Knox County hears first quarterly EMS report under new AMR contract; 911 dispatch merge planned

Knox County commissioners heard the first quarterly report from AMR and county emergency services on May 13, with presenters saying operational changes under the new contract are producing measurable improvements while the county plans a costly consolidation of EMS dispatch into Knox 911.

AMR regional director Josh Spencer said the hiring push since October produced “a 31% increase in our staff,” raising EMT and paramedic counts from about 178 to nearly 240 through April. He said unit hours — the count of ambulances on the street per hour — rose from roughly 9,300 to nearly 12,000 across the system, and transport rates have declined as nurse navigation and telehealth options were used in place of ambulance-to-hospital trips.

"That presents a very healthy EMS system," Spencer said, noting reduced transports and a drop in average hospital offload time from about 60 minutes to about 56 minutes in the reported period. Spencer also described a new subcontractor handling forensic transports so ambulances are available for urgent responses.

Brad Anders, executive director of the Knox County Emergency Communications District, briefed commissioners on plans to merge EMS dispatch services into Knox 911. Anders said the county has completed procurement and is awaiting delivery of the final radio/phone pieces; he estimated equipment modifications for the two call centers will run "close to $1,000,000" and said the transition will add roughly 20–22 employees to the payroll. Anders described training and workforce integration as the most difficult parts of the consolidation.

County and AMR officials pointed to nurse navigation as a driver of reduced transports: Spencer said about 935 patients had been referred to nurse navigation through April and that roughly 40% of those referrals did not require ambulance transport, which he estimated removed about 400 transports from the system in the period. AMR reported a customer hotline and new clinical monitoring tools (First Pass) were being turned on to track clinical performance.

Commissioners asked for the presentation slides and daily performance reports; Spencer said the materials would be sent to the commission that evening. Commissioner Kim Frasier praised the progress and noted her regular contacts and station visits had corroborated steady improvement.

During public comment, Mitchell Bennett recounted an incident on May 3 where, after his family called 911 for his son’s seizure, no ambulance arrived and he transported the child himself. Bennett told the commission, “My son could have died,” and requested the county improve dispatch communication. Commissioners acknowledged the complaint, and Commissioner Daley asked that analysts notify callers if a call has been diverted so callers understand the status of help being dispatched.

The presenters said they would continue quarterly reporting to the commission and that operational and clinical measures will be monitored as the county and AMR complete the dispatch transition.

What happens next: staff and AMR will provide the commission the performance slides and continued quarterly updates; the 911/dispatch consolidation timeline remains dependent on equipment delivery and a phased training rollout.