911 callers may get ‘nurse navigators’ rather than ambulances

American Medical Response (AMR), which provides ambulance service to Sumter County, announced the initiation of a 911 nurse navigation program to handle some calls that are not life-threatening.

Last Tuesday, Sumter County commissioners asked County Administrator Bradley Arnold to draft a proposal to establish an advisory board that will review options for improving ambulance services. Those options include continuing to use a private provider such as AMR, partnering with the University of Florida to operate ambulances or consolidating the service with the county’s two fire departments.

Many speakers at the meeting, who included firefighters and medical professionals, favored consolidating ambulances with the fire departments.

The nurse navigation program will direct some 911 calls for non-emergency injuries or illnesses to a registered nurse, who will assess the patient’s symptoms and refer them to a telephone conference with a doctor, a local clinic or an urgent care center. The nurse would be able to make appointments and provide transportation if needed.

Ed Badamo, regional director of Global Medical Response, AMR’s parent company, said in a news release that the nurse navigation program could provide faster care than bringing these patients to a hospital emergency room.

Sumter County AMR also was among ambulance services nationwide selected in March for a federal program to provide more flexibility for treatment of Medicare patients instead of transporting them to the hospital. The Emergency Triage, Treat and Transport (ET3) program allows paramedics and emergency medical technicians to assess a patient’s needs when they arrive and recommend alternatives to a hospital emergency room.

Although these programs would reduce the number of ambulance trips to hospital emergency rooms, local AMR officials have failed to acknowledge or publicly discuss the slow response times of up to an hour or more reported on some recent calls.

Christine Kennedy, operations manager of Sumter County AMR and wife of Assistant County Administrator Stephen Kennedy, has not responded to emails or telephone messages from Villages-News.com.

At Tuesday’s meeting, Stephen Kennedy said 90 percent of AMR response times in 2020 were within 16 minutes and 28 seconds. The AMR contract requires 90 percent of its responses within 10 minutes in the urbanized area and within 15 minutes in rural areas.

On April 20, an ambulance took 38 minutes to respond to the 73-year-old mother of former Villages fire chief Michael Tucker after she had fallen. A Village of Virginia Trace man waited 80 minutes for an ambulance when he passed out while mowing his lawn.

Firefighters, most of whom are paramedics or emergency medical technicians, usually respond in less than five minutes and can begin emergency care.

Delays in transferring patients at hospital emergency rooms often keep ambulances out of service. By law, ambulance attendants must transfer a patient to a medical professional of equal status. A paramedic, for example, must transfer a patient to at least a registered nurse.

County Administrator Bradley Arnold said more than half of ambulance crews wait at least 30 minutes for patient transfer.

Ambulance services nationwide were hard-hit by the pandemic and Sumter County’s problems with slow AMR response times are not unique.

Last month, San Diego fired AMR and contracted with another private ambulance provider. At a public hearing, speakers complained about slow response times.

AMR’s operations manager in Rochester, N.Y., told a local television reporter recently that slow response times were due to staff shortages, the pandemic and protests.

In Rochester, AMR’s contract allows the city to levy fines against the ambulance company for failure to meet its 90 percent standard, but city officials have not yet imposed them.