Oconee County weighs county‑run EMS to address response times, billing complaints

Oconee County commissioners on March 26 proposed creating a county‑run emergency medical services system to take local control of ambulance operations, citing slow priority‑1 response times and repeated billing complaints under the county’s private contractor, National EMS.

Commissioner (S1) said the county’s analysis, including a state PHIP report and two months of detailed CAD review, shows Oconee’s 2025 medical call volume at just under 4,000 and a need for three 24/7 ambulances plus a weekday peak‑hour unit. "It's my recommendation to the board of commissioners and citizens of Oconee County to create a county run EMS and to seek to become the designated 9 1 1 zone provider," the commissioner said during a presentation.

Why it matters: residents described instances of large ambulance bills and limited local oversight. The commissioner cited National EMS reports that recorded many priority‑1 calls with response times longer than 12 minutes and 59 seconds — a national dataset the county provided shows 239 such calls in 2024 and 112 so far in 2025 — and said spot checks suggest Oconee‑assigned units were sometimes on calls outside the county or performing nonemergency transfers when the exceptions occurred.

The county’s proposed operational model would start with five Type‑1 ambulances (three staffed 24/7, one 24/7 supervisor unit and one reserve) with supervisors operating a med unit during peak hours; medical responders would remain under Oconee County Fire Rescue for pension eligibility while an EMS director would handle training, quality assurance and daily operations. The county intends to restrict units to 911 responses and contract out nonemergency transports and billing to specialist vendors.

On costs and revenue, the county provided an estimated annual revenue of about $1.5 million and total operating expenses of about $3.4 million, producing a projected net taxpayer cost of about $1.9 million a year. The commissioner said National previously proposed a similar setup at roughly $2.4 million. The county said SPLOST and other funds could cover vehicle and equipment purchases; officials said the plan could proceed without a millage increase but that a millage reduction this year would be difficult.

Residents at the town hall offered a mix of support and caution. Heather Picklesimer, a Bishop resident who works in local health care, questioned whether some long calls were true priority‑1 emergencies and urged careful review of the data, but said, "I would much rather pay the $3,000 bill than pay the taxes every year for a whole county EMS service." Margaret Hale of Farmington criticized the timing and transparency of the rollout and asked the commission to form a citizen advisory committee; "There’s been no discussions, no public input until tonight," she said.

Several speakers described billing problems. Mike Sebring told the board he was billed $4,200 for an August 2024 transport to Piedmont and said he and his wife fought the bill for more than a year before settling. The commissioner confirmed the county has received examples of high bills and collection notices and said local customers sometimes faced collections while billing disputes were unresolved.

Industry perspective and state rules: Robbie Atkins, formerly part of a family‑owned EMS operator and now involved with Priority Ambulance, defended National’s accreditation and cautioned that starting a county service is complex and expensive, pointing to vehicle lead times and workforce shortages. The commissioner cited state law (Official Code of Georgia Title 31, Chapter 11) and Georgia Administrative Code requirements and noted that the Department of Public Health director (Dr. Kathleen Toomey) makes final decisions about designated 911 zone providers.

Next steps: commissioners said they have four applicants for the EMS director position (three interviewed so far) and that, if the board votes to proceed, they would complete hiring, approve contracts to buy ambulances and ambulance equipment, and set operational policies. The county said it would coordinate with local partners including Trinity St. Mary’s and Piedmont Athens Regional hospitals and that a 24–36 month demonstration period might be used to establish service before seeking a zone change from the state.

The board did not take a formal vote at the meeting and adjourned after public comment. Commissioners invited additional questions by phone and at future open meetings.