 Before we get started, tell me a little bit about your background in EMS. Do you have experience in the health care industry? I'm certified as an EMT back in the mid-80s. Also was certified as American Heart Association CPR instructor, which I've been teaching for over 30 years now. I've maintained those certifications. I only worked on the EMS about seven years, two hospital-based not-for-profit services. But I like to say what brings me to this issue is I'm a parent and I'm a concerned citizen, basically. I started as an EMT way back in 1975. I was interested in the program and I took the course and thought, what's this kind of good stuff to know? If I never use it, at least I know general first aid. Then when I wound up in Athens, I applied to St. Mary's and started there in the summer of 1976. While I was going to EGA, it was a great part-time job for school. And once I graduated from Georgia, I decided to proceed further with education because there was a basic EMT level. Then it was just the basic EMT level, cardiac technician level, and then the paramedic level. So I went ahead and did the paramedic level. I came back and started working at St. Mary's in 1980 full-time and was there for 33 years until National took over in 2012. No, 2009. Sorry, let's back a little bit. Tell me your names also. Oh yeah, that's important. Sam Raffle and Bob Gad. And you said you stopped working at St. Mary's? Yeah, just when both hospitals got together and decided that we were losing too much money, I was told off the record by an administrator that we were picking up too many poor people. So that's when they started to outsource, looking for other services to outsource to take over the EMS. Because back then, Athens Regional had a hospital-based EMS, as did St. Mary's. And back in the late 70s, they actually divided the county up into zones at a central dispatch center that was trying to coordinate the closest ambulance to get to the emergency. So it was like that for years and years. And then they came up with the number of a million dollars each per year that we were losing. Each service was losing. Each ambulance service. Correct, yeah. That number was never verified. Andy here actually asked for an audit at the time and was denied by the city manager at the time. So those numbers were never verified. I think for whatever reason they were ready to get rid of it. And maybe there are a lot of people who don't have insurance in this state. Maybe that's why 911 is not profitable. So March 1st of 09, I worked my shift at St. Mary's and wanting to stay in Athens as a medic because I knew the hospitals, knew the people. I just transitioned to National. And that was in 09. And I was there for three years with them. So you were at St. Mary's driving an ambulance as a paramedic for 30 years, you said? 33, yeah. 33 years. And you left when National took over? Not by choice. Yeah. Yeah. So they just decided to do away with it. I mean, one minute they were there and the next minute they dissolved the department. Oh, wow. So, and you know, no one wanted it, but we knew it was going to happen. And there were some issues with that. They were looking at different companies to take it. And National got the bid for it. And as you saw in the presentation the other night, they were glowing, you know, awards and all this kind of stuff to make them feel like they were a good, you know, good choice. Did you feel uneasy at the time that a for-profit? Oh, yeah. Yeah. It not as, we knew National, the reputation they had way back before they took over was that they had good equipment on their ambulances, but they had lousy pay. And so what I experienced was the equipment was fair. I mean, it wasn't exceptional. And I did take quite a bit of a pay cut to work for, work in the same shift. Yeah. I had concerns at the time. And I wrote letters to the editor and letters to the mayor and commission expressing a concern about terming this aspect of public safety over to a for-profit provider. And if I knew now what I didn't know then, so to speak, I would have been even more adamant because we have lacked transparency. And most of what I feared has come to fruition and it's been way worse than I anticipated. What I discovered working there pretty quickly is that the quote I had to describe it was that they put profit over patient care by having their ambulances take off to run non-emergency transport. So they have a fleet of a certain amount per day, say a half dozen trucks or eight to ten trucks, whatever, ambulances. And they would just use an unlimited amount of those ambulances to run non-emergency transports. And so those would involve both local transport, say from the hospital back to a nursing home, or all the way to Augusta, to Atlanta. We're just all over northeast Georgia taking folks. They use ambulances. So every ambulance that you see, they're responsible for 911 calls like you would expect an ambulance would be, but also they're doing non-emergency transports. Like, can you give an example? Just taking, say, a patient back, maybe they had an illness and they're in the hospital for pneumonia or maybe a fractured hip or whatever. And they may be non-amulatory, unable to walk, and they would require a stretcher to get them home. So it'd be just, you don't do anything. It's just a transfer to another facility. These patients no longer even need the hospital. So it's not emergent. It's not 911. There's probably half a dozen other non-emergency companies in Athens that could run that same call. But, you know, the goal of a for-profit company is to make money. That's not saying anything bad about the company, but the way National EMS, a for-profit ambulance company, makes money is by running non-emergency, non-9-1-1 transports. But we also gave them the 911 contract and they do not separate those two things out. And that's what we call playing Russian roulette with the community. And what I call a fatally flawed business model, because when is it a good idea to take a 911 ambulance out of its coverage area to run a call that has nothing to do with 911? Oh, yeah, non-emergency transport. Correct. And I would argue never. But in the hospital's interest, they're trying to clear that bad. And in the National EMS, in the ambulance provider's interest, that's where they make their money. But neither one of those things has anything to do with public safety and 911. And we've been offered the contract from the hospital, not the contract, the EMS licenses. Which means that if we put them up on that offer, which I think we should, we could take complete control of the contract. We wouldn't have to run it ourselves. But we could rebid the contract and require anybody that comes in here to run 911 have a separate division where their 911 trucks are dedicated to 911 only. Okay. Let's back up a little bit. So did before it became a for-profit business, were there ever ambulances driving non-emergency transport? Yeah, we would do some. The first one was hospital-based. Yeah. We would do some, but not near the amount they're doing now. There were other companies that were taking the slack. But we'd do around maybe back in the day, every cardiac patient that we had, we had to actually take the MRI. This was long before they were doing any kind of heart procedures here. So we were doing hospital-to-hospital transfers. And every blue moon, we'd do a back-to-the-nursing home. But typically it was 911 calls. And so when National took over, and what Sam was saying about the separate divisions, I asked Robbie Atkins, one of the family owners, one of the owners of the company, about making a separate division, 911 only, non-emergency only. And he said they couldn't afford to do that. So that's when I was like, well, maybe you shouldn't be doing it if you can't afford to do it right. Because they were literally used the last ambulance in the county to take a non-emergency transport. And this is when you were working for? For national. Okay. Three years. Three years. Three years. Yeah. So a quick story on that is I talked to Robbie about response times. And it was after one shift, one night, and I said, hey, I asked him about the divided divisions. And he said we can't afford to do that. And then he went on to say that he treats all patients with equal importance. And he's not going to let a little grandmother wait for transport when most 911 calls are for stubbed toes. And when he said that, I just went, I cannot believe this is the guy in charge of providing pre-hospital care for emergencies. And that's his attitude. So he said an emergency call is the same? As a nursing home patient going back to the nursing home. He gives them equal importance. And that's when I quit. I was like, man, I can't, I can't do this. And their behavior indicates that. Yeah. They will take a 911 truck out of its coverage area to drive to the hospital, go up to the fourth or fifth or third floor and sometimes maybe sit outside the hospital room for 20 minutes waiting for that patient to get ready to be released, which I have witnessed. But they probably have other ambulances. They do, but they just weakened their ability to respond. And if that ambulance isn't in its coverage zone, another ambulance may have to come from further away to an emergency. So yeah, there's any number of scenarios that makes that a game of Russian roulette? That's why we hear about response times being 15 and 20 minutes long. Or like Patrick said, they never showed up. Because I guess he left the house before. He was tired of waiting? Yeah. Patrick Duff, Commissioner Patrick Duff. Correct, yeah. When he called, he said he just got tired of waiting and put her in the car and left. But he lives out off Morton Road. And so the ambulances stationed in the east side zone that would be his ambulance, the closest one to him, they may have been who knows where. And so the ambulance that was responding made me come from Oconee County, the west side of Athens, you don't know. And there again, there's no transparency. So we can't find where ambulances are responding from. So do you guys think that nationals services deficient? Are they, do you think that they're putting people in Athens at risk? Absolutely. Oh yeah. Yeah. Horribly underserved. So just for example, let's say there's two ambulances in that east side station that could have responded to Patrick Davenport or any constituent out on that side of town. So they bring one of those units in to run somebody home from the hospital who no longer needs 911 or no longer needs any kind of acute medical care. So you say, oh, well, there's another ambulance there in that station. So they're good. But maybe that ambulance now has a 911 emergency. Their zone is empty. And they can go back and say, oh, well, we were on a 911 call. But what really set up that situation was weakening the whole system by pulling 911 trucks out of it to run 911 calls. Okay. So you're saying that they need any more ambulances, basically? They need dedicated 911 ambulances. We need to figure out how many ambulances we need to run 911, dedicate those ambulances. And then if they want to continue running the service, set up a separate division that runs the non-emergency transports. If the 911 side gets call saturated, you can pull ambulances up to assist 911. But you would never pull an ambulance out of the 911 system to do non-emergency, non-9-1-1 calls. Do other communities do it that way? Separate divisions. I know Grady does. Grady EMS, which is in Atlanta. I know as far as the counties that touch Clark County, Madison County is 24-7365, just ALS ambulances that do nothing but 911. Oglethorpe County, 24-7365, Advanced Life Support Ambulances that do nothing but 911. Jackson County, the same thing. The only exception to that is Akoni County, because they're being run by a national EMS. They will use their 911 ambulances. Every county-based ambulance service just does not 911 calls. Just do 911 but not emergency? No. Now, when I say 911 calls, not every call is a life-and-death situation. It could be someone that's sick, it's not life-threatening, but we don't do any... I work for a county service now, and it's all just 911 calls, no non-emergency transports. And they want to keep us available for the call. I mean, for the emergencies. They want us to be available for those because that's what the citizens expect. And I think most people in Clark County don't have a clue how the system is set up here, because when we talk to people, they go, oh, my God, I had no idea it was like that. So educating some folks in the county as far as how the system works. So why do you think that national is doing it that way? To make money. Yeah. For profit. Because it's a guaranteed payment on non-emergency transport. It's all prearranged, so they're already getting their guaranteed revenue from it. Whereas the 911 call may or may not and may have insurance, maybe not. So it's more of a sure thing. Right. And that 911 truck, just like a fire truck in its fire station is going to be... The wheels are not going to be turning. They're going to be waiting for the 911 call. They can take that truck and make money off of it. They're going to do it. It's a for-profit public service, which is kind of an oxymoron to me. Of all the public services, I mean, it's fine to privatize some things, but I think EMS should be the very, very last thing to privatize because of the situation right now. But I think they really do put the citizens at risk. And Chris, what got me interested in this or re-interested in, as I was saying, I go back to when we were first discussing this, saying that it's probably not a good idea, but there was a cardiac arrest downtown. I want to say July of 2016. The fire department responded. They were able to defibrillate the patient, shock the patient, and they got him back. And I was reading in the paper where either a friend or a relative of the patient was saying, yes, it was great. The fire department did wonderful and the police department was excellent, but it took the ambulance 15 minutes to get there. And that was in the paper. That was in the paper. So then I got re-interested and had multiple conversations with multiple police officers, firefighters, public school teachers who were basically kind of all saying the same thing. And that was if I ever needed an ambulance roaming the car or roaming the ambulance, don't call 911. I was being told this by police officers. By firefighters. Correct. NUGA. Was it more than one police officer? Yes. Yeah. I heard it independent. I was at a bike shop and bumped into an officer that was off duty. I've known him for years. And we're just kind of chatting along a little bit and the EMS came up. And he said the same thing that if they're ever heard in the line of duty, which we're talking to a police officer, you know how bad that could be, obviously. If I'm ever heard in the line of duty, throw me in the back of the police car and take me to the hospital. Don't wait for the ambulance. And this is coming from the guys that are doing it on the street every day. And I had one telling me essentially the same thing. The same thing. They're not confident that should they be wounded in the line of duty that there would be a timely emergency medical response. And this particular officer also told me that police officers were beefing up their trauma kits to treat their own wounds or the wounds of their partner. And that if... So we relayed those concerns to Chief Freeman and Mayor Denson. And he said he would look into them. And he did. And when he got back to us, he said, I talked to my officers and what you are saying is very accurate. And that he would be in contact with the city manager's office. So Bob and I thought, wow, our work here is done. There's no way that this is going to go unaddressed. But I don't know how far that got, whether it ever made it back to the mayor's office or even if it made it to the city manager's office. But that's why we are where we are. I mean, we're still trying to make improvements because we keep hearing stories like this. Well, my wife got a job working at a Clark County Elementary School. Her first day on the job, one of her administrators came to her and said, you know, Miss Raffle, this is a wonderful place to work. We have great kids. Our teachers are awesome. Great parental support. But this is not the place you want to be if you ever need an ambulance. Just out of the blue. Just out of the blue. I didn't know anything about her relationship to me and my relationship to this issue. And I thought, wow, if a Clark County Elementary School is not the place you want to be if you need an ambulance, then where is a good place? Why do you think they said that? There was a five-year-old boy who was unresponsive and it took 15 minutes for the ambulance to get there. The fire department got there fairly quick because this particular school was near a fire station, which makes a good case for basing your ambulances out of the fire station, by the way. But they are very limited in what they can do because it's a basic life support. Yeah, equipment-wise. It's an advanced life support. And they can't transport. How fast should the ambulance? Within eight minutes and 59 seconds, 90% of the time. Okay. That's a standard? That is a standard. It's in a couple of standards. One is the CAS, the Commission on Accreditation of Ambulance Services. They say eight minutes and 59 seconds, 90% of the time in an urban setting. And they may have, I believe, 12 minutes and 59 seconds for a rural setting. And they get that from the NFPA 1710 standard, which is the National Fire Protection Association, 1710. And basically what that says is whether your ambulance service is provided by a fire department, not for profit hospital, a city government, or a for-profit ambulance, private service, you should respond within eight minutes and 59 seconds, 90% of the time. Not an average. As far as that first fire response, that basic response, the BLS response, they said that should be within four minutes. So they have four minutes for BLS, eight minutes and 59 seconds, 90% of the time for ALS for advanced life support. Neither one of those standards are legally binding. It is written into their contract, however, that it be eight minutes and 59 seconds, 90% of the time for urban calls. And 12 minutes and 59 seconds, 90% of the time for rural calls. I checked that before coming. That was the version of the contract that we got. They may have rewritten it since then. We got that through Open Records Request a few years ago to reflect the fact that they're not meeting the standard. They also had to basically take a map of Clark County and with a pen or something, just gerrymander the map until they got eight minutes and 59 seconds, 90% of the time. And they called that urban. They had them. There's a map of Clark County and basically they drew a line. The smallest county in the state, by the way. The smallest county in the state of Georgia. They drew a line around the Athens Loop with two little appendages coming outside the loop and said that everything inside this line is urban. And that's where we have to meet eight minutes and 59 seconds, 90% of the time. Everything outside that loop. And they included a Coney County in this. But anything outside this loop in Clark County we're going to consider non-urban and that gives us 12 minutes and 59 seconds. Well, the problem is there's no such term. The federal government, Census Bureau, Metropolitan Bureau of Statistics, every statistical analysis I've seen that says that anything that's not urban is considered rural. Non-urban is not a term. So when they report their data to the state and the federal government, every square inch of Athens Clark County is urban. So the only way they meet their standard is by gerrymandering a map, which in a way that makes no sense to justify their response times to meet the standard, which is another way of saying, we don't meet the standard. That makes sense. Okay. But the hospitals have expressed that they have full confidence in national and they deeper cut from Piedmont Athens regional so that the work session the other day that national's response times were superior. Based on... Well, according to that map, yeah. But what we're saying outside the loop is you should still have 8.59 as your criteria. But they're making it... The hospitals are supporting... National... ...annual service. I guess why do you think that they're supporting them? If what you're saying is true. It sounded like to me after the work session is that they like having them there, they're beck and call to come in and move patients out. Like they need them for that service. And 9-1-1 stuff is just kind of like a secondary concern. That's what the impression I got from D was talking about. Public safety is a secondary concern. Well, yeah. Yeah. Why would a hospital... They evidently... With their business model, they need to get patients moved out so they can fill that bed with another patient. So moving the patients out seems to be their priority. That's why they were like... They gave national kind of first dibs on taking the non-emergency transfers out of the hospital. And so they're there to... There's a service to them. Yeah, I don't know that many people on the EMS Oversight Committee has ever seen the raw data. I don't know if D. Burkett's ever seen the raw data. We've seen the raw data and it's terrible. We had to do an open records request from the state of Georgia. As a matter of fact, we had to ask for over five years to look at the raw data. And that's the only way you're going to know if the response times are adequate or not. You can't just say, we're great because we say we're great and not provide any proof or not provide access to the raw data. So five years ago, we started asking for the raw data and they said, you know, our numbers are great but you can't see the data. And then four years ago, they said our numbers are still great but you still can't see the data. And three years ago, they said that our response times are wonderful but you can't see the data. And then a couple years ago, they started saying, response times don't matter. Yeah, that was a good one. But our response times are really good and you can't see our data. And then for 15 months, Andy, Herrod and Jerry Nieceman who are commissioners asked for the data, they were denied. We were told by our own city attorney that we could not have any access to that data because they're a private company and they can do what they want. But that was simply not true. So Bob and I hired an attorney and basically it took us seven months still at that point and we made an open records request. We got the raw data and it was horrifying. It was way worse than I thought it was going to be. And these are all in a column that says from the Department of Public Health 9-1-1 emergency response. And what we found is that out of about 50,000 calls between 2014 and 2017 that 31,055 of them exceeded the standard. So their response... 31,000. 31,055 9-1-1 emergency responses out of 50,000 over four years exceeded the response time standard. So what their response to that was was oh, okay, our response time sucked but response times don't matter. All of these were priority two calls but without any proof. Which means they're not running license sirens as a priority two. Then they said that the thing about response times don't matter. They came up with this theory if you look at patient outcome to measure whether or not the response was appropriate. Some kind of goofy thing that was totally immeasurable. It would be impossible to track. It would be very easy to cherry pick. That was just like a smoke screen of covering other crappy response times. Do response times matter? Yes they do, Chris. If you're hit by a car in your bicycle and you want someone there much sooner than later. And that's... I'd like to. But yeah, I think as a medic for over 40 years response times matter incredibly. And heart attack, strokes, accidents, suicides, childbirth, neonatal emergencies. We were on the whole gamut of every imaginable medical thing that could happen to someone. Medical and trauma. Yeah, sure. Oh yeah. Not every call obviously, but maybe what if it's 5%? Yeah. And what's 5% of 31,055? It's a big number. So a lot of human beings, a lot of families impacted. And just going back to that number what they basically said is that we deprioritize a lot of calls from licensed siren response to no licensed siren response. Well any service is going to do that. So I said, okay, well tell us your criteria because it feels to me that you're over downgrading calls. So you think it's legitimate to... Oh yeah, there are times. Yeah, you would want to be very careful because any medic any EMT or paramedic who's worth in the in the business very long will know that there are times where calls come in and it sounds like it's not going to be anything, not much to it and you get there just horrible. Very critical patient. There are other times where it comes in sounding very critical and you get there and it's not much of anything. So you really don't know until you get there. So you have to be very, very careful downgrading calls, very careful. There's a protocol out there called emergency medical dispatching which runs through a series of questions where you eventually get to whether it's downgraded. This is what we're hoping for. So anyway, they're saying that those were all just priority two calls but offering no proof that they were in fact priority two calls. Yeah, 31,000 and 55 calls out of about 50,000 calls and basically just wanting to just dismiss that saying that they were priority two and maybe something that response times don't matter and they've never accounted for a single one of those calls and accountability I think is key and we need access to the raw data to know if they're doing a good job or not. I still don't understand why the hospital would be trying to defend national. If a national is not doing a good job, why wouldn't they just get another company to do it? That's a great question and I think that the I don't know that the hospitals know that they're not doing a great job. I think that maybe D. Burkett has some idea but I don't even know that the rest of the oversight committee ever talks about this kind of stuff. So we can go to the meetings. I met with Commissioner Davenport I think after the May commission meeting and I just asked him straight up. I said Patrick I said if your phone rings right now and it's your mom calling you telling you that your dad is having a heart attack are you going to tell her to call 911 and he said hell no I'm going to tell her to throw him in the car and drive him to the hospital and I thought oh my god we have a serious problem police officers have told us firefighters, public school teachers and if you have a commissioner feeling like that then there's a problem and it's not just Patrick he's talking about some of those other constituents where they called 911 and they just didn't name this never showed up they gave up through their loved one in the car and drove to the hospital that's what the 31,055 calls or delayed EMS responses are about that's what this is where every page that's a person is 36 families 36 calls and I think there's like 800 or 900 pages of it when we were doing HB 264 House Bill 264 to try to get more transparency in EMS statewide it went through the state legislature it cleared the house it's about EMS House Bill 264 transparency and 148 to 6 in the House in favor of the bill 51 to nothing in favor of the bill in the Senate although it had some changes to it so it passed it was never brought to about 199 representatives voted for some version of this bill and only 6 voted against it and Jeff Mullis who was over the I believe the rules committee was able to effectively poison it by putting something in there that nobody could vote for and it's called poisoning a bill and it may be a coincidence it may not but the ambulance company priority EMS that owns national also just bought the ambulance service in representative Mullis's district so I don't know if there's a connection there or not but I'll let you have your own opinion but there is back to national and Athens there is an oversight committee so why haven't they been raising the alarm bells if the data is as bad as you're saying I don't think they've ever seen the raw data to be perfectly honest I don't know if somebody called national EMS to say that they have had a problem then Huey or Robbie or one of the applicants I don't know I'm so sorry we had this 9-1-1 unit was running a wreck and there was another 9-1-1 unit on this chest pain call we had another 9-1-1 unit at the nursing home with difficulty breathing and we're so sorry and they're not going to say anything about where their other 9 trucks were several of which could have been on non-emergency 9-9-1-1 transport and they're probably never going to say anything to the oversight committee about that and I think we got verification of that at the meeting when Mr. Burkett said that they don't look at calls and haven't looked at them for almost 5 years but this is the oversight this is the oversight committee that their job to to look into this kind of stuff it's the one that Sam went to and got pretty much berated out of there they're not open to the public you can't go as a concerned citizen and sit in I've been invited to Tube and it was interesting because several people there from the different hospitals and maybe some other entities but there were the largest contingent of people there were from National EMS they were from the executive ownership of National EMS and they were very clearly functioning as members of the committee and the second time I was there I was asking for a survey of our police officers just to see what their feeling is about response times like that I'd already heard from Chief Freeman but anyway so it was making a little bit of progress there and it was just shouted down by the members of National EMS and it just never had any traction after that at all Justin Johnson the assistant city manager asked me to go with him and Mayor Denson had Bob and I that we should go to these meetings so I did they had moved the meeting so I ended up getting there late they moved both place and time of the meeting but Justin Mr. Johnson texted me and told me where he was and when I got I walked in the room they were looking at me like I had just done something wrong I said I'm here to attend the oversight committee meeting he said well these meetings are not open to the public and I said well that's not what I was told and Mr. Burkett said well who told you that I said Mayor Denson and he said well she's mistaken and I said well okay and they said well you can say your piece and leave and again I just wonder about the legality of having public safety meetings that are closed to the public and emergency medical services are public safety it must have been subsidized by the county to get money when we went to Atlanta to meet with the chairman of the industry and labor commission for the house and the senate ethics commission for the senate of course and several people from DPH there were three attorneys in the room that described Georgia Department of Public Health so we were meeting with them about getting the kind of raw data about response time and the nature of those calls to become public information that was the purpose of that meeting and I brought up the issue of the oversight committee meetings in our local community being closed to the public and even though there were three pretty high powered Georgia Department of Public Health attorneys in the room keeping the public barred from those meetings was legal and they just basically referred us to the attorney general so we haven't gotten a meeting with him yet but we are trying and our goal is to have him look into that and see if in fact it is legal I don't think it will be if for some reason it meets some loophole of the law that's something HB 264 might need to look at in 2020 but even if it's legal it's not ethical and it's not right and it needs to stop Private public safety needs more transparency in my opinion So on the subject of the oversight committee meetings mention the time that you asked about protecting your family Right so I was at an oversight committee meeting and there were the four members of National EMS of the maybe nine people at the table so they were more represented than either hospital and they were very clearly functioning as members of the committee I asked the owner of National EMS I said you know if my son or a member of my family has a time sensitive life threatening emergency can you assure me that the ambulance designated to cover my area will not have been pulled to run a non-emergency 911 transport and he said no I will not I said well sir that's a serious problem and I think it's about time that we start asking that same question of our mayor and commission because at the work session the hospitals pretty much said that if you if Athens Clark County wants the zone licenses the ambulance license for your county you may have them and there was some misconception at that meeting that if we took control of the licenses we would have to run it ourselves and I'm not saying that that's not a great idea I actually think it is through the fire department through the public service through the fire department matter of fact Mr. Williams city manager has already done a study saying it would cost us four and a half million dollars to do that that study didn't include any revenues that EMS might bring in which might be about 40 to 50 percent of that total cost plus the more people who get health insurance in Georgia the less it will cost the city if they decide to do that but the bottom line is we were all for the zone contracts and we should take them up because if we get the zone contracts we can run it ourselves we can stay with national and rewrite the contract so that it preserves public safety or we could rebid the contract and go with another company that may have separate divisions so it would just give us control of the contract it would give us transparency flexibility and I think it would be a tremendous service to the community and I was actually pretty surprised to hear about that As was I about moving dispatch to ACC to them handle all medical instead of transferring it to the national Well you call 9-1-1 you have an emergency your baby is not breathing you're whoever is having a heart attack Athens-Clarke County picks up a phone what's your emergency you give your description they say hang on a minute and then you hear a down beep and then national will pick up you hear the phone ringing so it's like this huge delay and you're like well someone's like critically injured or sick and you have to repeat your subject or repeat your complaint call 9-1-1 and you get transferred you get transferred and you're patched over and the phone rings you actually can hear it ringing and the national EMS will pick up and say what's your emergency if the call gets dropped which it does you have to call back 9-1-1 explain your emergency put on hold and you call back and one of the tapes that we got 9-1-1 tapes that we got through an open records request of a dying baby that's exactly what did happen it's not efficient it's confusing when Patrick Davenport had this situation with his mom where he called 9-1-1 and was put on hold he thought he had made a mistake especially when the ambulance never came he thought he had done something wrong when in fact he had just called 9-1-1 so so the moving dispatch to have an ACC ACC handle all of it that'll create a lot more efficiency than one person if they certify them as emergency medical dispatchers they can go through protocols that tell the person on the phone this is what you should do in the meantime and they stay with them and it'll create transparency of the response time data because ACC will be keeping up with it and that will provide accountability why did you not have any ambulances here where you should have and so that will just be a tremendous amount of benefit improving the system I was a little bit confused about D. Burkett in his presentation at the work session on July 9 said that the national EMS is currently using emergency medical dispatching well that is simply not true unless they started like last week or something which I don't think but in the dying baby episode this father called 9-1-1 and just coming into it initially went to Madison County but they were actually coming into Clark County on 72 so it got patched over to Clark County 9-1-1 and he had to tell his emergency he put on hold patched over to national EMS where he had to retell his emergency the call dropped the call dropped as horrible he has to call back because they never took the phone out of the driver's hands the call took 4 minutes they never dispatched police fire EMS and they never the first thing the dispatcher should have done with any training would have been to ask the phone to be put on speaker and to be handed back to the person in the back seat doing CPR and rescue breathing and just kind of coaching them through that there was someone in the back seat doing CPR and rescue breathing on a 6 week old baby that was never offered an ambulance never offered a fire or police response just basically told to keep driving just keep driving and the guy went I'm going to get there as fast as I can no instructions and just hung up June 2nd of this year 2019 my wife and I and my whole family went to a concert at the Athens Clark County Library and about 40 minutes into the performance one of the musicians who was seated became unresponsive quit playing became unresponsive and then every skeletal muscle in his body contracted where he had an internal defibrillator that had shocked him in other words he had an internal defibrillator that recognized the life threatening arrhythmia and he was shocked my wife called 911 told her emergency was put on hold transferred transferred to national where she told the dispatcher we have an elderly male who's having some sort of cardiac event who's been defibrillated and all he did was take where she was confirm which room it was and hung up no instructions no staying with them being the protocol they're supposed to well I don't think they're supposed to I don't think they've ever done it I don't know why Mr. Burkett was saying that it's simply not true but to make matters worse oh yeah in the proposal that the Athens Clark County police department has put out which is option 3 it has Athens Clark County taking over all 911 dispatching to include medical and to train their dispatchers in emergency medical dispatch stay with that caller who has a critical event or a life threatening emergency and you coach them through it and you assist them and there's been a lot of lives saved it's a great system they are not doing it and the fact that he said that and it's simply not true I just I just don't understand that but this particular call the unit responding they got there maybe eight or nine minutes so that we were right across the street from the hospital so that that wasn't the issue but they came in without a cardiac monitor without a jump box without a stretcher and basically without ever monitoring the patient they had him stand up walk down steps and walk to the stretcher everybody in the room was shocked and I don't know whether that it was a basic life support unit and they couldn't do cardiac monitoring or what was going on but I'm going to try to find out that happens a lot now too they'll send an ambulance for just two EMTs not paramedic so but they'll send them to cardiac events like the young man I was shot in the chest on the east side last summer got a basic EMT ambulance responding to him which is horribly underserved because they can do a lot but they can't do everything a paramedic can so it makes a huge difference so he needed advanced life support and he needed it right away and he didn't get either and they justified it by saying that the basic life support truck was the closest unit and what I say is it shouldn't have been a basic life support truck that truck should have been an advanced life support truck if Madison County and over four county and Jackson County everybody were to do nothing but ALS because that's the right way to do it then that's what we need to be doing so he basically died without ever receiving advanced life support in the field that's inexcusable he died he died in route and the baby died eventually because they got that was November of 2017 the baby was transferred to regional and evidently was viable enough to be flown to either Eggleston or Scottish Rite in Atlanta where it died later so that tells me earlier intervention may have saved him I don't know we don't know it's very problematic we don't know you can't tell that family that you did everything that could have possibly been done for him because it wasn't it's a horrible tape but the guy goes I'm just going to drive as fast as I can this was like on a Monday morning at 7 o'clock in the morning going through the streets of Athens trying to get to the hospital from the furthest part so that's an example of the system we have now and that needs to be changed and the change or like I said before will increase the efficiency transparency and the accountability of the whole system you know interestingly enough whether we can prove to people I mean I think a reasonable person would say that this is unacceptable and that you need to account for these calls and I think then you would see even more how unacceptable it is but what we're asking for is just very reasonable we want Athens-Clarke County our 911 center to take over all 911 calls including medical we want our first fire response so when the fire department responds and they're doing a much better job of that than they have in the past but and they're responding with basic life support EMTs that's great it's a good first step as a matter of fact it is the first step towards what we're going to ask which is that they upgrade their first fire department response to advanced life support paramedic level what that does is bring advanced medicines and advanced procedures to the patient quicker they can get more medications, more treatment it's just a better skill set right and you asked this question and we never really answered it about due response times matter but Bob and I were meeting with Dodd Ferrell who's the mayor of Winterville who's police officers, firefighters first responders, citizens school personnel has told them the same thing that response times are terrible so it was me Justin Johnson who's assistant city manager Bob and Mr. Ferrell we were talking to chief Scarborough on the phone doing a phone conference he couldn't make it for whatever reason and I said chief Scarborough I said does the oversight committee in national EMS care about response times and his response was verbatim no they do not and I said again ok well that's a problem so you asked me do response times matter and I say that very much so and I've put this I've got a website now where I have this broken down response times matter medical response times matter trauma and even according to the local hospitals response times matter but basically you know I could just go on and on you can stop me when you want but time loss in a stroke the journal stroke has basically quantified that 1.9 million neurons per minute die when treatment is delayed and so the difference between a 7 minute response and a 17 minute response let's say which is what we're kind of we see a lot of 17 minute responses here we say they need to be 7 not 17 is 20 million neurons and every minute after that is another 1.1 million neurons so time loss is brain loss and that's according to the journal stroke the the same from Johns Hopkins Hopkins University for innovative medicine is when time is muscle and every little bit counts every little bit of time counts and every little bit of muscle counts and in the hospital they will fight for 15 seconds they will fight for a minute and a lot of money to get patients from the door to balloon or to definitive treatment for some art attacks but they're not fighting nearly as hard to get that patient from the floor from their house to the door but they're equally as important time is time and a minute is a minute and cardiac muscle damage and who would think that response times don't matter it's just a ridiculous I think it comes from the private ambulance services because it allows them to make more money to be perfectly honest so who do you think benefits from this does the hospital benefit from this they get patients out of the hospital more quickly, more efficiently and national benefits can't they do it with another service they could but for some reason I guess they're seeing this as more efficient I think personally that they've made a mistake and somebody's covering it up and that's how it feels to me I don't think the whole oversight committee is aware of just how bad it is and part of our job going forward is to meet with the hospital authority to meet with the hospital board so try to meet with the hospital administrators who so far have refused to meet with us but meet with these organizations and let them know what we know I honestly believe that most of the oversight committee does not know how bad it is but again David Port said what he said at the work session basically that he's not calling 911 and he's telling his constituents not to call 911 what else do you need to hear what else do you need to hear other than that Chief Freeman the police chief had talked to his police officers and yes they do not feel comfortable should they be wounded in the line of duty that they're going to get a timely medical response I keep thinking that our job is done because we've taken this but I felt like the meeting Tuesday, July 9th when Patrick said that I felt like the meeting should have just stopped and people say wait a second we can't go on until we fix this this is unacceptable so Dee Burkett said at the meeting I just lost my jackpot he said that we could have the zone contracts and that's huge so let's just go back to what's not controversial in my opinion the Athens 911 State of the Art Communication Center taking over all 911 dispatches absolutely no reason to do it police department supports it we support it, A4E supports it makes tremendous amount of sense it's going to cost a little bit of money but I think the commission is on board for that is what I heard I think I heard Mike Hamby say if I'm having difficulty breathing I don't want to have to explain that I don't know what I'm trying to think the private service that the hospital was losing was it one and a half million dollars? no no they said they were each losing exactly one million Andy Herrod asked for an audit and was denied but I mean do you think do you think that's true? no I don't I wanted somebody to find out there was a nurse who would occasionally arrive in the ambulance on certain transfers between hospitals or something and her entire salary was billed to EMS I mean little things like that also and here's another thing I mean accounting Mark Twain said there's lies damn lies and then there's statistics well we got statistics and I'm afraid that the people who are controlling the data don't want you to see underneath those statistics but if the ambulance runs a call and they don't transport the patient they might write that off as a $600 loss but it didn't cost them $600 to run that call medics were already being paid they were already there basically you're looking at fuel and wear and tear on the vehicle so did they write that as a $600 loss my guess is a $600 loss and the same thing to justify the $100,000 subsidy from Athens-Clarke County it's because the 9-1-1 is quote unquote not making money but we don't know because we don't get to see those figures and I think they're inflated because of the way it's reported and there's an accounting procedure that will take that into account and I think if the county ever gets control of the contracts they should ask to do that and to see the actual loss so the $100,000 subsidy from the taxpayers of Athens-Clarke County is subsidizing 9-1-1 because they say they're not making money on 9-1-1 the whole system is making a tremendous amount of money as a matter of fact priority EMS is the fastest growing ambulance company in the country so Athens-Clarke County citizens are subsidizing 9-1-1 trucks and then they're using those same trucks to make money again in the other area of 9-1-1 non-emergency transports so I don't see how that's legal it may be but I don't see how it's ethical and it's a community at risk I do think that would put the community at risk but let's see so if it was true that they were losing all this money and maybe something due to the way Athens is we have a lot of people in poverty maybe there is a non-emergency all those things are true maybe that would contribute to them losing money absolutely so I guess what I'm trying to say is that maybe this is how they're benefiting perhaps it could be another way and it may as far as for what we're asking it may be a new point but basically in all of this data I can't trust what I can't verify I just can't plus to me a public service should not be interested in making I mean how much money does the fire department make not much or the police department they write tickets and so like a public service is not there to generate money it's there to protect the citizens and the ambulance EMS is the same difference we have those figures Diber Blaine Williams came up with those figures and it was four and a half million dollars to run it ourselves but again I'm pretty sure that didn't account for the revenue it would bring in which would probably be somewhere around 40% with an uptick as more people in the state of Georgia have access to health insurance as many as we would like but every time more Georgians are covered by health insurance or war expansions that four and a half million dollars will go down I think it's probably somewhere around two and a half to be honest right now but I'd have to talk to Blaine about that let's say it's four and a half million dollars per year that's my understanding and that may be a lot of that may be the initial cost too of setting it up I don't know we'd have to sit down and talk to Blaine about that do you think that the people of Athens would be okay with the extra taxes that it would take in order to to do it right and separate divisions like this if it really is four and a half million dollars to separate divisions I think D said it would only cost a million dollars didn't he Mr. Brickett I think he said 1.5 to separate divisions again that's their number and I would want some pure clean accounting to either verify that and again I don't think that considers revenue they're always coming up with these numbers that are so we don't know we don't know and we don't have access again a public service is expensive fire trucks are expensive stations are expensive we already have the nine fire stations the stations are already built we can house ambulances in our nine fire stations and we should whether it's national or somebody else I've been saying that for 8, 10 years but to answer your question I do think they would and first of all again I don't think it's four and a half I think it's closer to half that or 60% of that they're splossed that may have come and gone but in the long run there may be splossed if we could ever get that it's a priority on there there's grants lots of grants out there again that's a chief Scarborough question but I think he'd be the first one to tell you that there are a lot of grants out there that could help mitigate that cost and there's also maybe some creative ways to go at it like I know there's already a 9-1-1 fee on your phone bill maybe we could bring that from $1.99 to $2.99 or something so there are different ways to look at revenue but I think we could support it yeah it's public safety I mean that's the big one you know one thing that we come up against a lot of times Chris is that people don't like to think about an ambulance until they need one and then unfortunately it could be too late if that ambulance that your family is relying on is somewhere else doing something that doesn't have anything to do with 9-1-1 then that's a serious problem but people typically don't like to think about an ambulance until they need one and again by then it might be too late most people that we talk about don't even know they don't have a clue they think it's all county based you call 9-1-1 you get a fire truck and an ambulance from the county and that's why I just you know I think if we can keep it simple it is a complicated issue but what we're asking I think again uncontroversial which is public dispatching instead of privatized 9-1-1 we're asking to keep going with the Athens-Clarke County Fire Department we're getting them all to the EMC level keep going get that those advanced procedures and medicines close to your patients we're asking for data to be available to stakeholders, citizens mayor and commission, others people who might be looking at this area to move into that's something David Block one of the retired neurologists that's been working with us is looking at we think oversight committee meetings should be open to the public they should be open to the public that's neither rocket science nor is it an extreme request to me public safety privatized public safety needs more transparency rather than less and what we have now is something close to zero transparency even the commissioners who just recently have been made members of the oversight committee have to sign non-disclosure agreements which again borderline legal our department of public health attorneys there were three in the room we asked them about that also they're like I don't know if that's legal and that was another one they punted to the attorney general we're going to try to get a meeting with him and we're just simply asking that they stop vacating zones to run out of emergency 9-9-1 transport stop abandoning state mandated 9-1-1 coverage zones to run calls that don't have anything to do with 9-1-1 and yes it does have everything to do with them making more money and the hospital is getting their beds cleared faster but we think there are better ways to do that that's all I have any closing comments I think just that in terms of the work session I think we need to expedite echoing Commissioner Neesmith and Commissioner Hamby here if I'm not mistaken I'm echoing and agreeing with them that we need to expedite the implementation of the undiluted recommendation of the Athens Park County police department to take over all 9-1-1 dispatching and by undiluted I mean that doesn't mean moving national EMS into our communications center it means us taking over ourselves making it a public system as it should be and that's option three and to answer I don't know why they didn't answer Commissioner Hamby yes several times about when did this timetable start well the recommendation made was made in August of 2017 two years ago which is almost two years ago and again I don't know how that was kept quiet but we just learned about it thanks to Mayor Gertz so I thank him for that we think Athens Park County should take over the EMS licenses that were offered to us by Mr. Burkett and I think St. Mary's the St. Mary's person agreed and maybe they are as happy as we think I don't know but I was surprised to hear that we should take them up on that yesterday where as soon as possible opportunity again it doesn't obligate us to run 9-1-1 it gives us control of the contract saying you can pick who you want you can pick how you want and write the contract you can redid it or you can do it yourself do most counties own their own EMS yes when I mentioned to Senator Kirk Patrick that we didn't have the zone licenses here in Athens and the hospitals had she was absolutely shocked she couldn't believe that we wouldn't want our own zone contracts I think part of the trouble too has been that St. Mary's started their EMS in 69 so 50 years ago and regional then AGH Athens General got there shortly thereafter to compete and I think the fact that both hospitals have been providing this service essentially for free for the last you know 45 years or however long the subsidy of course cost a little bit but I think the county just isn't used to having to pay for this they've been like spoiled all these years by someone else providing the service and now I think it's time for them to step up and really do it right they need to really step up there's a classic economic term that ain't such a thing as a free lunch well our free lunch is Commissioner Davenport saying hell no I'm not calling that one I'm going to tell her to throw them in the car and get them into the hospital our free lunch is our police officer telling our police chief that they don't feel secure that should they be injured in the line of duty that they're going to receive a timely medical response our free lunch is John Cooper having over a period of maybe a year and a half calling nine times and never getting the timely response for his critically ill son and there were times where it just took so long where they ended up having to intubate his child whereas if they had been there earlier then it may not have gotten that far so there are we are paying for this service in other ways I think the take away I got from watching I wasn't there at the meeting but I watched it and I think if you have a Commissioner that experienced what Patrick did and if that doesn't give the motivation or whatever to make major changes I think something's desperately wrong he was sitting there and said he called and he got so he waited so long he drove him in now that seems like that should be enough to get people's attention to do something and that just kind of blew me away that he said that and people were like oh well that's probably just a one time deal or whatever whatever reaction they had to me it wasn't enough they were calling them outliers they're not outliers they're part of this stack they're up here because this is 2014 to 2017 like 2018 and 2019 it's they're in here and we need to account as far as I know not a single one of these calls has been accounted for so anyway we just want more transparency and accountability and I think the best way to do that is to take listen to your police department take over 9-1-1 and get some transparency in those meetings and take control of those licenses if they're given to you that'd be huge thank you Chris for having us appreciate it absolutely