‘Life-saving clauses’: Jackson issues request for proposals for ambulance services

JACKSON, Miss. (WLBT) - Jackson could soon be going it alone when it comes to providing ambulance services.

On Monday, the city issued a request for proposals for emergency ambulance services for the city.

The news comes less than two months after North Jackson resident Donna Echols told WLBT her ex-husband James Mabus died after waiting more than 90 minutes for an AMR to arrive at her home, despite an ambulance being stationed just minutes away in Madison County.

The ambulance couldn’t respond to Echols’ call because it’s with Pafford, and per its contract, Hinds County and its cities are served exclusively by AMR.

Provisions in Jackson’s request for proposals could have saved Mabus’ life.

According to the 66-page document, the firm chosen would have to have a “helping hands clause” to allow other service providers to respond in the event of equipment or personnel shortages. The firm could also face fines for failing to respond to emergencies in a certain period of time.

“I want to say congratulations to the city for listening to people who have had to deal with this,” Echols said. “And judging from what it sounds like is listed in the RFP, in terms of response time penalties and with respect to mutual aid, those sound like life-saving clauses to have in the contract.”

The firm hired will be required to enter into a mutual assistance agreement within 30 days after the contract is awarded.

“What’s different between what we have proposed and what the county currently has is we won’t actually block anybody from coming in,” City Attorney Catoria Martin said. “What currently happens with the county is that if the provider is too busy, they block other providers from coming into the county.”

“Ours will allow for, if they have a period of time where they’re too busy [and] they can’t respond, those other providers can step in.”

The RFP also addresses another issue extending wait times in the county - “wall time.”

Wall time is the time ambulances must wait at a hospital before their patients are booked in. The ambulance and EMT workers cannot leave the hospital until their patients are admitted.

According to the RFP, the “service provider shall propose affirmative steps/solutions for the issue of ‘wall time’ delays and specific ways in which the service provider shall work with local hospitals to ameliorate” those delays as much as possible.

The RFP goes on to state that “wall time” will not be a “continuously accepted reason for delayed emergency response times.”

Service providers will be required to respond to calls within eight minutes. Fines of $500 to $1,000 will be levied for each response that does not fall within that eight-minute period.

The RFP also includes monthly fines if the provider fails to respond to at least 90 percent of service calls within eight minutes. Those fines range from $2,000 to $16,000 a month.

Nicole Michel, director of public relations for Global Medical Response, AMR’s parent company, said wall times average about 46 minutes in Central Mississippi.

“It is not unusual for a local AMR ambulance crew and their patient to wait on the wall for several hours,” she wrote. “These delays happen numerous times every day and night for every ambulance service in our state.”

Two issues that exacerbate wall times include people using emergency room doctors for primary care and individuals calling ambulances who do not need them.

“For decades ambulance services have been required to respond to every 911 caller - even if the ambulance service call-taker from the information the caller provides, discerns the patient is not suffering a major emergency or is not suffering an emergency at all,” she wrote.

Michel went on to say AMR is planning to implement new alternatives this summer to address that concern.

Jackson entered into an inter-local agreement with Hinds County to provide ambulance services in 1991. At the time, the city was providing ambulances in-house and was losing money.

According to that agreement, it would take a vote by the city council and board of supervisors to end it.

AMR has been providing services in the county since then. Under the company’s current contract, which was approved by the board of supervisors in 2016 and renewed in 2021, the company must answer 85 percent of service calls in eight minutes or less in Jackson and Clinton, and 12 minutes or less in Byram.

The contract also allows for “exceptions,” which allow response times to be longer after a certain number of calls are responded to.

Proposals are due by 3:30 p.m. on September 12. They will be evaluated by a committee that includes Fire Chief Willie Owens, Assistant Fire Chief Patrick Armon, Deputy Fire Chief Cleotha Sanders, Chief of Staff Safiya Omari, Chief Administrative Officer Louis Wright, and Chief Finance Officer Fidelis Malembeka.

Firms will be evaluated on their technical proposal, their management plan, and their overall presentation.

According to RFP provisions, the city issues a notice of intent to award a contract by September 29.

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