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Officials describe EMS zoning and 'wall time' problem; committee hears treatment‑without‑transport options
Summary
DPH explained the state's EMS zoning process, regional EMS councils (REMSAC), and performance measures used to review providers. Lawmakers and DPH discussed ambulance 'wall time', workforce shortages, and emerging reimbursement options such as treatment without transport and alternate destination billing codes.
Department of Public Health officials briefed the House Study Committee on how Georgia regulates emergency medical services and described current operational challenges lawmakers should expect to confront.
Megan Andrews of DPH summarized the EMS framework: Georgia is divided into EMS zones (mostly county borders) and the regional EMS advisory councils (REMSACs) analyze complaints and performance data — including STEMI and stroke transport metrics — before recommending changes to zone providers. The REMSACs can require providers to improve or, after review, open zones to competitive proposals.
DPH officials and legislators spent much of the session discussing so‑called "wall time," the period ambulances spend waiting at hospitals to transfer care. Andrews said the issue is driven by "staffing" and "bed" shortages and that long wall times remove ambulances from 911 response. "When we're having high volumes... there's challenges with enough workforce to cover the number of patients they're trying to serve," Andrews said.
Policy changes under consideration include treatment without transport (reimbursing EMS for on‑scene care without hospital transport) and allowing EMS to take some patients to alternate destinations (urgent care or other clinics) under new Medicaid reimbursement codes, measures DPH said it has discussed with the Department of Community Health. Andrews said some of those changes are already being piloted or have reimbursement mechanisms under Medicaid.
Committee members asked whether increased behavioral‑health or crisis‑center capacity has reduced wall times; Andrews said the primary driver remains high volume seasons (flu/RSV/COVID) but indicated data can be run to examine mental‑health transports specifically.
The committee did not take formal action. Lawmakers requested further data on wall‑time causes, REMSAC quarterly reviews, and whether statutory or regulatory changes are needed to facilitate alternative‑destination transports while protecting patient safety and meeting federal EMTALA considerations.
