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State set to decide fate of Augusta ambulance service this month

Saturday, Jan. 4, 2014 4:49 PM
Last updated Sunday, Jan. 5, 2014 1:17 AM
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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.

Gold Cross EMS is in a dispute over who should be named zone provider for ambulance services in Augusta.  SARA CALDWELL/FILE
Gold Cross EMS is in a dispute over who should be named zone provider for ambulance services in Augusta.

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.

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TCB22 01/04/14 - 07:56 pm
Jefferson County Administrator

Jefferson County Administrator Mestres stated, "The contract is an agreement between a local government and an ambulance service and in no way obligates a state agency to do anything."

Maybe coming from SC EMS he doesn't realize that in GA the state reviews and approves the contracts prior to awarding the zone, therefore, the state has already agreed to the terms when they award the zone.

If it really is about control, the contract gives that without the government running the day to day operations.

TCB22 01/04/14 - 07:32 pm
double post

double post

Riverman1 01/05/14 - 08:29 am
Other Way Around

I'd give the Fire Department to Gold Cross to run.

nocnoc 01/05/14 - 09:17 am
I think the county Fire Dept should control the Service

This contracting out to 3rd parties seems to cost ARC more & deliver less when its needed most.

Paint the ARC-FD Chief a power hungry control freak all you want.
But If he is not to be trusted managing EMT's, then why is he trusted
as a Fire Chief protecting ARC?

I am for getting the Living / medical care control out the Politicians hands. (that should comes as not surprise.)

My argument is simple.
When You need and ambulance, you need it ASAP in that golden hour.

Good Local Example:
When we get a call from my Brother-in-law, who is at CC's in Martinez with his family. Asking us if everything is OK on Brown rd. Why? Because the Ambulance crew sitting next to his family just jumped up and ran out the door in mid meal, after a radio call.

The call, 2 people found beside the road on Brown Rd. not far from us.
never saw the AC story on this

So why are they calling meat wagons 19+ miles away plus a unit that has to fight lunch hour Washington rd / BJ traffic? A unit not even in the county and that will have a 30+ mins response time the location?

It is also telling me they don't have enough meat wagons in ARC to handle the load.

This is NO way to run an ambulance service.

Since ARC seems to adopt/ clone / mimic a lot of BAD ideas from many other GA Cities and Counties. Maybe they need to copy a GOOD Idea for once, copy something that does work?

Many GA Cities/Counties and Metro Areas decided since they already deploy the Fire Dept personnel & FD trucks as 1st responders, which ties up resources. Then why not set up EMT units at key stations.

Make every call billable, NO Free rides, Get a Medicaid #, Insurance, get an Obamacare #. But bill it, especially the common bogus stub toes callers.

The consensus is it has been a revenue source for the counties that properly operate these EMT teams.

Properly meaning Politician Hands off.
EMS Director demotions and promotions are based solely on preset factors like response time, care and delivery to a medical center.

When you have a problem who do you call?


What a better marriage than the fire department with EMS.

stephykins 01/05/14 - 10:26 am
You have great ideas nocnoc,

You have great ideas nocnoc, but clearly no grasp of how EMS actually works. It doesn't matter what insurance number you get, no company is going to cover a "stubbed toe". You can bill all day long, but it isn't going to get paid.

Where do you suppose the local fire department is going to get the unit, equipment & staff to handle these medical calls especially if you think 10+ trucks that are in place aren't enough?

Promotions based on delivery to a medical facility is ridiculous. You can't force someone to go to the ER. If you do, they toss around that word kidnapping. People call ALL THE TIME just to get checked out and/or for help off the floor. These calls are also not billable.

If it ain't broke, don't fix it. I can understand wanting a clearer contract, but to bring in a completely different company to start fresh is just asking for a disaster.

Unbelievable 01/05/14 - 11:04 am

The FD does a great job fighting fires. They also do a great job in responding to medical emergencies. The majority of them also have second jobs for their days off because the pay sucks. Maybe the city should quit worrying about finding the cheapest EMS provider and maybe focus on taking care of the employees they currently have.

Look at what EMTs and Paramedics make. Not much. Look at what the charge is for an ambulance ride. Why is it so much? That ambulance you're riding in costs a lot of money, plus it's your best chance at surviving a life threatening situation. I would say over half the calls an ambulance runs are free. Free as in the patient has no insurance and no intent of ever paying.

When the city becomes the zone provider no ambulance service is going to bid on the job unless there is guaranteed pay for each run. No service worth having anyway. If the service isn't making money don't expect the equipment to be in good shape.

When they come to your house and hook you up to the heart monitor and want to give you a jump with the defibrillator but the batteries don't have enough charge, you can thank the county and go in peace knowing that they saved a couple of dollars.

rmwhitley 01/05/14 - 12:53 pm
Richmond county

is becoming dangerously stupid.

nocnoc 01/05/14 - 02:20 pm
"but clearly no grasp of how EMS actually works."

But you don't know my 40 years of Employment background, now do you? Just let me say, I do have a grasp (understanding) having worked the EMS/Ambulance services field early in my career.

BTW: my Son is a GA Certified FF/EMT plus a 1/2 dozen specialize certs including Fire Forensics Investigations (PT) etc, etc, etc, as Fire Fighter in DeKalb. My son has shared dozens of Wamoo, to tried to walk to the bus stop, my foot hurts, I got a headache lame type of stories. Which I have listen to 1st hand exp. after many a shift when he worked his scheduled regular EMS rotation of calls.

One thing he shared was the constant screw ups by many Private EMS Services. Screw up he has seen 1st hand in the Hospital ER's.
he also shared that many, not most, of the Private EMT/EMS fail to pass the FD tests and have to retrain for acceptance.

I guess your right I have no grasp.

BTW: What is the nature of your grasp?
Golden Ambulance employee/owner or related?

Sweet son
Sweet son 01/05/14 - 02:52 pm
I would say let the Commission Public Safety committee hold

the designation rather than the Fire department but the commission through it's inaction on anything is no more capable than Chris James. Let the FD control the 'zone' on paper but don't allow them to control 'our' ambulances. Make sure that a contract is given to Gold Cross because they have invested most of their resources into providing quality service to Richmond County. DON'T let any of these 'point to point' ambulance services you see around town get anywhere near a contract to provide emergency ambulance for the citizens of Richmond County.

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