The ‘right person has not died yet’

By Tia Lynn Ivey
The Morgan County Citizen

“The elephant in the room that no one will acknowledge is, plainly: the right person has not died yet,” said Paula Sellers in an impassioned plea to the Morgan County Board of Commissioners (BOC) about long ambulance wait times last Tuesday. Sellers appeared before the BOC to publicly urge officials to address emergency medical service delays in the county by adding another ambulance in the county. In May, her husband, Scott Sellers, who also sits on the Morgan County Board of Elections and Registration, suffered a severe seizure while riding a tractor outside of the couple’s home in Buckhead. Thankfully, he survived, but it was not due to speedy ambulances. According to Paula Sellers, at the time of her husband’s medical crisis, both of Morgan County’s ambulances were tied up on other calls, unavailable to come to Scott Sellers aid.

“One ambulance was in Rutledge. Ambulance two was taking someone home to Macon we were told,” said Paula Sellers to the BOC through tears. Out of county ambulances from Watkinsville and Greene County were about 30 minutes away. Luckily, a close friend arrived to help the Sellers through the ordeal.

Paula asked the BOC to hold a public forum on ambulance service in Morgan County to disclose any findings they discovered after an internal review was promised by county officials earlier this year after other Morgan County citizens complained about ambulance response times. After two controversial cases, one in which a woman died after waiting nearly a half hour for an ambulance and another in which seven injured car accident victims waited while bleeding on the side of the road for almost an hour before an ambulance arrived, several local citizens are asking for a third ambulance to be added in Morgan County.

“I am here to express frustration about our medical emergency service and the wait time that we have to experience,” said Paula Sellers.

Sellers asked the commissioners to secure a third ambulance for the county, no matter the cost, arguing that just two ambulance for a population of nearly 19,000 in a county spread across nearly 350 miles. She also asked the county to halt Morgan County ambulances from providing non-emergency transports.

“I stand before you today telling you that it should matter to the younger and older generations of Morgan County. Our lives depend on our emergency medical team getting to us in a timely manner,” said Sellers. “We only have two ambulances to cover our entire county.”

She called upon County Manager Adam Mestres to live up to his promise to support a third ambulance should the numbers warrant it. She asked the commissioners to hold a public forum to reveal the findings of the internal review the county pledged to conduct.

“If you need raise taxes, raise them. If you need to restrict out-of-county transports, restrict them. There are private companies that do only transports which make a great deal of sense to me. We the people of Morgan County deserve better than this,” said Sellers.

Sellers argued that if the county had to raise the millage rate by half a mil to generate the $500,000 it would cost to add a third ambulance, most people would gladly pay extra tax money for emergency medical services. Mestres had estimated that the average homeowner of a house worth $225,000 would pay an extra $67.50 per year to fund a third ambulance for EMS.

“Even if it’s $100 or $200 extra a year, that seems like a small price to pay to save lives,” said Sellers.

The BOC only listened and did not respond to Sellers’ remarks.

Ambulance service in Morgan County has been under scrutiny since last summer, when local citizens complained of long wait times for serious medical emergencies. From November 2017 to October 2018, Morgan County Dispatch called out-of-county ambulances a total of 88 times to respond to emergencies when Morgan County’s two designated ambulances from National EMS were either tied up on other calls or needed more assistance on the scene. Two controversial cases prompted county official to address the matter and began an internal review. According to County Manager Adam Mestres, in November 2018, county staff pulled every call for an ambulance in Morgan County for the past 12 months and began reviewing response times from Morgan County’s designated two ambulances with National EMS and all out-of-county ambulances who respond to emergencies in Morgan County under mutual aid agreements.

“We are looking at everything,” said Mestres. “Our review will encompass everything—all the data to get a clearer pictures of what our emergency medical needs truly are…Once we verify all the data, and determine all the response times, the question we have to ask is what is the community willing to accept?” said Mestres. According to Mestres, whether or not another ambulance is added will ultimately come down to cost and what the community is willing to pay for.”

To date, the county has not publicly discussed the findings of that review or future plans for EMS.

Ambulance service in Morgan County is currently contracted out to a private company, National EMS, bought by Priority Ambulance last year. National EMS has been Morgan County’s ambulance provider since 1988. The county pays $289,000 a year for two ambulances that operate 24-hours-a-day, 7-days-a-week, mandating that the ambulances respond to Priority One calls in less than 9 minutes and 59 seconds, 90 percent of the time. Both officials from the county and National EMS claimed last year that the two ambulances are adequate to handle the vast majority of emergency medical needs in Morgan County, a community of more than 18,000 people. The addition of a third ambulance would cost the county $500,000 extra per year—a cost that would most likely be passed on to the taxpayers, according to County Manager Adam Mestres.

“A half a million dollars would amount to a half mil increase to the millage rate,” said Mestres. “Ultimately right now, based off the data in their contract with us and the analytics they send to the county quarterly, National EMS is meeting, on average, those response times, for both Priority 1 and Priority 2 calls,” added Mestres.

“We are meeting that threshold,” said Huey Atkins, National EMS Director of Operations for Morgan County. According to Morgan County Dispatch, the average response time for Morgan County ambulances were: 8 minutes 58 seconds in 2017, 8 minutes and 55 seconds in 2016, and 9 minutes 28 seconds in 2015.

Atkins did, however, concede, that mutual aid, calls for out-of-county ambulances that happen when Morgan County ambulances cannot respond at all, are not factored into National EMS’ review of ambulance service. “If we can’t respond, we can’t factor that in to our response times,” said Atkins.

Sisters Ellen Sims and Holly Martin have become vocal advocates for transforming Morgan County’s emergency medical services after their mother, Donna Martin, a 73-year-old Madison woman, succumbed to complications after a wasp sting, waited a harrowing 28 minutes for an out-of-county ambulance to arrive after her family called 9-1-1 when she collapsed on July 21.

“I think it is only fair to ask the community – is this okay? If this were your loved one, would a 28-minute response time in a life-or-death situation be acceptable?” said Ellen Sims, Martin’s daughter. “You put your faith in the system. You entrust that calling 911 is your best bet for life-saving care. Our mother was a tax paying citizen of our county for 35 years, and our local EMS failed her…we had to wait 28 minutes for Greene County’s EMS team and ambulance to arrive. Morgan County’s ambulance system never came.”

In October, a local nurse began advocating for another ambulance after she witnessed seven injured car crash victims wait nearly an hour on the side of the Highway 83 before an out-of-county ambulance arrived. The victims included an infants and a teenager.

Beth Hallman Herring, a nurse at Piedmont Athens Regional Hospital Medical Center, happened to drive past the accident and stopped to help. Herring became most concerned for a young college girl, the driver who accidentally crashed into the other car, who was bleeding from her stomach while lying on the side of the road, unable to stand up.

“She said she couldn’t get up and was seeing stars,” said Herring. “She was complaining of abdominal pain. She laid there so long, ants started to crawl all over her.”

According to Herring, the Morgan County ambulances were tied up on other calls. Initial calls for mutual aid from surrounding counties were also denied because of other emergencies.

“This isn’t a fluke,” said Herring. “This is a serious problem in our town and in our county. What if these were your children laying on the asphalt for an hour, possibly bleeding to death, and being eaten by ants?” said Herring, who claims other law enforcement and medical officials at the scene admitted to her that this was not a rare occurrence.

However, officials with Morgan County and National EMS argue that these cases are rare and not reflective of a broader problem that would warrant the addition of a new ambulance. According to Atkins, the number of ambulances needed in a county is based on several factors, including population, emergency medical call volume, current average response times, and financial considerations.

“I live in Morgan County, and I do think two ambulances are enough, but we have committed to looking into adding more with the new hospital opening. We will look at adding additional ambulances,” said Atkins last November. “If the county wants it, and the people are willing to pay for it, we will provide as many ambulances as desired…You don’t even want to say you have to discuss money when it comes to this, but unfortunately, that’s what it comes down to,” said Atkins. “We will do whatever the county commissioners want us to. If they want, three, four or five ambulances, we would provide it. But the volume is just not there long-term to offset the cost.”

“We do have an obligation to provide the best service possible within the means of what the county can afford—what the taxpayers are willing to pay for,” said Mestres last year.

The Morgan County Citizen reported last year how surrounding counties determine the number of ambulance needed to serve their communities in comparison to Morgan County. Morgan is one of the few counties in the region with only two ambulances.

Morgan County’s population is estimated to be 18,412 residents, spread out across 347.35 square miles. Morgan averages around 2,500 emergency ambulance calls per year. National EMS handles emergency medical calls as well as hospital transfers from Morgan Medical Center. According to Morgan County Dispatch, in 2017, there were 2,557 calls for ambulances, 2,436 in 2016, and 2,655 in 2015.

After examining ambulance service in Greene, Putnam, Oconee, Oglethorpe, Rockdale, and Hancock counties, Greene County bears the most similarity to Morgan County’s makeup. Greene County runs three 24/7 ambulances plus a private service handles hospital transfers. Greene County’s population is about 1,000 less than Morgan County’s, with 17,281 residents spread across 387.44 square miles. Greene County averages around 2,900 calls for ambulances per year since 2016, a reduction from previous years since Greene County EMS stopped handling non-emergency transfers between hospitals. However, Greene County’s service costs nearly three times as much as Morgan County’s ambulance service.

The county has not publicly addressed the issue since last November, but Mestres pledged to go where the numbers lead.

“But if the numbers overall were to dictate the need for a third ambulance, the county would support that despite the tax burden,” said Mestres.

“The problem with Morgan County, is we can go two or three days and not run one ambulance call at all and then it’s like someone rings a dinner bell and we have four or five calls at one time for an ambulance,” said Atkins, who encouraged citizen to reserve ambulance calls for true emergencies. “It’s something you just can’t count on. You can always say you need more ambulances, but the volume is not there on average. In instances when we can’t respond, we rely on mutual aid and we also give mutual aid and we count on our first responders. We all help each other,” said Atkins.