Knox County rehires AMR ambulance company and demands quicker emergency responses

American Medical Response has been rehired to continue providing ambulance services in Knox County, and the new contract is designed to improve long wait times residents have encountered during medical emergencies.

The new contract, which goes into effect Feb. 1, has provisions that seek to reduce wait times, but it comes at a cost to taxpayers.

Targeted wait times are 10 minutes for inside Knoxville city limits and 20 minutes for Farragut and the Corryton, Mascot, Powell and Strawberry Plains communities, according to the contract. AMR is required to meet those response times or it will face a penalty.

History shows they will be difficult to achieve in Knox County.

In 2022, AMR's response times to outlying neighborhoods averaged more than 17 minutes on Priority 1 calls (the most life-threatening situations) 90% of the time. Inside Knoxville city limits, call times were less than 17 minutes 90% of the time, but AMR barely hit that mark.

The new five-year contract is expected to cost taxpayers roughly $2 million because of the increased staffing needed to meet the new expectations.

How Knox County got to this point

AMR needed six votes among 11 commissioners for the contract to go through, and seven supported it. Commissioners Richie Beeler, Carson Dailey, Courtney Durrett, Terry Hill, Rhonda Lee, Dasha Lundy and Gina Oster voted in favor. Commissioners Kim Frazier, Larsen Jay, John Schoonmaker and Kyle Ward opposed it.

Commissioners were not allowed to make adjustments to the proposed contract, only to vote it up or down. They faced tremendous pressure to approve it because of a condensed timeline before the Jan. 31 contract expiration date.

AMR was chosen by a committee appointed by Knox County Mayor Glenn Jacobs. It included medical experts but not commissioners.

Commissioners told Knox News they were frustrated by the short timeframe since the decision is vital to the safety of community members. The mayor's office didn't make the contract available until Oct. 26, and if commissioners rejected it, the rebidding process would have to start over.

And if American Medical Response, commonly called AMR, decided to walk away from providing service beginning Feb. 1, the county would need to improvise to provide emergency medical response. The selection committee and representatives from AMR said Nov. 2 there hadn't been discussions about temporarily extending AMR's contract if the commission votes "no."

"I feel like (the commission) has been put in a hard place because we weren't part of the process," Commissioner Kim Frazier said. "It's an executive branch-driven process."

But the majority ultimately followed the committee's recommendation, saying the need for coverage is greater than the imperfections of the contract.

"We need a contract and I believe we need a contract approved tonight. Is it perfect? Absolutely not. Is it better? I do believe it's better," Beeler said.

Why is the new contract necessary?

The new contract attempts to solve a problem that isn't unique to East Tennessee or AMR.

Response times are delayed across the country as ambulance providers often become the first option for residents who lack health insurance or a ride to the hospital. Understaffed emergency medical service systems and health care centers add to the problem by creating logjams for ambulances when they arrive with patients.

Still, the situation in Knox County is dire enough that Knoxville Police Department spokesperson Scott Erland told Knox News in October "there’s no guarantee an ambulance will show up quickly or at all." Residents and Knoxville firefighters and police have been sharply critical of AMR's abilities to provide emergency response in a timely fashion.

A firm hired by Knox County to review the situation, Fitch & Associates, interviewed hospital administrators and law enforcement and fire representatives and analyzed data to create baseline information and a review of the current emergency response system.

Fitch & Associates said the expiring contract is "financially nonviable."

Allie Feinberg reports on politics for Knox News. Email her: allie.feinberg@knoxnews.com and follow her on X, formerly known as Twitter, @alliefeinberg.

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This article originally appeared on Knoxville News Sentinel: Knox County Commission rehires AMR as its ambulance provider