County staff explain how regional ambulance zoning and councils shape South Fulton response; commissioners discuss options

Fulton County staff told the Board of Commissioners on Feb. 19 that the state's ambulance framework places zoning and provider oversight at the regional level and is governed by a Region 3 advisory council, and offered options local governments and the council can pursue to improve ambulance response in South Fulton.

Mike Rawicki of the Strategy and Performance Management Office summarized state law and the Region 3 Emergency Medical Service Advisory Council's role. He said Region 3 covers multiple counties (Clayton, Cobb, DeKalb, Douglas, Fulton, Gwinnett, Newton and Rockdale) and that Fulton County appoints six members to the council. Rawicki emphasized that Fulton County itself does not have direct transport contracts with ambulance providers and that the county's role is limited to 9-1-1 dispatch services.

Rawicki and other staff listed options the regional council or municipalities could pursue: (1) South Fulton cities and Grady could negotiate a performance-based contract (the county distributed the North Fulton performance contract as an example); (2) the cities could use fire-department transport resources to augment response; (3) the Region 3 council could conduct more frequent reviews and open competitive application cycles for providers; and (4) the board could reconsider how it fills its six Fulton County appointee slots (for example, appointing two fire chiefs from the North, two from the South, and two other representatives).

Commissioners discussed perceived conflicts where Grady-employed representatives sit on the council and have recused themselves in votes affecting Grady; several commissioners proposed replacing those appointment slots with fire-chief representatives to reduce recusal patterns and increase cities' influence. County staff said one of the Grady-appointed terms expires in June and the other later; commissioners asked the manager and county attorney to propose a process to adjust appointments by the next meeting.

Commissioner Khadija Abdul Rahman said she had checked with South Fulton oversight officials and reported no formal complaints had been filed to the council, and urged that city and county officials coordinate before making structural changes. Commissioner Marvin Arrington Jr. and others recommended asking incumbents to resign or waiting for terms to expire to change the representation.

Rawicki also noted staff is working to automate regular performance-report distributions. He said E-9-1-1 already circulates monthly reports to fire chiefs and Grady and that creating online access to those data would let cities see response metrics on demand.

Where it stands: County staff presented options and said staff would follow up with the county attorney and the manager to propose appointment and engagement changes; commissioners indicated willingness to seek reappointments that shift representation toward municipal fire chiefs if necessary.

Ending: Commissioners asked staff to return with recommended language for appointment changes and with options for South Fulton cities to pursue performance contracting or dispatch changes; staff said they will continue coordinating with city partners and the Region 3 council.