‘This is a big problem,’ | Knox Co. mayor weighs in on ambulance shortages

Four companies have placed bids for the ambulance contract in Knox County.
Published: Sep. 20, 2023 at 5:54 PM EDT|Updated: Oct. 16, 2023 at 2:36 PM EDT
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Ambulance Response Issues

Live: Knox County Commission hears a report breaking down issues affecting ambulance response in Knox County and what should be done next. https://tinyurl.com/y6rpvmy8

Posted by WVLT on Monday, October 16, 2023

KNOXVILLE, Tenn. (WVLT) - Right now there is an ambulance crisis around the nation, including right here in Knox County.

Just last week, the county opened an emergency operations center after a shortage of ambulances and an overwhelming amount of calls in a short amount of time. That center was open for a few hours. American Medal Response, the company that currently holds the contract for ambulance service in Knox County, said it put more ambulances on the road, but the next day they hit level zero several times. That means ambulances are in service but are busy with other patients.

Previous Coverage: ‘The Perfect Storm’ | Knoxville Fire Department activates emergency operation center due to ambulance shortages

In a WVLT News investigation, we uncovered dozens of complaints over the past year of ambulances taking too long to respond or not at all.

In some cases, bodies laid on the side of the road for more than six hours. Firefighters and police officers were forced to transport some patients to hospitals themselves because an ambulance wasn’t available, according to emails WVLT received through an open records request.

WVLT sat down with Mayor Glenn Jacobs for a one-on-one interview about what needs to change before they approve a new contract.

“When this contract was put into place we were not in this environment. It was fine for what it was, but now I think we have 12 amendments to the contract and you never want to see that,” said Jacobs.

He admitted there was a problem with the current system, but said the problems are systemic.

“A lot of the issue is wait times at hospitals. What they call “wall time” is how long it takes to unload patients as well as the volume of calls became overwhelming,” he said it’s not the hospital’s fault, but they’re also dealing with staffing issues.

Right now, AMR’s contract with Knox County requires them to respond within 17 minutes or get fined. So far this year, AMR racked up more than half a million dollars in fines. The county has waived most of them.

“That’s money that’s coming to the county and we don’t need it. We would rather see it be used by AMR for things like training, to get more ambulances on the road,” he said.

American Ambulance CEO Maria Bianchi, said this is a nationwide issue.

“Our nation’s EMS system is facing a crippling workforce shortage that threatens to undermine our emergency 911 infrastructure. Congress can help by promoting initiatives for the hiring, retention, and training of paramedics and EMTs, the numbers speak for themselves. Our 2022 study found that overall turnover among paramedics and EMTs ranges from 20 to 30 percent annually with organizations on average having 30% of their paramedic positions open and 29% of their EMT positions.”

Both AMR and Knox County have programs in place to get more people into the workforce.

Right now there are four bids being considered from four different ambulance companies, including AMR.

WVLT Anchor Casey Wheeless asked the mayor about the new contract:

CASEY: “The county brought in a consulting firm that found problems with the current contract as it is with AMR. What steps are you taking to rectify that as you look at these new bids?”

JACOBS: “The new contract will include things that are more performance-based and those sort of things even the contract point #3 with the hospital wall times that’s going to be challenging for anyone. I think the main thing is trying to have the benchmarks for performance and outcome not only the number of ambulances on the road but making sure they’re responding correctly.”

CASEY: “We’ve had several reports- one said there was a body laying outside for 12 hours and a pedestrian for six to seven- that’s got to raise some red flags.”

JACOBS: “Oh it does absolutely. We have ambulances that could be taking people to the hospital but under the current contract, they’re being used for deceased and transport and that gets pushed to the bottom. "

CASEY: “I think people want to know if they are in an emergency situation - this is a life or death situation- they want to know- is someone going to come help or are they going to lose a loved one or die themselves?”

JACOBS: “No. No, They will. When you’re looking at ambulance response times you have to remember too what often will happen is a paramedic responds and they’re there to stabilize the person maybe the ambulance doesn’t get there but the care is being provided.”

CASEY: “Where is this on your long list of--”

JACOBS: “It’s number one. Right now we understand this a big problem we want to get this rectified we also want to bring some certainty as far as this ambulance contract going into the future and all those sorts of things.”

The county commission will review the contract after a decision is made. That meeting is expected in late October. WVLT will be there and bring you the latest.