The Dunwoody City Council voted Nov. 5 to approve a contractual agreement the mayor negotiated with DeKalb County that outlines requirements intended to ensure quicker ambulance response times in the city. But council members are also making clear through a separate action to inform state authorities they want to still move forward to create a separate EMS zone if the county fails to meet the most recent demands.
Mayor Denis Shortal, who explained in an interview he is now “neutral” on the city creating a separate EMS zone, said he and DeKalb CEO Michael Thurmond worked out a memorandum of understanding that gives the city most of its requests to ensure rapid response times. He called the council’s move to wish to push forward on the new EMS zone despite the negotiated agreement nothing more than a “political move” that exacerbates distrust between the two governments.
“Well I think there is some kind of stigma against DeKalb County that they can never be trusted,” Shortal said in an interview after the council meeting. “I believe the current CEO can be trusted.”
Councilmember Terry Nall, who has led the effort carve out an EMS zone specifically for Dunwoody, said the issue is not about trust but rather about history. The City Council has made several complaints to DeKalb County officials over the past several years about slow response times by their contracted ambulance provider, American Medical Response, he said.
Initiatives implemented in the past by DeKalb against AMR to speed up response times, including significant financial penalties and requiring more staff, did not work, Nall said. Finally in May, the council declared an “EMS Emergency” requesting the Region 3 EMS Council that oversees DeKalb to step in and consider their request for a new EMS zone.
“For now, the MOU is merely words on paper,” Nall said during the meeting. “The burden is on us to make sure they [DeKalb] comply. They have failed in the past. The request for a new EMS zone must remain part of our request … otherwise there is no penalty for non-compliance.”
Nall successfully added an item to the agenda over Shortal’s objections calling for another vote. The vote requires the city to inform state health authorities overseeing DeKalb County’s EMS program they plan to continue seeking a new EMS zone should the county fail to meet the MOU’s mandates.
Shortal said he and city staff members and DeKalb CEO Michael Thurmond and his staff agreed to try to resolve the city’s concerns about ambulance service over about the past two weeks. Shortal said he did not tell council members he was in talks with Thurmond until last week when it was clear an agreement was reached. As CEO, Thurmond can enter into MOUs without a vote from the Board of Commissioners, according to a spokesperson.
Shortal said he agreed to talk with Thurmond after the state ad hoc subcommittee voted last month to delay making a recommendation to the Region 3 EMS Council, allowing DeKalb County more time to address concerns such as slow response times. That meeting, Shortal said, led him to believe it was unlikely the city would be granted its own EMS zone.
“We [he and Thurmond] both went to each other, said this is not going anywhere and let’s try to solve it if we can,” Shortal said. “I wanted to enhance EMS services for the citizens.”
Requirements in the MOU include: a response time of nine minutes or less on 90 percent of calls to life-threatening emergencies, and 15 minutes or less on 90 percent of calls for less serious emergencies; three posted ambulances at fire stations in the city and a roving fourth ambulance from 9 a.m. to 9 p.m. during weekdays serving Perimeter Center; technology upgrades to ambulances stationed in Dunwoody including GPS and traffic signal preemption devices that stops traffic to allow emergency vehicles the right-of-way; monthly reports on response times from DeKalb to the city; and all ambulances in the city to have advanced life support and a paramedic.
“This is exactly what we asked for,” Shortal told the council. “Do you trust DeKalb? I have the inner ability to trust people. His [Thurmond’s] word is on here. He gave his word.”
The council approved the MOU unanimously. The council then voted 6-1 a(Shortal voted “no”) to approve sending transmittal documents to the Region 3 EMS Council stating their request for a new EMS zone remains on the table if the county cannot deliver on the MOU demands.
The MOU demands must be met for at least one year by AMR or a possible new ambulance provider to be selected next year. AMR’s contract expires Dec. 31, but the county is still working with a consultant on a request for proposal that may not be ready until March.
“I believe in trusting the county, but with verification,” Councilmember Jim Riticher said.
Councilmember Lynn Deutsch said the city has been working for years with the county trying to resolve ambulance response times to no avail. To give up on creating a new zone at this time could mean another disruptive process.
“We want to spare the citizens from having to start all over,” she said.
Members of the ad hoc subcommittee said last month the contract between AMR and DeKalb County made five years ago sets up the ambulance service provider for failure. For example, it does not include tiered response times — different response times for different kinds of emergencies. The tiered response times in the MOU are expected to be included in the new RFP.
Dunwoody’s location at the top end of the county and traffic congestion are also reasons for slow response times, according to DeKalb and AMR officials. AMR has also said that sometimes an ambulance is forced to wait an hour or more at a hospital emergency room until a patient is admitted, keeping it off the roads to answer other emergency calls.
Dunwoody council members said these issues have been ongoing but no serious efforts by the county have been made over the years to change the contract despite their complaints. Nothing happened to seriously address the matter, they say, until they declared the EMS emergency.