Rural/Metro passes Knox County response time standards; faces $82,000 fines for 2015

June compliance numbers for Rural/Metro point to performance concerns

KNOXVILLE (WATE) – Rural/Metro ambulance met Knox County’s response time standards for June, but just barely.

The county’s contract with Rual/Metro requires a first responder to arrive on the scene within 10 minutes of a call for emergency medical service at least 90 percent of the time. An early assessment of the June 2015 numbers indicated Rural/Metro only met a 10 minute response time 89.1 percent of the time, but after an review with the Knox County Health Department new data pushed response times to exactly 90 percent. However, other data for Rural/Metro shows some serious performance concerns.

Previous story: Knox County raises concerns about Rural/Metro ambulance service

One of the biggest performance problems in June was how many times Rural/Metro got to Level 0, which is when the service doesn’t have any ambulances available to respond to emergencies. In all of 2014, Rural/Metro hit Level 0 once; in April of this year, it happened twice. The June numbers show Rural/Metro had four Level 0s.

The Knox County Health Department, which oversees Rural/Metro’s contract with the county, said the performance problems have to do with the ambulance service’s lack of employees. “We do know that they’re trying to increase their staffing,” said Knox County Health Department Director Martha Buchanan. “So if they increase their staffing, they can increase the number of ambulances on the road and we support that. So hopefully we’ll see fewer Level 0s in the future.”

Previous story: Rural/Metro addresses staffing issues with Knox County

level3notificationsThere’s another set of data that the health department uses as a performance indicator: the number of times the company has Level 3 notifications. Level 3 means Rural/Metro only has three ambulances available in the county to respond to emergencies, and it’s then required to contact other ambulance services as a heads up that they might need Mutual Aid. There’s a fairly dramatic increase in the number of calls from March, where it happened 56 times, to June, where it happened 108 times as Rural/Metro got down to Level 3 almost every day.

Dr. Buchanan said those numbers also point to the staffing issue. “We have seen an increase in the number of times they go to Level 3. When we compare last year’s data to this year’s data we do see that,” she said. “We’re hopeful to see that number go back down to previous levels when they get back to fully staffed.”

Every time Rural/Metro has a Level 0 or a response time issue it gets fined by the county. The fines have more than quadrupled over the last four months, with the ambulance company being fined $32,000 in June alone.

To put the penalties in perspective, the combined fines for all of 2014 totaled $45,250. So far in 2015, Rural/Metro has already coughed up $82,000, almost doubling last year’s total in six months. The health department says even though Rural/Metro is struggling, other ambulance services are stepping in to help so that when you call 911, someone will respond to the call, even if it’s not the company holding the county contract.

WATE 6 On Your Side did reach out to Rural/Metro for comment on the final compliance data for June, but did not hear back. However, earlier in the month, the company said performance concerns were unfounded, but admitted it was having staffing problems due to an EMS rule change and educational institutions not keeping up with demand.

Previous story: Rural/Metro says performance concerns are unfounded; Knox County mayor still concerned

Rural/Metro at ‘mercy’ of educational institutions

The rule change from the state required more EMT’s with advanced certifications, which requires two full semesters of training at a community college or fire department. Rural/Metro said it was at the mercy of educational institutions, pointing to meetings with Cleveland State Community College and Roane State Community College where it requested their help. Rural/Metro said those meetings were without success.

Roane State Community College said it understands Rural/Metro’s staffing difficulties, but given the state curriculum, there is no effective way to reduce the time to complete EMT programs.

“We offer multiple sections of the EMT and AEMT programs, both in the fall and spring semesters. The issue we are facing is that the number of applicants to those programs has declined,” Roane State Community College EMS Faculty Member Marty Young said in response to Rural/Metro. “Understandably, an ambulance service provider might desire that educational institutions reduce the amount of time required for a student to complete the EMT and AEMT programs. However, the curriculum for the EMT, AEMT, and paramedic programs was established by the Tennessee Board of Regents.”

Under the current curriculum set by the Tennessee Board of Regents it takes one semester to complete the EMT program and an additional semester to complete the AEMT program. They said they look forward to continuing their decade-long partnership with Rural/Metro.

More: Read a full copy of Roane State Community College’s letter [PDF]

To address staffing issues Rural/Metro said they are offering paramedics a $2,500 and EMTs with advanced certifications a $1,500 signing bonus. Currently their are roughly 20 available positions.


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