Promising Practice: GA SORH Looks at the Feasibility of EMS Regionalization in the State

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by Beth Blevins

A study commissioned by the Georgia State Office of Rural Health is looking at the feasibility of regionalizing 911 emergency services in rural counties in the state.

Between 2010 and 2016, six rural hospitals closed in Georgia, and others reduced their service lines in an effort to save money. As a result, emergency services were left to fill the gap. This led to an increase in 911 calls and in the distance ambulances traveled to transport patients to an appropriate facility, sometimes leaving no coverage in the county. As rural county tax revenues decreased, the idea of “regionalization” seemed promising.

“Since 24/7 response-ready EMS is expensive, and each small rural county seemed to be duplicating the efforts of the surrounding counties, it seemed logical that having three to four counties join together in a regionalized effort would be an efficient and effective way to provide quality patient care while reducing operating costs,” said Nita Ham, director of SORH Programs at the Georgia Office of Rural Health (GA SORH).

When approached to find funding for a regionalization pilot project, Ham said she was worried that an unsuccessful first attempt would prevent anyone from trying again. “We decided to commission a solid, comprehensive study first, to evaluate if the climate was right for Georgia to attempt something that had never been fully attempted before,” she said.

The grant for the study was awarded to the Association County Commissioners of Georgia (ACCG), which, Ham said, “has a strong working relationship with all counties in Georgia and has been directly involved in EMS issues.” She also noted that the relationship between SORH and ACCG is invaluable. “Since the ACCG has such an intimate working knowledge of county needs, finances, and local government, we have recognized that including them in our discussions and projects is extremely helpful,” she said. “They can give us insight to how well a project may be received, or potentially rejected, based on the local budgets, community relationships, needs, and political climate.”

According to Ham, the intent of the study was to present the information as research findings and to allow state, regional, or local leaders to decide if, how, or when they will use the information. Since the report was issued last June, the findings have been widely distributed at ACCG meetings, as well as state and local EMS meetings.

“The primary takeaway from these meetings, so far, is that there probably will be an effort to consolidate some aspects of daily EMS operations such as purchasing, medical direction, training, and CQI programs,” Ham said. “Some stakeholders also noted a potential benefit in forming a multi-county consortium to fund one ambulance for 12 hours per day to cover gaps within those counties when the primary unit leaves the county for a long-distance transport.”

Ham said it could take one to two years before they can expect to see changes in practice as a result of these efforts. “Accepting ‘change’ as well as budgeting for that change will take time,” she said. She added, “The Georgia State Office does intend to use these findings to guide other future projects, and will also monitor any programs that may be created within the state as a direct or indirect result of the Study.”

The Georgia State Office is making the publicly available. “Through this, we are hoping to perhaps engage with other states and counties that are considering regionalizing their services,” said Patsy Whaley, the Executive Director of the GA SORH.


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