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The Villages
Saturday, May 8, 2021

It is past time to dump Sumter County ambulance service

David Bussone

Several weeks ago I sent an email to Sumter County commissioners regarding a number of concerns I have with the performance of the Sumter County’s EMS service, provided by AMR, and management of the contract by county administration. I have not heard from a single commissioner. Since our elected officials apparently have no concern for the inability of our pre-hospital provider (American Medical Response) to meet our needs, and county management is unconcerned about the Kennedy family’s poor operational and contractual management of AMR, it is time to raise things a notch. Actually we need the residents of Sumter County to raise heck. The issues I raised previously affect not only our quality of life, but our very lives. To county administration we look like money pockets, and to AMR we look like profits. On the other hand I’m convinced that, to our fire departments we look like human beings who need their skills during periods of weakness, harm and illness.

Let’s discuss the issue of AMR delays in responding to scenes, The 2010 Request for Proposal that Sumter County used to hire a new ambulance contractor dictated the response times required that the new provider must meet. These were: so called Urban & Suburban ALS response times, the requirements are (per “A,B,C,& D calls) respectively, 8.00 minutes plus a 90 percent or 50 percent reliability factor depending upon its Urban or Suburban nature. The area, predominantly defined as Urban, extended past CR44 to 468. (see p.31 of the RFP, and Exhibit A, included as attachments). I requested publicly available data, from the District (The Villages) because of recent concerns I’m aware of from using PulsePoint. For example, there was an issue on April 5 during a call regarding a stroke patient. No AMR ambulance was available, so a mutual aid call was place to another county. That ambulance was more than 1 hour away. As it was arriving. A helicopter from Shands arrived. I do not know what happened to the patient, but I would be very concerned about the outcome. Time is Brain – scientists estimate that for every minute the brain goes without blood or oxygen, 2 million brain cells die.

The data from The District indicated that 67 patients did not receive AMR response for 45-60 minutes after a call was dispatched (from the period 7/8/2020 – 4/5/2021). For 29 patients, response time was 1.00 – 3:00 hours during the same time period. (The response time excluded accidents, fires, and non-Villages portions of Sumter County. The request was made for Village’s data.) Keep in mind, that during these extended delays, our fire department personnel are on the scene, after an average response time of 5 minutes, and waiting for AMR. As I reported previously, this ties up FD equipment and staff. So, for 96 patients (our neighbors), after Villages firefighters and paramedics were on the scene, the prolonged wait for transport was abominably long. What the data does not indicate is the eventual outcome. For seriously ill patients – heart attacks, strokes, etc., it was likely not positive. The data I requested was for 45 minutes plus. Having seen this data, I cannot believe that the bulk of AMR responses are within the RFP requirement of 8.0 minutes. AMR has not fulfilled its contractual responsibilities to Sumter County and County management has not held AMR to their joint contractual requirements. Both have failed the citizens of Sumter County.

We will hear lots of excuses from both parties about “reasons” for delays. I expect one “reason” to be delays at The Villages Regional Hospital and Leesburg (both owned by UF). If they use this excuse, I will call BS. I am a retired hospital executive who has had responsibility for as many as 15 hospitals at a time, trauma centers, air ambulance programs, and transport programs. Such an excuse is a diversion from poor operational controls and management. It happens at times, certainly, but is indicative of other problems. Since AMR and County management, including our Commissioners, don’t seem to care about anything but the dollar, we must speak out for ourselves. Just wait for the upcoming explanation from Bradley Arnold regarding his need to strip The Villages FD of its response to medical calls. Personally, I think it is time for the residents of Sumter County to strip the County of Mr. Arnold. If The Villages firefighters cannot function as first responders to residents, the likelihood of increased adverse incomes and unnecessary deaths will increase, in my opinion. You can also expect to see a far smaller fire department in The Villages.

Pay attention. Speak up! More to come, including UF’s interest in this mess.

David Bussone is a resident of The Villages.

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