The rift between Dunwoody and DeKalb County over EMS services grew even wider July 8 after the City Council approved a resolution declaring the county has continually violated a memorandum of understanding that promised to improve ambulance response times in the city.

The resolution, presented by Councilmember and mayoral candidate Terry Nall, also reasserts the city’s desire to break off from the county and have its own ambulance zone, a request that can only be approved by state health department officials.

But Mayor Denis Shortal, the sole “no” vote against the resolution, is siding with DeKalb County CEO Michael Thurmond to deny the county has broken any agreements with the city over emergency services. Shortal also defended the county, saying officials have made great strides in improving emergency services to the city.

The county is also saying the MOU approved by the two governments last year never mentions “ambulance” response times. Instead, the MOU outlines response times for those providing advanced life support and basic life support services. These services are provided by DeKalb Fire Rescue firefighters who are also trained paramedics and EMTs and who consistently arrive within the MOU’s specified response times, according to the county.

Specifically, the county points out, the MOU drawn up by Shortal and Thurmond last year and approved by the City Council states, “A nine (9) minute or less, 90% response time for Advanced Life Support (ALS) calls and a 15 minute or less, 90% response time for Basic Life Support (BLS) calls can be achieved.” ALS calls are for serious life-threatening emergencies, such as a heart attack, and include a paramedic. BLS calls are for less serious injuries, like a broken leg, and include two EMTs.

“The MOU does not require that an ambulance be the first responder,” says an email from Thurmond’s chief of staff and sent to the council and mayor hours before the July 8 City Council meeting.

Nall called Thurmond’s email a “stunning turn of events.”

“This MOU has always been about ambulance transport units,” he said. “We’ve gone out of our way to say this is not about the fire department.”

Councilmember Lynn Deutsch also expressed frustration that DeKalb is now saying the MOU had nothing to do with ambulance response times, calling their argument “disingenuous.”

She noted the battle between the city and DeKalb County over ambulance response times began several years ago when a young Dunwoody couple told some council members their child nearly died from a seizure disorder when an ambulance from the county’s contracted provider, American Medical Response, or AMR, did not arrive quickly to take the sick child to the hospital. Only ambulances are authorized to transport patients to a hospital, not fire trucks.

“I’m not sure anyone is taking this seriously enough … and I’m concerned that now we’re playing word games,” Deutsch said. “Let’s not pretend who the first responder was … this was about getting people who need to get to the hospital to the hospital.”

AMR’s 5-year contract with DeKalb County was also set to expire last year, but the DeKalb County Board of Commissioners has extended the contract twice for a total of nine months through Sept. 30 as it evaluates awarding a new contract. AMR is one of three ambulance providers vying for the county contract.

Nall said AMR has failed to meet the response times standards the entire eight months the MOU has been in effect and it was up to the city to hold the county and AMR accountable.

“We entered into the MOU on the promise that the CEO [Thurmond] would make changes, a man of his word, if you will,” Nall said. Because the county violated its contract with the city, the city must now tell state health authorities the city needs a new ambulance zone, Nall added.

The divide between Dunwoody and DeKalb County over AMR’s response times has been growing for the past several years. In May 2018, the City Council voted unanimously to declare an “EMS emergency” that was sent to the Region 3 EMS Council, a division of the state Department of Health in charge of overseeing EMS services in DeKalb and other metro Atlanta counties. DeKalb Fire Rescue Chief Darnell Fullum serves on the Region 3 Council.

In response, the Region 3 EMS Council created a subcommittee to review DeKalb’s EMS system countywide and consider Dunwoody’s request for its own ambulance zone. Those on the subcommittee are Clayton County Deputy Fire Chief Richard Elliott; Marietta Assistant Fire Chief Chris Whitmire; Atlanta Fire Deputy Chief Jolyon Bundrige; Roswell Fire Chief Ricky Burnette; and Dr. Eric Nix, Cobb County Fire medical director.

The subcommittee meets again July 18 at Dunwoody City Hall, where the Dunwoody resolution is expected to be discussed.

Shortal made a motion to defer a vote on the resolution until Sept. 30, but it died for lack of a second. The other council members said they wanted to send a strong message to the EMS subcommittee that DeKalb was not living up to its promise as stated in the MOU.

But Shortal defended the MOU, saying he wrote much of it. He said the county now has three dedicated ambulances support equipped and staffed for advance life support in the city, something the city never had before. He also agreed with the county that it is not necessary for ambulance providers to be first on the scene because trained firefighters are able to stabilize a patient.

“We’ve got ALS people in there in that time limit,” Shortal said, backing the county’s claim that the MOU does not require ambulances meet the response times. “They are the key to survival. Secondly is getting them to the hospital,” he said.

Shortal also questioned why the council was focusing on a national standard for ambulance response times as the only way to judge the success of an EMS system.

“It’s difficult for me to believe time requirements are one-size-fits-all, for the entire U.S.,” Shortal said.

Nall said the response times outlined in the MOU are drawn from the National Fire Protection Association. The NFPA sets national EMS standards that are voluntary, but are considered by public safety agencies as the standards to follow.

Shortal said the city has only received three complaints about ambulance service since the MOU went into effect when before the city was receiving one or two a week. The service now is much better than when the city was founded, he added.

“Since the MOU, we have better equipment, better personnel,” he said. “Sometimes you’ve got to give credit where credit is due.”

But Nall said the county’s refusal to hold AMR accountable for not meeting the city’s designated response times in the MOU means the city is forced to take action through the resolution to send a “unified message” that the city tried to work with the county but the effort failed.

“I wish DeKalb County would own up to its mistakes,” Councilmember John Heneghan said.