Commissioners Study MEDIC Ambulance Proposal

In This Episode of the Little Ambulance That Couldn't ...

By Leslee Kulba- If you want county taxpayers to loan you $1 million to default on a project in 20 years, the Buncombe County Commissioners will be happy to oblige.

If you want a few thousand dollars, or tens of thousands, for your group to raise awareness about something that generates warm and fuzzies, “The Commish” is on it. How about a million for your company with a business model so bad you can’t make your bottom line without it. Call it economic development, and The Commish will say, “This is exciting!” But what if you want to do good, as in helping people in real-world, life-and-death situations?

We return to the saga of MEDIC, a private ambulance company that has been operating “under a handshake agreement” with the county to fill in gaps in calls for service. That is, MEDIC runs a state-certified ambulance service.

The county allows its vehicles to sit on standby at sporting events and transport people with medical conditions, but it does not allow them to answer 911 calls. The company has, however, been helping the county out beyond the terms of its franchise agreement by staging its seven ambulances in areas where county ambulances run sparse.

Kermit Tolley of MEDIC has been trying to get permission from the county to connect to the 911 service for about twelve years. At first, reasons for denying his request included: MEDIC did not fit into the county’s emergency plan, a private provider would confuse dispatchers, MEDIC mistakenly supplied one document instead of another with its application, and it’s a for-profit company [It’s actually a 501(c)(3)]. This time around, the reasons were different. Commissioner Amanda Edwards explained.

“I’ve not seen a cost-benefit analysis of this proposal in terms of how moving toward partnering with a private EMS provider looks for the county: How much is that going to cost us? How much revenue will our fire departments lose as a result of this? Would that result in needing to increase the fire tax rate if we do move toward this direction? Prior to my time, I know, I’ve read thoroughly the study by the Bost group that does not recommend moving toward a private company. And again, not only do I have questions about the tax rate and the loss of funds, but there could be some significant implications with federal funding as a result of this, and I think we need to look at that in terms of kinds of things that our fire departments and ambulances receive in federal dollars.

“But the biggest overarching one that is really disconcerting to me: This was not put out for an RFP. We have continued to talk about transparency and accountability – There hasn’t been anything out, and I’ve been told there’s no other provider, but we’ve not been allowed to put that out and give another provider an opportunity. We’ve asked for Waste Management to put out an RFP, we’ve had a solar farm proposal, and I think it’s only fair and transparent to do the same in this exact same case…. Perception is reality, and if people think we’re not being transparent, we’re not. I take great issue that this has not gone out for an RFP.”

The Bost report actually determined there was room for improvement in emergency response times, and it didn’t appear to correct for what response times would be were MEDIC not picking up calls.

Commissioners Mike Fryar and Joe Belcher pointed out the report didn’t even seem to notice what Interim County Manager George Wood found: The county is paying excessive overtime for emergency responders and still falling short of filling shifts. Wood recommended hiring four more paramedics and giving MEDIC 911 access for a year-long trial period.

As for the RFP, one might draw an analogy with the real estate business, now that the county is getting into it. Would it be fair for the county to approach a realtor who had grown his business as his passion for 30 years, revoke his license, and say if he wanted it back, he would have to apply via an RFP process because somebody might be more aligned with the commissioners’ strategic goals? Sharon Tolley, co-founder of MEDIC, explained the infrastructure and institutional knowledge MEDIC has acquired in over 30 years serving Buncombe County is not something acquired easily or lightly.

Chair Brownie Newman asked if the county was prepared to raise taxes or lay off emergency-response personnel should a private ambulance company be given 911 access. Belcher made a motion to approve the hiring of more personnel and direct county management to return to the board with a draft franchise agreement that would grant MEDIC permission to offer the full range of ambulance services. It passed 4-3, Belcher, Fryar, Robert Pressley, and Al Whitesides in favor.

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