Level Zero: Documents show dire state of ambulance situation in Knox County

Documents show Knox County is at a level zero several times a day, meaning there are no ambulances to send when someone calls 911.
Level Zero: Documents show dire state of ambulance situation in Knox County
Published: Oct. 25, 2023 at 6:15 PM EDT|Updated: Oct. 26, 2023 at 4:06 PM EDT
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KNOXVILLE, Tenn. (WVLT) - When you call an ambulance, you expect it to get there fast. However, a WVLT News investigation shows that’s not always the case in Knox County.

WVLT News requested the data to take an in-depth look into the ambulance availability situation and discovered hundreds of documents including emails, uncovered complaints and numbers showing just how serious things are.

WVLT News asked the county for the number of times they were at a “level zero.” That means there are no ambulances available to send because they are busy with other calls. So far this year, it’s happened more than 1,800 times. September saw 555 level zeros alone. Since the beginning of 2023, the number of level zeros has grown each month.

So what’s the delay? Officials said it’s a systemic problem.

When there are no ambulances, someone else will respond like a firefighter or police officer. The Knoxville Police Department said officers are transporting people to the hospital on a weekly basis.

A spokesperson for the Knoxville Fire Department said they recently started tracking how often they’re taking patients themselves. “We started because it became clear that we may continue doing it more often,” said Assist. Chief Mark Wilbanks.

The county’s contract with the current ambulance provider American Medical Response is ending. Including AMR, there are four companies bidding to secure the next contract with Knox County.

AMR is also the transport company for the coroner’s office. One complaint from an officer at the Knox County Regional Forensics Center stated there was a “body lying outside for over 12 hours and a pedestrian layout for six or seven hours.”

WVLT News spoke to Knox County Mayor Glenn Jacobs in September, which is when the Knoxville Fire Department had to activate its emergency operation center. In that sit-down interview, Jacobs said, “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.”

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

AMR agreed with Jacobs’ statement and said their ambulances get held up at hospitals that are short-staffed, adding that they can’t offload their patients.

The county hired a consulting firm to review the current contract to determine what needs fixing. It found hospital wall times average 53 minutes per transport in Knox County, which is 40 minutes above normal.

Jacobs said he recognizes there are issues with the current contract that was first put into place ten years ago and has been amended a dozen times. “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,” he said.

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

Matt Myers, the county’s director of procurement, told WVLT News it’s not just one thing that’s the issue. “The Mission District, there were 3,500 calls last year. That’s just taking resources,” Myers said “We need to look at our provider and try to tweak that as best we can.”

WVLT News contacted several hospital systems including Covenant Health, Tennova and UT Medical Center about the wait times at the emergency rooms, but none provided a statement.

The county delivered an intent to renew notice to AMR Thursday, meaning, should AMR accept and the County Commission vote in favor, they will be handling ambulance services for another five-to-ten years.