An AMR ambulance sits in the parking bay of the AMR facility on Bessemer Street.

Blount County’s new contract with American Medical Response, Inc. takes a new approach to emergency response that could change the model of service. The contract shifts focus from a 911 call to triage at Blount Memorial Hospital’s Emergency Room.

Blount County General Services Director Don Stallions said the approach of shifting focus to clinical, instead of time-based performance, makes the contract one of the first in the country to implement a clinical-based model.

“This could have national implications,” AMR Operations Manager Jonathan Rodgers said. “This could be a trend-setter.”

Stallions said one of Mayor Ed Mitchell’s biggest concerns was to assure a new contract for ambulance service will meet the needs of a growing community. Mitchell challenged Blount County Emergency Medical Services and the purchasing department to create a contract and award the bid to a provider who can accommodate the rising population.

Rodgers said AMR and the county were able to work out an agreement with few changes to the county’s request.

“Personally, I’m excited that this new contract is going to push us further into the 21st century with EMS care, with clinical performance,” Rodgers said. “I’m excited, and we have a great partnership with the county and the community. And we’re just going to continue to grow and continue to push forward.”

Blount County Board of Commissioners voted in unanimous favor of awarding the new EMS contract to AMR during the April board meeting. EMS implemented new aspects of care into the contract that starts on July 1. The agreement states the initial term of the contract will end on June 30, 2027, and the extension term on July 1, 2032.

A county-focused medical director and clinical-based performance standards are the two biggest steps the contract takes into a new-age of emergency care, Stallions explained.

In the past year, AMR has racked record-high fines imposed by the county for being late to emergency calls. Several factors played into being tardy, such as employee shortages or ambulances stuck in line at BMH.

Rodgers said adjusting the work schedule and raising pay brought in new hires to solve shortages. Additionally, the most recent statistics published by BMH showed a sharp decline in COVID patients.

“We are doing exceptionally well compared to across the state,” Rodgers said. “We are 95% staffed with full-time employees. We’re consistently putting 13 to 14 trucks on the road seven days a week.”

With the new contract, AMR can be fined based on low clinical performance as well as arriving late. Response times have been adjusted, extended and made more flexible based on varying locations in the county and seriousness of the call. Splitting the county into four different compliance zones to flex arrival time for ambulances is another innovative change to the contract, Stallions said.

Although the new contract imposes time-factor fines, it emphasizes clinical performance. The new medical director will be responsible for habitual clinical evaluations of AMR’s performance.

The current medical director was hired and is maintained by AMR. With a medical director that reports directly to the county instead of the contractor, Stallions said the position will focus more on the community’s needs.

If law enforcement or firefighters have a question or concern, they can take those directly to the medical director for answers.

Don Heinemann, BMH chief executive officer, previously said as reported by The Daily Times, that having a local and emergency-trained physician as the medical director is important for the well-being of the community.

The fourth change Stallions highlighted in a memo to the Blount County Budget Committee was county ownership and administrative access to call data software.

Extracting data from emergency calls directly, Stallions said, will help the EMS department perform clinical evaluations.

By July 1st, Stallions said the county is planning to be ready to go with all the new aspects of the contract. Currently, officials are discussing who would best serve the community as the director.

The clinical score cards will also need to be complete by July 1.

Fitch and Associates, LLC., the same company that helped EMS write the contract is helping implement the changes.

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