County committee hears EMS report, fleet troubles and concerns about potential hospital operator takeover

The County Building Committee received an EMS report that call volume is increasing and that vehicle and staffing issues are pressing, while commissioners discussed reports that a hospital system may be seeking to take over ambulance personnel.

An EMS representative reported 139 calls last month and said call volume is expected to rise to the 140'150 range for the year. He said staffing is effectively full except for one employee working limited days to maintain billing until a third-party billing vendor starts next month. "Call volume is starting to creep back up," he said, and he anticipated third-party billing would begin the first of next month.

The EMS representative described fleet problems after an ice storm left the department operating with one fully functional ambulance while repairs were made: the reserve truck is in the shop and a second vehicle lost its turbo during the storm. He said a chamber-offered grant could allow purchase of an AMONSWIFT unit to bolster the fleet and that a state EMS grant originally listed as $20,000 came back at $30,000, which the department plans to use to buy stair chairs and other equipment.

Commissioners asked whether a remount or new ambulance would be requested in the 2026 budget; the EMS representative said if the chamber grant is approved, a budget request might not be necessary. He also explained procurement procedures: vehicle purchases sometimes use existing competitively bid contracts, and when no such contract applies the department prepares bid specifications and posts them for public bidding.

Committee members and residents pressed about patient transfers and appropriate destination hospitals. The EMS representative said the data showed 29 transports to medical care last month and 28 transfers on to higher-level hospitals; he explained that transferred patients can include walk-ins and that state rules require transport to the "closest, most appropriate facility for the patient's condition." He added that for conditions such as certain heart attacks the goal is to reach a cath lab in 90 minutes or less.

Much of the later discussion centered on reports that Ascension, which has partnered with local LifePoint hospitals, may seek to buy local hospitals and offered a proposal related to ambulance service operations. A commissioner said the presentation from a Trousdale-area hospital (reported as coming from Trousdale) was not an offer to buy ambulances but to take over personnel while the county would retain buildings and vehicles; the commissioner said what was presented would have cost the county an estimated "200,000 to 300,000 more a year" to operate than the current arrangement and described that estimate as "ridiculous." The transcript includes no formal offer document; participants characterized the information as coming to the commission in pieces and said a committee was being formed to investigate whether transferring personnel or operations would be advisable.

The meeting also included praise for first responders whose coordinated response during a recent ice storm was credited with helping the Grable Hill community, and a rescue squad update that said the squad has 21 members, several training activities planned, and a grant application submitted on Feb. 20 with results expected in May.

What happens next: commissioners said they expect a separate committee to examine any hospital/ambulance proposal and its implications for employees and county costs; no formal transfer or change in service was authorized in this meeting.