances is insufficient, while the key terms continue to lack sufficient controls to monitor Gold Cross’ performance, a complaint raised by Fire Chief Chris James last year.

“There’s no way in Augusta, Ga., you can run six ambulances at night. That would be absolutely EMS suicide,” Masters said.

Left out of the key terms are response times, such as the 8-minute maximum response allowed for a “Priority 1” call from the city’s urban area, or the 10-minute response to a rural area included in the commission’s request for proposals it issued earlier this year but later abandoned.

Also missing is specific language about when the clock starts ticking on an ambulance call, Masters said.

“That’s the loophole in all this,” he said.

Georgia cities’ manner of
providing ambulance service varies widely, even in cities of similar size to Augusta.

In Columbus, the consolidated government’s fire department runs its own seven-ambulance EMS service, but supplements the service using two private providers for a total of 11, according to Marie Harrell, the EMS coordinator for the department.

All 11 ambulances run 24 hours a day, all are equipped for advanced life support and Columbus pays no subsidy to the private providers, Harrell said.

The proposed terms presented by Russell show Gold Cross reducing Augusta’s annual subsidy of $1.2 million by $120,000 to $150,000 for the next three years.

In Macon, Bibb County contracts with two providers, Mid Georgia Ambulance and Medical Center of Central Georgia, to cover two 911 zones.

Amy Abel-Kiker, the director of public relations for Mid Georgia, said there’s no minimum number of ambulances specified in the firm’s contract, nor is there a subsidy.

The firm, a nonprofit, has been in Macon for 35 years and is the only provider in the area certified by the Commission on Accreditation and Ambulance Services, she said.

In Savannah, some 24 Southside Fire Department ambulances are on hand 24 hours a day to attend to the EMS needs of all of Chatham County’s approximately 275,000 residents, according to all Deputy Fire Chief and EMS Director Bengie Cowart.

Southside grew out of a fire service that originally served unincorporated areas of Chatham, and has gradually increased its EMS coverage area to include the entire county.

Of those 24 ambulances, all but four are equipped for Advanced Life Support, and the county has gradually reduced its original subsidy of $1.167 million over the last few years, Cowart said.

When the Savannah Police Department, which handles 911 traffic, issues an alert tone to Southside, the clock begins ticking on an ambulance call, and paramedics have only eight minutes to respond in urban areas, he said.

Southside doesn’t get paid until SPD reviews its EMS call records and response times against the company’s, Cowart said.

Augusta Commissioner Marion Williams, who pushed longest to restore the city’s relationship with Gold Cross after the commission voted to put EMS out for bids earlier this year, said city officials were busy tweaking the contract terms Monday.

The changes, perhaps an additional ambulance or two, are “a whole lot better than we had before,” Williams said. But he was unfamiliar with specific changes.

Gold Cross is “a local company,” Williams said. It has “got a lot of people working.”

The Martinez-based firm services both Richmond and Columbia, and was recently renewed in Columbia County through June 30, 2015, according to Emergency and Operations Division Manager Pam Tucker.

Columbia County’s contract specifies five ambulances, all of them 24 hours a day and ALS equipped, to serve the growing county of about 130,000, Tucker said.

Maximum response times for a Priority 1 call are 8 minutes and 59 seconds in non-rural areas, Tucker said. A 13-member advisory board reviews call reports monthly to ensure the times are met 90 percent of the time, she said.

Commissioner Bill Lockett, who opposed suspending the city’s procurement process, said only through an RFP could Augusta be certain it was getting the best service for residents.

“What has been offered is better than what we previously had,” Lockett said. “I suspect had we gone out with an RFP we’d have gotten an even better deal.”

Commissioner Donnie Smith, who works in law enforcement, said he’s suggested to Russell the new contract include response times, using the maximums in Columbia County as a model.

Commissioner Wayne Guilfoyle, who questioned response times in the rural parts of Richmond County he represents, said he was “waiting on a little bit more information” about the proposed terms to make a decision.

Gold Cross has provided letters of support from University Health Care System, Doctors Hospital, Georgia Health Sciences University and Trinity Hospital of Augusta. All cite the firm’s pre-hospital care and investment in advanced life support equipment and training.

The contract terms are Item 40 on the commission’s regular Tuesday meeting, which is scheduled to start at 5 p.m. in the commission chamber on the eighth floor of Augusta Municipal Building, 530 Greene St.

IN OTHER ACTION

A second Monday work session allowed Augusta commissioners to further study a proposal to merge Augusta Municipal Golf Course with First Tee of Augusta, and the body is expected to vote on the plan at today’s meeting.

First Tee Chairman Emeritus Paul Simon told five commissioners who attended Monday that he’d played “The Patch” recently and they ought to be ashamed the city was charging for play there.

The proposal relies on voter approval next July of special-purpose, local-option sales tax VII to fund $2.25 million in renovations at the course, but Simon’s group would maintain the 18-hole facility until that time, he said.

Without the city’s investment, the course is nearly inoperable and probably ought to be closed, Simon said.

Commissioner Alvin Mason, one of several to support Simon’s proposal, said the proposal “by far outweighs other plans.”

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Little Lamb
46903
Points
Little Lamb 08/05/13 - 09:19 pm
2
1
Services as a verb

From the story:

Gold Cross . . . services both Richmond and Columbia Counties.

I have no beef with Gold Cross, but this use of the verb "services" seems to be similar to how a bull services a heifer or a stud services a mare.

dichotomy
34357
Points
dichotomy 08/05/13 - 10:29 pm
2
2
10 minutes response

10 minutes response time......IF one of the 4 ambulances with ALS is available......and I live in a rural area with a heart condition.........I'M A DEAD MAN.

Just another one of the JOKES of a service we get for our tax money in Southeast Richmond County. My guess is the 4 ALS ambulances will be mostly in the "old city" and West Augusta areas and possibly over near the Southwest part of the county.

Why don't you clowns just go ahead and save ALL the money by authorizing our once a week garbage contractors to pick up the dead bodies when they come by.....oh wait.....they aren't coming by everywhere once a week yet are they.

ccboesucks
10
Points
ccboesucks 08/05/13 - 10:40 pm
0
2
buyer beware

By that math Columbia County should have at least 10 ALS trucks, not the 5 they've had for over ten years. Gold Cross can't keep employees right now. They can't fill their shifts on a daily basis and the trucks they do staff are being abused for out of town trips and moneymaking general transport runs. The few ambulances they can staff aren't dedicated to 911 calls in the first place.

Docinabox4456
15
Points
Docinabox4456 08/05/13 - 11:01 pm
1
2
So Savannah gets one

So Savannah gets one ambulance per 1200 or so people 24 hours a day, but Augusta get's one ambulance for every 2000 or so from 8am to 8pm and then one for every 3100 or so people from 8pm to 8am under this contract ? (the number during the day will actually be worse when you think of all the people who will come from outlying counties to work and shop in Augusta) That's of course if those ambulances aren't taking patients to Atlanta, Columbia, Charleston, etc... or doing transfers from hospital to hospital in town or taking people home from the ER. The Commissioners might want to think this through. You get what you pay for.

PBrig822
64
Points
PBrig822 08/06/13 - 07:25 am
4
2
Here's a thought

You want better service. Call an ambulance when needed and a taxi when it's needed not an ambulance. Oh and if you call for an ambulance pay your bill.

GnipGnop
12454
Points
GnipGnop 08/06/13 - 08:11 am
2
2
This is what's wrong in Augusta

If the contract wasn't right in the first place why did you pass it? Why wasn't someone from the fire department in there to advise on the intricate details of what is needed to service our area? We have the most inept incompetent leadership I have ever seen running this town!!

sturk222369
14
Points
sturk222369 08/06/13 - 09:04 am
3
0
The contract says a MINIMUM

The trucks already at Goldcross aren't being cut which means there are already more than 4 trucks!!!!!!!!!! So no it won't be only 4 trucks running at night.

sturk222369
14
Points
sturk222369 08/06/13 - 09:03 am
4
0
There would be so many more

There would be so many more available trucks if people didn't call for stubbed toes and vomiting! People don't know the real meaning of an EMERGENCY.

GnipGnop
12454
Points
GnipGnop 08/06/13 - 09:46 am
2
2
It makes perfect sense

how we wound up with this wonderful garbage tax....uh I mean service now.....

Unbelievable
85
Points
Unbelievable 08/06/13 - 11:20 am
3
0
Sturk hit it right on the

Sturk hit it right on the head. People using the ambulance service as a taxi to get downtown. The reason the subsidy is there is because the majority of these callers dont have insurance and no intent on paying for the ride. Every GC ambulance in Richmond County that is stationed as ET (emergency transport) has ALS on board. They all have at least one paramedic on board. They are staffed 24/7.

If your cousin calls for an ambulance at 3am because she is constipated and having abdominal pains, they are sending an ALS truck, and usually a fire truck too. Maybe the call center should keep repeat abusers on a list and have RCSO send out a deputy to give them a ride to the hospital.

Unbelievable
85
Points
Unbelievable 08/06/13 - 11:22 am
2
1
GnipGnop

The fire department has its own stuff to worry about. This isnt an episode of Chicago Fire.

ccboesucks
10
Points
ccboesucks 08/06/13 - 11:41 am
0
2
RE unbelievable

Check your facts. Not every ambulance is paramedic staffed. They cannot fully staff most ambulances at a BLS level, let alone ALS.

Sweet son
10729
Points
Sweet son 08/06/13 - 11:56 am
2
2
Those who commented about the misuse of the ambulance

service were right on the spot. Maybe Chief James and Masters need to go to the ERs and watch what kind of patients get out of the units. They know that the ambulance will come and that they will get a free ride when a cab would do. Maybe the cabs should take an EBT card!! As for those who live in the sticks, you choose to live there where the services are always not as good so why would you want to sacrifice the good of the whole for a few?

TakeAHike
191
Points
TakeAHike 08/06/13 - 12:08 pm
0
1
Patient costs

How about addressing how Gold Cross gouges patients for its services? If you or someone calls 911 on your behalf, you're on the hook for whatever they feel like billing you. Unlike the ER staff, they will not negotiate with you or your insurance company. The contract needs to protect the consumers against their predatory billing practices. They should not be allowed to gouge patients who have insurance and/or excellent credit just because they don't like what Medicare/Medicaid reimburses for other patients.

shelby547
272
Points
shelby547 08/06/13 - 12:52 pm
2
0
Masters and Patient Costs

Here we go again....Masters wears his firefighter hat when he needs to bash GC, the puts back on his other job's hat at Capital City daily trying to get business for them at the hospitals. Conflict of interest???

And you must know nothing about billing? Call some big cities and see how the price is double to three times what GC charges. And as far as Medicare; if they pay it is usually a couple hundred bucks and you can't bill a patient the entire remainder. Heard of Medicaid? If they don't pay neither does the patient. Most cities with no subsidy charge 2-3k a call.

Masters and James make a great team. Two people spewing off at the mouth about EMS services when neither of them have valuable experience. Why don't you ask James how many times he has ran an ambulance call.

GnipGnop
12454
Points
GnipGnop 08/06/13 - 03:31 pm
1
0
Unbelievable....

Who do you think is going to answer the calls that the ambulance service can't handle? The fire department...and instead of a for profit comapny getting the call the taxpayers will be paying for every firetruck that leaves the station. So this is a fire department worry...quit watching so much TV....

Unbelievable
85
Points
Unbelievable 08/06/13 - 03:52 pm
1
0
CCBOESUCKS - every emergency

CCBOESUCKS - every emergency transport, not general transport, ambulance has at least 1 paramedic on them. I promise.

GNIPGNOP - the fire department does a helluva job with what they have been given. Dont think Chief James is the solution to this, the fire department has enough problems keeping up with their own equipment to add an ambulance service. Oh, and who is going to pay for that? Taxpayers.

Everyone has their pie in the sky solution to this but truth be told no one has the equipment, availability, and personnel that Gold Cross currently has. You think GC is going to just donate the ambulances to the county? Do you go to work for free or are you a 'for profit' employee?

It must be nice and cool with your head that far down in the sand. You know what? I think I figured it out. If the tax payers pay for it then its not for profit. Kind of like free healthcare and the such. Now I get who Im talking to.

GnipGnop
12454
Points
GnipGnop 08/06/13 - 04:06 pm
1
0
You totally misunderstood my first statement...

I said get the fire department involved to tell them what GC needs so that the fire department doesn't answer any calls. I DO NOT WANT THE FIRE DEPARTMENT TO ANSWER ANY AMBULANCE CALLS AT ALL!!! You obviously never read my posts if you think I am for the taxpayers paying for any of Augusta's crappy decisions!!!! So take some time and read and quit making unfounded and asinine judgements!

Sweet son
10729
Points
Sweet son 08/06/13 - 04:14 pm
1
0
TakeAHike

'If you or someone calls 911 on your behalf, you're on the hook for whatever they feel like billing you.' You know what, if you don't need an ambulance you can just say N0 THANKS!

Then, someone on here can tell you if there is a response fee. If you don't get service then there should be no fee.

Docinabox4456
15
Points
Docinabox4456 08/06/13 - 04:24 pm
1
1
Unbelievable, Not every

Unbelievable,

Not every Richmond County 911 Gold Cross ambulance has a Paramedic on it all of the time. Columbia County units almost always have one. Sometimes they even have two of them. The Columbia county contract stipulates 100% ALS coverage, while the current and future Richmond county contracts do not. It is a rare day when you have 100% ALS coverage in Richmond county. That doesn't guarantee you that one of those Richmond county ALS ambulances aren't sent out of the county or even out of state on an ALS transport of some kind. It is unknown if the county commissioners are aware of that or just don't care.

Unbelievable
85
Points
Unbelievable 08/06/13 - 04:31 pm
2
0
Okey Dokey

"Why wasn't someone from the fire department in there to advise on the intricate details of what is needed to service our area?" - GnipGnop

mmmk.

Doc- every ET ambulance I have worked on has had at least 1 paramedic and at least an EMT-I or AEMT. Both counties.

Docinabox4456
15
Points
Docinabox4456 08/06/13 - 04:39 pm
1
1
Unbelievable, Of course you

Unbelievable,

Of course you have in Columbia county, because the contract requires it there. That's not what happens in Richmond county. The only way you can 100% guaranteed that you have a paramedic on the ambulance that you work on is that you, Unbelievable, are the paramedic on that ambulance. Otherwise, you have been very lucky. Ask your coworkers who are not paramedics how often they have to work with another EMT in Richmond county on the 911 ambulances.

shelby547
272
Points
shelby547 08/06/13 - 04:50 pm
1
0
Docinabox

Not every call needs a paramedic which is why you have basic trucks.

Docinabox4456
15
Points
Docinabox4456 08/06/13 - 05:00 pm
0
2
If every patient doesn't

If every patient doesn't require a paramedic, then why does Columbia county have one on every ambulance? How many units do they have in Columbia county that don't have paramedics on them? According to the article, there are 0. Is the need for a paramedic higher in Columbia county higher? The population sicker or more injured than that of Richmond county? Or is it just because the contract says so in Columbia county, but not Richmond? I am willing to bet that in the mind of the owner of Gold Cross, that the primary difference is the requirement for 100% ALS units in the Columbia county contract and not actual patient need. If the number of ambulances and staffing were based on patient need, there would be non ALS units in Columbia county and according to the articles, there are none.

GnipGnop
12454
Points
GnipGnop 08/06/13 - 05:02 pm
1
0
Duh...

What goldcross needs to service our area...wasn't hard to figure it out or ask if it was to confusing for you

PBrig822
64
Points
PBrig822 08/06/13 - 05:06 pm
2
0
GoldCross billing

If you can't afford an ambulance don't call one for a stub toe. Medicare and Medicaid isn't paying for anything right now. Why do you think rural metro just declared bankruptcy yesterday? 911 doesn't pay

Docinabox4456
15
Points
Docinabox4456 08/06/13 - 05:23 pm
0
2
GnipGnop It's neither hard

GnipGnop

It's neither hard nor confusing. I do not speak from a lack of knowledge on the situation. Gold Cross is a for profit business. They are in the business to make money. That in itself is not a bad thing. However, businesses will often push things as far as they can go in pursuit of that. If Gold Cross thinks they can still make a profit by running 6 ambulances at night, that is what they will do, regardless of what the cost is to the community overall. They want to bet that they can handle whatever happens with the minimum cost to them. If something bad does happen, they can simply point to the contract and say "We are within our obligations under the contract. Take it up with the county commissioners." If the contract doesn't hold their feet to the fire through some means, it can and will happen. People need to be aware of that fact.

shelby547
272
Points
shelby547 08/06/13 - 05:41 pm
0
0
6 is the Min

6 ambulances is just a min in the contract. They also have mutual aid agreements. Do you really think GC would only keep 6 up? Do you really think a for profit would want to turn calls over to another service? The county put the minimum in but GC already has more than that as it is and will keep that up. The subsidy wouldn't keep a service afloat more than a couple months.

Docinabox4456
15
Points
Docinabox4456 08/06/13 - 05:54 pm
0
1
Yes, they will probably keep

Yes, they will probably keep extra ambulances up, so they can do things, like send them out of town or transports between hospitals or taking patients home in the middle of the night and still keep their minimum of 6 contractually obligated units. Mutual Aid agreements? That is not covered by sending units in from Jefferson county or Columbia county. How likely do you think they are going to turn calls over to their competitors? Not likely as it would give them ammo for the regional EMS council. The closest non Gold Cross services are in Burke, McDuffie and Lincoln counties. How close are they closest to the majority of the population of Augusta? South Carolina ambulances can't run in Georgia. If Gold Cross decides that 6 ambulances are all they want to keep in the city and send the others home or away on other calls and you're the 7th person to call for an ambulance, you are just going to be out of luck. The people of Richmond county need to be aware of what this contract doesn't do, as well as what it does do.

GnipGnop
12454
Points
GnipGnop 08/07/13 - 06:21 pm
0
0
Nor do I

I know how our commission works...rush it through apologize later, get the taxpayers screwed in the long run!!

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