Alamance County’s governing board has given a tentative “all clear” to a proposed ordinance that would enable the county’s emergency medical services to outsource some non-emergency operations to private franchisees.
The county’s board of commissioners voted 5-to-0 in favor of this new ordinance last week as a precursor to the potential privatization of low urgency calls, such as the “convalescent transports” that EMS provides to shuttle bed-ridden patients between different medical facilities.
Under state law, the commissioners still have to confirm last week’s unanimous decision with another vote on a “second reading” before the new ordinance can formally take effect. Even so, the prospect of unloading the county’s more mundane ambulance services has already struck the likes of commissioner Pam Thompson as a cost-effective way to reduce the workload for Alamance County’s paramedics.
“I think we should look into this,” Thompson declared before she and her colleagues approved the proposed ordinance on first reading last Monday. “This helps the 9-1-1 part of EMS, and they need all the help they can get.”
This preliminary move on the part of the commissioners isn’t the first time that Alamance County’s leaders have entertained the possibility of farming out their non-emergency ambulance calls. More than a decade ago, a different board of commissioners considered and ultimately tossed the idea due to concerns about the accountability of private ambulance services as well as the prospective loss of EMS’s most financially lucrative transports.
In this case, the county’s leaders have had an added motive to pursue privatization as an alternative to spending more money in order to address the growing number of emergency and non-emergency calls which EMS fields.
Earlier this year, the prospects for a spending increase hit a bit of a speed bump when Alamance County’s manager Heidi York resolved to omit a budget request from EMS that submitted this spring in order to add a “peak time” ambulance to its motor fleet.
Ray Vipperman, the county’s EMS director, assured the commissioners that the privatization of non-emergency calls could indirectly have the same benefits as an additional ambulance on his department’s overall distribution of resources.
Vipperman said that a franchise agreement would be particularly useful in the case of convalescent transports since these glorified taxi rides routinely diverts his ambulances from other, more pressing calls, He added that he presently has two vehicles set aside for convalescent transports but still has to dragoon full-service ambulances to ferry bed-ridden patients when those dedicated vehicles are in use.
“What we find is that, almost daily, it ends up falling back on the paramedic level units,” Vipperman went on to explain. “We do about 300 convalescent transports a month; 200 of them are done by those two ambulances, and 100 fall back on the other paramedic-level units. If, in the future, we can look at contracting that out, it in effect gives us back 100 hours of paramedic-level coverage.”
Alamance County’s attorney Rik Stevens noted that he and the county’s EMS director ultimately put their heads together to devise some rules and procedures for private ambulance services that would operate alongside Vipperman’s crews. Stevens observed that, in broad terms, the ordinance he and Vipperman crafted also serves as a set of metaphorical shock pads for the county’s existing EMS ordinance, which hadn’t been updated in half a century or so. But the focus of their joint effort was nevertheless the inclusion of a franchising option.
“The idea in drafting this ordinance was basically to have a turnkey set of terms that we would expect from somebody who comes to franchise with us,” the county attorney elaborated. “We would have a set of rules for them to go by…and they would know what we needed from them in advance.”
Stevens assured the commissioners that would ultimately need to take additional action to consummate a franchise agreement – either by soliciting proposals from potential contractors or by approving a proposed contract that a would-be franchisee brings to the county directly.
“There is nothing here that would require us to franchise out the service,” he added, “and I am not aware of any interested parties at this point.”
The commissioners went on to vote 5-to-0 in favor of the proposed ordinance. This “first reading” will be followed by a second, more definitive vote when the commissioners reconvene in August.
