Rafal: Solutions to fix Athens’ emergency medical response system

Sam Rafal is public safety advocate who has been working for years with Bob Gadd, a recently retired local paramedic, to shine a light on Athens’ private ambulance service which he believes is performing inadequately and putting people at risk. You can read part one of this letter to the editor here.

The Sub-Standard State of Our Emergency Medical Response in Athens-Clarke County and Solutions to Fix It (Part 2)

When you or a loved one are experiencing a time sensitive, life-threatening emergency, seconds count, minutes matter, and receiving the appropriate pre-hospital medical care can mean the difference between life and death. TWENTY-ONE YEARS INTO THE 21st CENTURY, Athens-Clarke County has 1/3 of its public safety system run by a for-profit, private equity corporation, by the name of National EMS. As part of their highly successful business model, National EMS routinely and systematically pulls taxpayer subsidized 911 ambulances out of their neighborhoods to run profitable non-emergency transports out of the hospitals.

Additionally, we are hearing that National EMS does not routinely staff their ambulances with paramedics. And since this is a non-transparent company that has repeatedly stated, “We are a private company and we can do what we want,” this is hard to quantify. Paramedics can deliver by far the highest level of prehospital medical care, and have been the standard of care in Athens since the 1970s.


Solution 1 – National EMS needs to be asked to stop pulling 911 ambulances out of our neighborhoods to run non-emergent patients home from the hospital. National EMS needs to be asked to staff all of their 911 ambulances with paramedics and to meet the long held “Gold Standard” in Athens-Clarke County.

Paramedic staffed ambulances have evolved to being a rolling Emergency Room with many prehospital procedures and medications performed at the highest level. Just as you would expect to see a physician in the Emergency Room, when you call 911 you should expect to see a paramedic on your ambulance.

Solution 2 – Our city manager should request that our 911 Communications Division find out each morning how many ambulances are serving our county, and of those, how many are staffed by Paramedics. Not only do we have a right to know, we have a need to know. What if my child (or your loved one) is experiencing a time sensitive, life-threatening emergency that can only be treated in the field by a Paramedic? And what if I know that if I call 911, I only have a small chance of getting a Paramedic based ambulance response? Why in the heck would I call 911?

TWENTY-ONE YEARS INTO THE 21st CENTURY, Athens-Clarke County has a confusing 911 call system where you often have to tell your emergency twice. Once to our state of the art 911 Communication Center and then again after our 911 Center is forced to hand your call off to the for-profit ambulance service. This is confusing, inefficient, and dangerous. Additionally, we do not utilize Emergency Medical Dispatching (EMD) protocols, even though this lifesaving technology has been around since the mid-1970s.

Solution – We fought hard for important upgrades to our 911 system known as “Option 4”. We are hopeful that this problem will be solved soon with full implementation of these dramatic improvements. Option 4, is the Athens-Clarke County Police Department recommended, Mayor and Commission approved upgrade to our 911 Center where all 911 calls are handled from beginning to end by our 911 communications center and Emergency Medical Dispatching (EMD) is used as needed. Many thanks to our Athens-Clarke County Police Department for working hard on full implementation of Option 4 and to our Mayor and Commission for voting to fund it.

TWENTY-ONE YEARS INTO THE 21st CENTURY, Athens-Clarke County does not have control of their EMS zone licenses. This essentially relinquishes transparency and control of this critical aspect of our public safety system to private interests.

Solution – We need to obtain our zone licenses from the state. This will take having the right people in place to shepherd this process through. It can and should be done.

TWENTY-ONE YEARS INTO THE 21st CENTURY, we have an EMS “Oversight” Committee that hasn’t met since our county attorney advised them (over two years ago) that their meetings were in violation of state law. Prior to that they met illegally for over 10 years (ignorance of the law is no excuse), and their goings on remain shrouded in secrecy. This secrecy is enhanced by having each member sign nefarious Non-Disclosure Agreements, that unnecessarily blocks transparency in public safety going well beyond protecting proprietary interests. For years, several corporate members of the company being oversighted held prominent position on their own oversight committee. That influence continues to this day, yet local citizens are banned from attending.

Solution – The so-called EMS “Oversight” Committee is dysfunctional. We need a citizen run Athens-Clarke County EMS Oversight Committee appointed by the Mayor and Commission. It would need access to all pertinent public safety data and should have the ability to inform and advise elected and appointed government officials.

Sam Rafal

Bob Gadd, Rafal’s partner in advocacy and retired paramedic who once worked for National EMS, has an open video letter he is sending to the mayor and commission, which you can view below:

“My name is Bob Gadd, a recently retired paramedic after 43 years of public service with 36 of those years serving the citizens of Athens Clarke county. I made this video to express my heartfelt concerns to ACC mayor and commission about the current state of our EMS.

In all my years as a medic I believe we’ve reached a new low and are even going backwards. Please be aware this video was made prior to our discovery that ACCFD was training their personnel to be Advanced EMT’s but is not equipping them to perform at their level of training. This adds to the already poor EMS response and is inexcusable and should be accounted for. After watching this video, ask yourself what’s the most important thing in your life.

Well, for me, it’s life itself. That’s exactly, exactly what this is all about.

Thank you for your time Bob Gadd”

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