Ambulance service is at a crisis point in Sumter County.
Some people who dial 911 for an ambulance are facing intolerable delays like a Village of Virginia Trace man who waited an hour and 20 minutes for an ambulance when he passed out while mowing his lawn.
The long delays in response times come a decade after the county switched to a private contractor to provide emergency medical services (EMS). Ambulance service in Sumter County now is operated by Advanced Medical Response (AMR), a large national company.
The current system of fire departments and ambulances serving The Villages can be confusing. Firefighters under the umbrella of The Villages Public Safety Department respond to calls in all three counties of The Villages. The Lake and Marion fire departments also respond to Villages calls in their counties, depending on the address.
Although The Villages Public Safety Department does not staff ambulances, it has four non-transport rescue vehicles. Many firefighters also are trained as emergency medical technicians or paramedics and they respond to medical calls.
Response times for Villages firefighters often are about four minutes. On some recent calls, AMR ambulances have been delayed for up to an hour or more.
Emergency medical services in Lake and Marion counties provide ambulances in their counties, including in The Villages. So, an AMR ambulance could pick up a patient in The Villages while another county’s ambulance would handle a call across the street, depending on county boundaries.
By 2010, Sumter County Fire Chief William Gulbrandsen had succeeded in merging 10 separate fire departments into one.
The separate Sumter County and Villages departments also had developed advanced medical response systems with emergency medical technicians and paramedics. The county could buy ambulances, hire staff and start a public emergency medical service as an extension of those departments.
That was the traditional approach, but Bradley Arnold, the new county administrator, had another idea.
Supported by commissioners and then-chairman Doug Gilpin, who still serves, Arnold wanted to hire a private contractor to run the service.
Arnold has received national recognition for his efforts to privatize Sumter County services. Outsourcing services like transit and building inspection was less controversial than others such as libraries and EMS.
In 2011, Gulbrandsen suggested that the county also consider a firefighter-based public system, but he said Arnold refused.
The fire chief worked on a proposal to hire a contractor to provide 911 emergency ambulance services. Among the bidders were AMR, American Ambulance of Orlando and Rural Metro.
Rural Metro was selected because, Gulbrandsen said, the company promised to provide 10 ambulances to serve the growing county. They began operation in 2011. In 2015, AMR bought Rural Metro and took over the five-year contract, which was renewed in 2017.
Christine Kennedy, wife of Sumter County Deputy Administrator Stephen Kennedy, has been local operations manager both for Rural Metro and AMR. She and AMR’s national media team did not respond to questions or interview requests from Villages-News.com. Stephen Kennedy formerly was the county’s director of public safety and his duties have included managing the AMR contract.
Gulbrandsen reached the firefighter retirement age of 55 in 2011. He chose to retire from Sumter County partly due to philosophical differences with Arnold over firefighter-based vs. private ambulance systems. He also said he did not want to bear responsibility for employees over whom he had no direct control.
After leaving Sumter County, Gulbrandsen served as Longwood fire chief and, for the past six years, has worked as a consultant on fire and emergency medical services throughout the southeastern United States.
After a decade of private ambulance service in Sumter County, Gulbrandsen said the crisis of long response delays illustrates the flaws of the private provider system.
“In densely populated areas, fire-based systems have replaced private providers because they can’t keep pace,” he said. “A private system is profit oriented. When you’re dealing with public safety, you have to put a higher value on life than profit.”
The practice of using private ambulance services to handle 911 EMS calls is common nationwide, but Sumter County is an island in the midst of surrounding counties with firefighter-based emergency ambulance systems.
Gulbrandsen said it’s difficult for public services to have mutual aid pacts with private ambulance providers because they are such different types of operations.
Mutual aid agreements allow fire departments and EMS providers to assist each other if needed, for example, for a large structure fire or a motor vehicle accident with multiple injuries.
“We do not have a mutual aid agreement with AMR,” said James Lucas, public information officer for the Marion County Fire Department. “We have a mutual aid agreement with Sumter County Fire.”
Despite the absence of a mutual aid pact, Lucas said Marion County is willing to assist AMR if requested.
“If it’s a life-threatening emergency and we have available units and it makes sense for us to travel into Sumter County, we will go,” he said.
Next: Sumter County commissioners will have three choices when it comes to future of ambulance service.