The city of Dunwoody’s quest to break off from DeKalb County to create its own emergency medical services zone hit a wall July 18 when the state subcommittee tasked with reviewing the county’s EMS system and ambulance response times said that decision is out of its hands, despite what city officials originally thought when the group was formed one year ago. The subcommittee also voted to disband, saying its work to facilitate discussions between the county and municipalities to improve EMS services is complete.
That message disappointed Dunwoody officials who said the underlying reason for seeking intervention from state health authorities was to gain support for opening a new EMS zone for the city due to consistently slow ambulance response times by the county’s current contracted provider, American Medical Response.
“I guess I’m disappointed our request for an EMS zone was not considered,” said Councilmember Terry Nall in an interview after the subcommittee’s July 18 meeting at Dunwoody City Hall. Nall has driven the city’s protests about ambulance response times but did not address the subcommittee at this meeting as he has done in the past.
“The ad hoc committee believes it was not their charge, but that was the underlying request of the EMS emergency … to have our own EMS zone. And that went to the full council. That was the original request of the city,” Nall said.
After years of complaining to county officials about AMR’s slow response times – including records of patients waiting 20 to 30 minutes or more — the City Council voted unanimously last May to declare an “EMS emergency.” The declaration was sent to the Region 3 EMS Council, a division of the state Department of Health in charge of overseeing EMS services in DeKalb and other metro Atlanta counties. DeKalb Fire Rescue Chief Darnell Fullum serves on the Region 3 Council.
In response, the Region 3 EMS Council created in August 2018 a subcommittee to review DeKalb’s EMS system countywide and consider Dunwoody’s request for its own ambulance zone. Those on the subcommittee are Clayton County Deputy Fire Chief Richard Elliott; Marietta Assistant Fire Chief Chris Whitmire; Atlanta Fire Deputy Chief Jolyon Bundrige; Roswell Fire Chief Ricky Burnette; and Dr. Eric Nix, Cobb County Fire medical director.
At the July 18 meeting, Elliott, chair of the subcommittee, said the subcommittee’s role was to assist DeKalb, Dunwoody and other municipalities to find ways to improve quality of care and discuss what kind of EMS services they want to see in their cities and areas. Those responsibilities have been accomplished, he said, and members voted to close out its work and prepare a final report for the Region 3 EMS Council.
Nothing about recommending Dunwoody getting its own EMS zone was part of the subcommittee’s responsibilities, Elliott said.
“We keep bringing up [that] Dunwoody wants its own zone, but we are not charged with that and can’t make a decision on its own zone,” Elliott said. “Any action related to opening a zone must go back to the full [Region 3 EMS] council.”
Subcommittee members said the county has made significant improvements to ambulance response times and EMS services in DeKalb and Dunwoody over the past 12 months. Dunwoody officials argue AMR and the county continue to violate a memorandum of understanding signed in November that requires ambulance responses in the city to be under 9 minutes for advanced life support, or urgent, life-threatening emergency calls, and under 15 minutes for other calls.
“Unfortunately, DeKalb County hasn’t met the terms of that MOU in relation to those times,” Police Chief Billy Grogan told the subcommittee.
The City Council voted July 8 to declare DeKalb County in violation of that MOU and sought assistance from the subcommittee to resolve the issue. DeKalb County has denied it violated the MOU because the agreement doesn’t specify ambulances arrive at those times, only first responders. And DeKalb Fire Rescue responders, who are trained EMTs and paramedics, regularly arrive within the MOU’s times.
Elliott also said the subcommittee had no standing to enforce the MOU because that is a local issue between DeKalb and Dunwoody.
“Response times are just one piece of the picture,” he added. “We have to look at different parts of the picture.”
Cobb County Fire Medical Director Eric Nix said he was impressed with AMR’s response times, saying “a lot of communities would like to have these.”
Mayor Denis Shortal and Councilmember Lynn Deutsch agreed improvements have been made in response times but urged the subcommittee to stay together in some form to facilitate discussions between DeKalb and the city.
“I would hope you go back and … reconstitute,” Shortal said, “because I think this is one of the things that keeps both of us together talking. One of the biggest things you’ve done is brought us together to speak to each other.”
Deutsch, speaking to the subcommittee for the first time since it was formed last August, said the reason there have been improvements with AMR’s response times in Dunwoody and the county is due to the subcommittee’s work. But response times are still lagging in Dunwoody according to the MOU. She also said the city’s request from the beginning of the process was for its own EMS zone. That request remains, she said.
“I don’t think we are far enough into the process for this process to end,” she said. “The well-being of our citizens is not being served as good as it could be … we are not there yet.”
Roswell Fire Chief Ricky Burnette said his job as a member of the Region 3 EMS Council and the subcommittee was to make sure Dunwoody and others have adequate services to their citizens, including adequate response times and care.
“And that has improved. It may not be where you want it to be, but I think you have to agree there has been an improvement,” he said. “My job is not to make sure [they] meet contractual response times.”
Another layer in the ongoing debate between Dunwoody and DeKalb County over ambulance response times is that AMR continues to provide services through contract extensions after the original contract expired in December. Fire Chief Darnell Fullum told the subcommittee July 18 there is a chance its contract, extended twice so far through September, could be extended a third time until the end of this year.
Dunwoody currently has 3 full-time advanced life support ambulances in the city as part of its MOU. Fullum said other improvements have been made and are continuing. The county recently purchased rapid response vehicles that are much smaller than larger fire trucks and include firefighting equipment and emergency medical supplies.
These vehicles can be used instead of ambulances for non-life-threatening calls, he said, enabling ambulances to remain on the streets. Plans are to station one of these vehicles at Station 21, a small station on Crown Pointe Parkway, by the end of August, Fullum said.
Funding for 20 new paramedics was also just approved by the Board of Commissioners, Fullum said. Where they may be stationed is not yet known, he said.
This story has been updated.