When Villager Carol Peters suffered a fall in February, her husband, John, became alarmed when her speech seemed slurred a few hours later.
He called 911 and first to arrive within about four minutes were firefighters who examined her for a stroke, conducted an electrocardiogram test (EKG) and started an intravenous line. The ambulance arrived about 40 minutes later, she was put on a stretcher and taken to the hospital. She quickly recovered.
Firefighters are supervised by The Villages Public Safety Department. Ambulances in Sumter County are provided by American Medical Response (AMR), the largest private ambulance company in the nation.
A paramedic for 15 years in Virginia Beach, John Peters was in a unique position to evaluate his wife’s care.
While his perspective is unique, his experience is not. There have been multiple reports of ambulances taking an hour or longer to arrive. Local AMR employees who spoke recently to Villages-News.com said the company is short-staffed and, in one case, a resident had to wait more than an hour for a backup AMR ambulance to return from Ocala.
Emergency medical services in Sumter County clearly are in crisis.
If response times do not improve, AMR could be in violation of its five-year contract with Sumter County, which requires 90 percent of its responses in the county’s urban areas within 10 minutes or less. The contract ends Dec. 31, 2022.
Local AMR operations manager Christine Kennedy, wife of Sumter County Deputy Administrator Stephen Kennedy, and the company’s national media relations staff did not respond to questions or interview requests by Villages-News.com.
County Administrator Bradley Arnold said he will present options May 18 to commissioners on modifying or improving the ambulance service.
UF Health, which is operated by the University of Florida, may be given more oversight authority over the program. Sumter County AMR also recently was selected for a five-year federal program that allows paramedics and EMTs more flexibility to assess Medicare patients on site and determine where they should be taken or treated.
Firefighters and their union fear Arnold’s options will include a plan to end firefighter response to many medical calls, which would have left Carol Peters untreated for 40 minutes.
Public and private ambulance services were strained beyond their limits nationwide by the COVID-19 pandemic and AMR may have been affected more severely due to its size. Less than two weeks ago, San Diego decided to oust AMR in favor of another provider after residents faced some of the same issues as in Sumter County.
“The EMS systems nationwide are being taxed very heavily due to the pandemic,” said James Lucas, public information office for the Marion County Fire Department. “We were affected.”
How did Sumter County reach this point? The answer is a story that begins nearly two decades ago.
William Gulbrandsen was hired in 2002 by then county administrator Bernard Dew as Sumter County’s first paid fire chief. Michael Tucker had been hired a few years earlier as fire chief of The Villages.
Gulbranssen, a firefighter-paramedic who served as a battalion chief and interim fire chief in Boynton Beach, was recruited due to Sumter County’s growth.
At that time, The Villages was mostly in Lake County and had not expanded south of County Road 466. Ambulance services were provided by Lake-Sumter Emergency Medical Service, which served the two counties.
With nine firefighters, one station and a chief, Villages Fire Rescue began in 1999 to provide fire protection for a much smaller community than today. Sumter County still has two separate fire departments, one for The Villages and the other for the rest of the county.
Gulbransen was charged with two major tasks – merging the county’s 10 non-Villages fire departments and developing medical response within the consolidated department.
Firefighters in the 10 departments were volunteers in the rural areas with paid chiefs or staff in the cities. Some volunteers worked as paid firefighters elsewhere but lived in Sumter County. Departments included Lake Panasoffkee, Royal, Croom-A-Coochee, Oxford and Tri-County (west of Bushnell), as well as the cities of Coleman, Center Hill, Wildwood, Bushnell and Webster.
Gulbrandsen began training firefighters as medical first responders. Soon the new department had about 25 emergency medical technicians and nearly 10 paramedics.
Ambulances provide emergency and non-emergency transport. Non-emergency, also known as horizontal transport, brings people to the hospital for kidney dialysis or chemotherapy.
Gulbrandsen said Lake-Sumter EMS was getting so bogged down with horizontal transport that the service put up a sign reading “we’re not a horizontal taxi.”
Sumter County retrofitted an old ambulance and assigned it to Lake-Sumter EMS to help ease the burden of horizontal transport.
In 2006, Sumter County Rescue received a state award as an outstanding non-emergency transport system. The following year Sumter County’s first countywide fire department debuted and Gulbransen was recognized statewide as fire chief of the year.
The department acquired some used sheriff’s office vehicles and equipped them with defibrillators, oxygen masks, backboards and other equipment. By 2009, Sumter County had a well-developed medical first response system.
Friction was growing between Sumter County and Lake-Sumter EMS.
“We were hearing complaints about longer EMS response times and Sumter County being treated as a weak sister,” Gulbrandsen said.
When an ambulance took too long to respond to a Lake Panasoffkee call for a prominent construction contractor, Arnold, then the recently hired county administrator, approved a plan to sever the county’s relationship with Lake-Sumter EMS.
Not only would the county break off that relationship, but Arnold would take ambulance services in an entirely new direction.
Next: Villages-News.com’s Marv Balousek examines whether a private ambulance service will always put profit over people.