MT. JULIET -- Cooperation, not competition, with the Wilson Emergency Management Agency will be essential if Mt. Juliet contracts with Medic One instead of WEMA to provide the city’s emergency medical services, Medic One CEO Jim Reeves told a “town hall” meeting of Mt. Juliet citizens and officials Monday night.
“For this to work, we’re going to have to work with WEMA. We’re going to have to get along,” said Reeves, who is a paramedic himself and the sole owner, with his wife, of Medic One.
“I think they do a great job,” he added about WEMA.
Providing mutual aid will be essential, Reeves told the gathering of about 40 people in the sanctuary of Mt. Juliet’s Abundant Life Church who came to the first of two “town hall” meetings this week on possibly privatizing the city’s emergency medical services.
The need for “a good relationship with the local agencies” was Reeves’ answer when Del Webb at Providence resident Marie Lang kicked off the questions and answers by wondering, “If you have two rigs for Mt. Juliet, and one is going to Vandy with a critical transport, and the other is on another emergency run, what happens when another call comes in?”
Likewise, citizen Michael Peveto asked Reeves, “Would Medic One come out in the county and back up WEMA? Would Medic One leave the city limits?”
“We would have to provide mutual aid – it’s a bilateral agreement,” Reeves responded. But “the unique thing we can do is provide back-up resources from Davidson County,” where Medic One already operates, he added.
However, several citizens employed by or associated with WEMA seriously questioned the need to bring Medic One into the community, even after Reeves outlined his Dallas-based company’s commitment to professional service, advanced technology and community involvement.
“Everything you say you do, we already do,” said Matthew Kendle, a 10-year veteran EMT and firefighter with WEMA. “You’re not advancing care, because we’ve got it already.”
Furthermore, Kendle said, “Right now there’s a total of five ambulances that cover parts of Mt. Juliet. You’re going to take two of those out, add two more, and bring nothing more to the party when you do it. It doesn’t seem advantageous to the county to trade six of one for half a dozen of the other. Why even take the risk?”
“Since you guys are already doing everything we’ve talked about, we would interface well together,” Reeves responded. “It’s a perfect marriage. If you’ve got five ambulances covering Mt. Juliet, great. Let’s put in two more and we’ll have seven.”
On the other hand, Willoughby Station resident Butch Huber said some of the WEMA ambulances that serve Mt. Juliet are really a considerable distance away, so the number serving Mt. Juliet is really two, and they serve parts of the county as well.
Assistant Mt. Juliet Fire Chief Jamie Luffman, who presided over the meeting, made a similar point. “There are five ambulances, but none serves Mt. Juliet exclusively,” he said. “They each have a portion of responsibility that’s out in the county.”
In addition, Luffman said WEMA may not be leaving the city’s two firehouses where it currently bases its Mt. Juliet-area emergency medical services.
“They’re welcome to stay where they are now,” he said, even if Medic One moves in to be the city’s primary EMS provider.
“It’s going to be tight, but there’s room,” Luffman added. “There’s been no talk at all that if Medic One comes into the city, the county units will be asked to leave.”
The reason WEMA may stay is that “there are parcels of unincorporated parts of the county that are located within the city limits, and those will still need to be serviced,” Luffman explained to the gathering. “If this comes to fruition, we don’t want to do anything that’s going to cause the county to have any longer response time to those areas.”
“I live in one of those unincorporated parcels,” said Hunting Hills Drive resident Baker Woodroof. “If I call, is there going to be any question who comes to get this old boy?”
Luffman responded that the new arrangements would clearly identify each EMS agency’s service areas, and Woodroof proceeded to wonder what effect privatization would have on response times – but then he answered his own question.
“If you’re going to have two more units than what we already have, that would definitely cut response time,” Woodroof said.
Even though WEMA is well-trained and offers similar services to those Medic One would offer, Reeves said, contracting with his private EMS agency would offer other advantages including local control and the extensive collection of data that Medic One performs.
“What we would bring to the table would be ambulances under the control of the City of Mt. Juliet,” he said. Mt. Juliet Fire Chief Erron Kinney would do the hiring of Medic One personnel serving the city, under the proposed agreement, Reeves emphasized.
The data collection that Medic One performs allows responders to identify community needs and make life-saving changes to EMS practices, such as staffing the city more heavily if peak times for calls are noticed, Reeves added.
“You’ve got a ton of data (that Medic One collects),” noted skeptical WEMA volunteer Andy Street. “Is the city going to have to hire another person to analyze this data?”
Reeves responded that the data Mt. Juliet will receive will be specific to the city, winnowing it down considerably, and Luffman added that he’ll be able to focus on the specific data he needs. “There are certain criteria that are near and dear to my heart,” he noted.
Street’s wife Sue Street, a part-timer at WEMA who also serves as the county agency’s chaplain, was equally skeptical. “WEMA has been here since 1972 in the county,” she said. “Why fix something that’s not broken?”
Money is the biggest reason to keep WEMA, Andy Street said. “We need to remember, we are citizens of Mt. Juliet, but we’re also citizens of Wilson County,” he said. “When they run a call, that money is going to go to them. It’s not going to go to Wilson County. That revenue is going to go away.”
The ultimate result is that taxes countywide may have to go up, Street indicated. “As those revenues go away, guess where the money’s going to come from?” he said. “Everybody’s going to have to pay.”
But Jason Dush, Medic One’s vice president of clinical services, said he also works for the Arlington, Texas, fire department, which has a successful relationship with another private EMS agency because the department “drives the boat” rather than letting the agency control itself and only operate for profit. And Dush said privatization is the only way many fire departments and public EMS agencies will be able to survive other than by raising taxes.
“If you count in your overhead, you’ll find that a lot of times, you’re actually losing money” by operating a public EMS service, Dush said.
Huber told the gathering that in his opinion, Wilson County is breaking state law by putting ambulance proceeds into the general fund, so keeping the proceeds coming in shouldn’t be a consideration. The county, in fact, is not providing adequate emergency medical services to Mt. Juliet, Huber claimed, because “there should be three ambulances – about one for every 10,000 people.”
With an annual appropriation of about $8.8 million for WEMA, Huber added, “The county will not properly fund WEMA – that’s the issue here. The county forced us to have our own fire department, and now they don’t want us to have our own ambulance service.”
However, neither the opinions of Kendle, the Streets, nor Huber may accurately reflect the views of WEMA and Wilson County officials. Both WEMA Director Joey Cooper and Wilson County Mayor Randall Hutto were present at Monday night’s meeting, but neither spoke.
Medic One would not charge the city for providing emergency medical services in Mt. Juliet, operating solely on user fees, which should become more reliable under the Affordable Care Act’s, or Obamacare’s, health-insurance mandate, Reeves said.
And while the private ambulance service also would profit from performing non-emergency transportation, Reeves also promised Hickory Hills resident Marshall McGowan that two Advanced Life Support (ALS) ambulances would remain on duty in Mt. Juliet 24/7, and would not go out of the city on non-emergency runs.
District 1 City Commissioner Ray Justice also had a significant question for Reeves about Medic One’s potential staying power.
“I’ve been asked by a lot of people, your company’s a business,” Justice said. “What’s to keep you from getting the contract, coming in and realizing you’re losing money, and leaving the city?”
“There are no guarantees,” Reeves said, “but there are no guarantees with anything. We wouldn’t invest the money to come in, in the first place, if we didn’t think it had viability.”
However, after the meeting City Manager Kenny Martin said Reeves had offered to have Medic One post a $100,000 performance bond that it would forfeit if it doesn’t stay at least five years, and Reeves confirmed that he had made that offer. He would mention his offer Tuesday night at the second scheduled “town hall” meeting at Joy Church, Reeves added.
District 4 City Commissioner Jim Bradshaw, who also represents Mt. Juliet on the Wilson County Commission, also wanted to know whether Medic One would charge patients who declined to be transported by the private EMS agency after it had already sent an ambulance.
The answer is no, Reeves responded. “The scenario I gave you at City Commission was if we provided any interventions,” he said. “That’s the only scenario, if we treat the patient and they refuse transportation.”
“I would like to commend WEMA,” Bradshaw said. “They have done a great job. There are three Mt. Juliet commissioners here tonight, and this is a big decision. I’m trying to get all the information I can get.”
The other commissioner attending was Vice Mayor James Maness, who represents District 2, but he did not speak. It will be up to the City Commission to make the final decision on whether to go with Medic One or not, and the question will be on the commission’s agenda next Monday, July 14.
A third “town hall” meeting was contemplated before then, but a specific date, time, and place for it have not been set. Martin said possibly Medic One will simply come back before the City Commission next Monday to make its final presentation.
Correspondent Connie Esh may be contacted at firstname.lastname@example.org.