KNOXVILLE, Tenn. (WATE) — The Knox County Commission heard a report on ambulance response in a presentation Monday.

The independent consulting firm Fitch and Associates gave the report, outlining issues with the county’s current emergency service model. The county currently contracts American Medical Response, or AMR, to provide emergency services.

The reports comes as the county is deciding what provider will service the county starting next year. Four companies have submitted bids for the contract, including AMR.

J. Todd Sheridan with Fitch and Associates gave the report and outlined five critical findings. He said that the area Knox County covers requires significant resources and additional funding has not been allocated to account for increased costs.

“The current contract is not financially viable or operationally viable as it sits today, as it started in 2013 and has had about 11 amendments since then. Because of that, it has not had a market correction as you’ve seen a lot of costs go up since COVID has entered our world in 2020,” Sheridan explained.

In addition to funding, Sheridan said response time is another weakness.

“Right now the contract is designed to capture and for the contractor to perform in the highest volume areas. However, that’s not creating the equitable response into your rural communities that’s getting elongated response times,” he said.

Problems can continue once an ambulance arrives at a hospital.

“When an ambulance gets to the hospital and has to stand there and wait, they’re standing there in excess, on average, of about 40 minutes, which is costing the system about $4 million a year,” Sheridan said.

Commissioners questioned how much fixing ambulance staffing shortages would help, when hospital staffing shortages are still a problem.

“That’s why it’s going to take both parties working together to make sure that we reset, get back to the norm,” Sheridan said. “As you start seeing hospital staffing improve, you get the EMS staffing improved, you get the equity of performance set for your community, everyone collaboratively works together to solve this problem.”

Sheridan also described a lack of transparency when it comes to monitoring performance. He said currently, the medical director, software and all programs that monitor the performance of the system are provided by the EMS contractor. He suggested that moving forward these things should be provided by the county itself.

He added that parts of the population often require more emergency response.

“You have this transient population that goes through the mission area in your community, and that is creating an overall healthcare burden that is going to have to be managed by your community,” Sheridan said. “It’s going to take the hospital staff, health department and EMS agencies moving forward to really tackle those challenges as you start progressing in the future.”

AMR, Ameripro of Tennessee, Falck, Priority Ambulance all submitted a bid for the contract. The winning contract will take over responsibilities for emergency services on February 1.

In addition to AMR, AmeriPro of Tennessee, Falck, and Priority Ambulance have submitted bids for the contract. The winning bid will take over emergency services starting on Feb. 1, 2024.