Oconee County staff recommend creating county-run EMS; board to consider ambulance and equipment purchases next week

County staff on Tuesday recommended that Oconee County create a county-run emergency medical services (EMS) system and seek designation as the county's 911 zone provider, citing recent data showing a rise in long response times and gaps in local oversight.

"Our citizens deserve to have some accountability outside the corporate structure," the county staff member said during the March 31 meeting of the Oconee County Board of Commissioners.

Staff summarized the change in oversight that followed hospitals' decision to move away from operating ambulances and the cessation of a county–hospital oversight committee after a 2019 legal opinion and HIPAA concerns. The county cited a national report showing 239 priority-one calls with response times over 12 minutes, 59 seconds in 2024 and 112 such calls in the first quarter of 2025.

Why it matters: staff said those trends represent a notable change in service performance and argued that a county-run model would restore local accountability and allow the board to set protocols, performance expectations and local oversight.

Operational plan and costs: staff outlined a startup model that would focus 100% on 911 readiness (no scheduled non-emergency transports). Key elements described include a single EMS director, one EMS supervisor per shift, three 24/7 med units each staffed with a paramedic and EMTA, and five ambulances at startup with three operating daily. Staff said unit-hour utilization is expected to range from about 0.20 to 0.26 and estimated ambulance chassis life at four to five years based on mileage and remounting practices.

On cost, staff estimated a net annual taxpayer cost of about $1.9 million. The presentation compared that figure with staff's stated estimate of a $2.4 million annual subsidy under the previous arrangement and with a figure derived from a recent Priority bid of about $2.354 million. Staff emphasized that figures are estimates subject to final procurement and staffing choices.

Procurement next week: the board was told it will be asked next week to approve cooperative-purchase contracts for five Type 1 ambulances (HGAC/AM 1023) at $224,800 each, totaling about $1.24 million to be funded from SPLOST, and to approve ambulance equipment under a Sourcewell cooperative purchase from Stryker Sales LLC at $768,279.65. Staff said some vehicle deliveries could arrive in late June with others rolling into July owing to lead times.

Medical oversight and volunteers: commissioners asked whether the county would have a medical director; staff said a medical doctor must review protocols and that the medical director would be a contracted position responsible for protocol approval, case review and training. Staff estimated roughly 150 volunteers in county rescue organizations, with about half providing medical response and approximately 30 certified at EMT level or above. Under county protocols and with a medical director in place, staff said local paramedics and qualified volunteers could operate at higher scopes consistent with state training and protocols.

Timeline and next steps: staff said readiness depends on coordinating licensing and protocol development with hospitals in neighboring Clarke County and on hiring an EMS director; staff suggested the county could be ready by the end of the calendar year if all parties align. The board did not vote on the EMS plan Tuesday; the ambulance and equipment purchases and related budget amendments were scheduled for a vote at the next meeting.

The board also scheduled an executive session to discuss land acquisition, personnel and litigation and adjourned.