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County staff explain how ambulance services are governed; board told it has no direct ambulance contracts
Summary
County staff briefed commissioners on regional ambulance zoning and the Region 3 EMS advisory council; staff said Fulton County does not hold direct transport contracts and suggested appointment changes to the local advisory membership.
County staff told the Board of Commissioners how ambulance services are governed across Fulton County and the greater Region 3 zone, and outlined options available to cities and the Region 3 Emergency Medical Services Advisory Council to address response‑time concerns.
Mike Rawicki of the Strategy and Performance Management Office said Georgia law requires a regional ambulance zoning plan and an advisory council for each region; Fulton County is part of Region 3, which includes Clayton, Cobb, DeKalb, Douglas, Fulton, Gwinnett, Newton and Rockdale counties.
Rawicki said Fulton County itself does not hold direct contracts with ambulance transport providers and that county responsibility is limited to 9‑1‑1 dispatch services; transport services are governed through the regional plan and providers approved by the Region 3 council and the State Department of Public Health. He said the county’s E911 office distributes monthly response reports to fire chiefs and that staff are exploring an automated portal so cities can review response metrics on demand.
Options presented
Rawicki and staff described several potential paths for municipalities: pursue performance contracts tied to response metrics (as the North Fulton cities did), allow city fire departments to perform patient transport to augment service, hold regular performance review meetings with providers, or ask the Region 3 council to re‑open service applications to increase competition.
Board members and city representatives discussed the composition of Fulton County’s six appointees to the Region 3 council. Commissioners raised concerns that two Fulton appointees with ties to Grady Memorial Hospital have recused themselves in the past on Grady‑related votes; commissioners discussed whether to change appointments so that more fire‑chief representatives from North and South Fulton serve on the council. The chair said he would bring back proposed changes for the board to consider; staff noted one representative term expires in June.
Why it matters: ambulance governance is regional by statute; county and cities can influence local performance through appointments, interlocal agreements, dispatch practices and optional city transport services.
No formal board vote was required on the presentations; staff said the South Fulton cities could consider a performance contract similar to the North Fulton example.
