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The County Commission has approved a contract totaling $600,000 annually to have Priority Ambulance LLC be Franklin County’s main emergency-services provider.

Franklin County’s ambulance service has recently faced a medical-personnel dilemma with the commission agreeing earlier this year to fund Priority Ambulance LLC, doing business as A&E EMS of Franklin County, with $250,000 to close out the 2022-23 fiscal year. The appropriation provided $50,000 monthly during the last five months of 2022-23.

With a new fiscal year on tap, beginning this month, the Finance Committee had recommended the commission approve a new contract which will provide $50,000 monthly toward ambulance service — $600,000 annually.

The commission Ok’d the contract in 13-0 vote at its July 17 meeting. Commissioners Monica Baxter Jeffers, William Anderson and Johnny Hand were absent from the meeting.

County Mayor Chris Guess said the county thoroughly researched the issue and solicited requests for proposals. However, Priority was the only entity that submitted one.

“The bottom line is we’ve got to have ambulance service, and this is what we’ve been faced with,” he said. “It is what it is.”

Rob Webb, Priority’s vice president of East Tennessee Operations, said in a press release that Priority is happy to continue serving Franklin County residents.

“We are excited to be able to maintain our services in Franklin County,” he said. “As a dedicated partner, we prioritize collaborative efforts with community leaders, first responders, and healthcare organizations to enhance our citizen’s overall health and emergency-response capabilities.”

Under the agreement, Priority Ambulance commits to the continuous operation of four ambulances with round-the-clock service. In addition, the company will actively collaborate with local agencies to develop county-wide first-responder programs, the press release said.

As part of its innovative initiatives, Priority, in conjunction with its parent company, Priority OnDemand, will introduce telehealth visits for TennCare patients who call 911 with low-acuity injuries or illnesses, the press release said.

The new program, under Tennessee’s Triage, Navigate, Treat, and Transport (TN-T2) model, offers flexibility to EMS personnel to utilize Priority’s OnDemand Visit platform to ensure appropriate patient care and minimize unnecessary transports, maximizing ambulance availability, the press release said.

Priority approached the county about additional funding in January, and the commission unanimously approved on Jan. 17 to use nearly all of the county’s remaining American Rescue Plan funds to pay the $250,000, at $50,000 per month over the ensuing five months, to close out the 2022-23 fiscal year.

Commissioners agreed to reassess the situation and potentially include additional funding in the 2023-24 budget to offset Priority Ambulance LLC’s losses.

County Commissioner David Eldridge, who serves on the Finance Committee, previously explained Franklin County’s ambulance-service-provider costs, compared to those from surrounding counties, and the verdict is the same — all are facing huge increases to continue providing service at their current levels.

Priority Ambulance LLC was previously under contract as the county’s ambulance-service provider. According to the agreement, operations were paid through patient fees, and the county wasn’t contributing financially to the company’s operations.

However, other counties, like Franklin County has done in the past, fund their own ambulance services.

Eldridge said Coffee County expends $1.3 million annually for its ambulance service while Bedford County pays $2.1 million, Marshall County spends $1.6 million and Warren County pays $1.7 million.

Eldridge said many residents deem public safety as government’s No. 1 priority, and ensuring that ambulance service is readily available fits into that category.

He said A&E has four ambulances in operation 24 hours per day. He added that one 12-hour shift could probably be cut during the day at a time when demand is less.

However, Eldridge strongly advised against it.

“I have grave concerns about doing that,” he said, referring to reducing the ambulance shift schedule. “It’s a gut feeling, but nothing good can come from it. … It scares me to death.”

Webb had addressed the Finance Committee on Jan. 5.

He said he is with Priority Ambulance’s Knoxville branch, and the company is a national medical-transportation and healthcare-services provider. He added that Priority Ambulance provides emergency and non-emergency ambulance services to municipalities, counties, hospitals and healthcare facilities in 13 states under a family of local brands, including A&E.

Webb said trained ambulance personnel have gone on to other jobs that pay better salaries at a time when they are highly sought after in the field. He added that the circumstances have financially plagued A&E’s operations.

Webb said A&E’s salary level has been between $14 and $16 per hour. However, medical facilities such as Vanderbilt University Medical Center and St. Thomas Hospital in Nashville are paying between $25 and $30 per hour, he added.

Webb said A&E had to increase its salary level by about 25 percent just to compete with the companies paying higher wages. He added that A&E has started to get some of the employees back, but the pay increases have led to a financial shortfall, making it difficult for the company to operate.

Eldridge had agreed to research the issue and draft comparisons to ambulance services in other counties to gain a better picture about what Franklin County is up against.

Eldridge said Franklin County’s government operations are also facing a difficult financial path ahead, and the County Commission needs to do all it can to combat inflation and the related negative financial consequences.

“It’s just a huge problem,” he said. “We’re already facing a difficult challenge, but I don’t know what the answer is.”

Webb asked if the county could not fund the full $600,000, if it would be possible to provide half that amount and adjust operations to offset A&E’s financial losses.

He used an example that A&E has four full-service ambulances and might be able to get by with one or two less at certain times when demand would be reduced.

Eldridge said a $600,000 appropriation would weigh heavily on taxpayers’ minds.

“We do what we can to help our taxpayers, and this is the first time I’ve heard about this,” he said, referring to the financial request. “Our taxpayers are going to be paying more than just $600,000.”

Eldridge explained the problem is not going to go away and will only escalate in subsequent years.