Proposal for mental health transports could save county money

Posted 11/15/19

In 2018, it cost Bradley County more than $130,000 to transport people in need of mental health services, with the cost paid from the Bradley County Sheriff’s Office’s budget.

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Proposal for mental health transports could save county money


In 2018, it cost Bradley County more than $130,000 to transport people in need of mental health services, with the cost paid from the Bradley County Sheriff’s Office’s budget.

The Bradley County Commission recently heard a proposal that would save the county money, while shifting mental health transports to a company already working with law enforcement agencies in Hamilton and Shelby counties.

Introducing discussion, Law Enforcement Committee Chair Erica Davis said former committee chairman, the late Jeff Yarber, and Sheriff Steve Lawson talked about mental health transports last year. State statute requires the sheriff to handle mental health transports, she said, introducing Tracy Day with Amerimed EMS.

Day said the company started in Georgia and began working in Tennessee in Shelby County. Amerimed now offers service in Hamilton County, doing about 90% of mental health transports there. She noted the current mental halth transport situation "is not a pretty picture,” adding the sheriff's office has personnel trained in law enforcement, not medically trained to deal with mental health patients.

In addition, Day said Bradley County EMS is "busy with 911" and not in a position to take over mental health transports.

Day proposed that in Bradley County, mental health transport calls for Amerimed would go through the 911 Center.

"The sheriff is out of the loop …," she said.

Discussing Bradley County’s 2018 numbers, Davis said 522 mental health transports cost $131,278.98.

Commissioner Charlotte Peak asked Day about the cost of mental health transports as provided by the company.

"We bill insurance so it does not cost the county anything," Day said.

Peak asked what happens if the person has no insurance.

Day said the person is still transported and the company's account for indigent patients covers the cost; she said the company has not come anywhere near the limit on the indigent account.

Commissioner Howard Thompson said he is proud of Bradley County's ambulance service and wants to be sure Amerimed is not competition.

"We have no desire to do 911," Day said, adding Amerimed's only medical transports are dialysis patients. However, Day said Amerimed is willing to serve as backup for Bradley County EMS, if that need arises.

Peak asked Shawn Fairbanks, director of Bradley County Emergency Medical Service, if he would want Bradley County EMS to do mental health transports.

"Bradley County EMS is taxed out," Fairbanks said. He added the only way the ambulance service transports mental health patients for law enforcement is if the patient is pre-medicated.

Fairbanks added he got a call last week for a mental health transport patient in a wheelchair, and agreed to do that one.

"We work together like that," he said of EMS and the Sheriff's Office.

Fairbanks added, with the call volume, EMS can't take on mental health transports. He also suggested he would like to see the calls made for mental health transports.

"I want the hospital to make the phone call to Amerimed," Fairbanks said. He added he would rather do that than "tax" the 911 Center.

Lawson said there have been 343 mental health transports so far this year, and he thinks legislation proposed by the Tennessee Sheriffs Association to alleviate the cost burden "got hung up" and it has not gone into effect.

"I think it will help us tremendously," Lawson said of contracting with Amerimed.

However, Lawson said he is not sure Amerimed can take over the full Bradley County mental health transport volume at once. He would like to see a contract in effect on Dec. 1, and reviewed after three months.

Commissioner Thomas Crye asked Day about indigent patient costs.

Day said the company allows for 20% indigent care; in Chattanooga they have reached about 1% of that allowance.

"… We are taking care of those who need the help," Day said.

Crye asked if Amerimed has a contract with Erlanger Health System. 

Day replied Amerimed has a contract with Erlanger Behavioral Health Hospital, but not the other Erlanger hospitals.

Thompson noted Amerimed bills the mental health patients' insurance companies; he asked what the BCSO has done "all those years."

Lawson said they had to find a line item to pay for the mental health transports, drawing from an overtime line item for deputies to make the transports. Lawson added no sheriff before him has dedicated a budget line item to mental health transports.

Thompson asked if that meant Bradley County went all these years without billing insurance for people they transport. Lawson said they pick up most of them from the hospital, so the BCSO had no billing information.

Thompson said he is glad they are looking at this issue.

Commissioner Kevin Raper said he interprets this as a "double win" of savings for Bradley County, plus liability is removed from the BCSO and going to Amerimed.

Lawson said deputies may still have to respond to mental health transport requests, especially if the person being transported is violent.

"The law still says the sheriff is responsible," Lawson said.

Lawson added he met with Fairbanks and representatives from Tennova Healthcare-Cleveland to make sure all are on board with a change in the transport policy.

Lawson noted they still have details to work out, like who originates the call for transport.

Commissioner Louie Alford asked if Amerimed needs space in Bradley County for its vehicles.

Day said the company's ambulances will be stationed in Ooltewah. She added Amerimed became aware of situations when other ambulance services tried to come into Bradley County — that is not the case here, and she doesn't want it to be perceived that way.

Day said Ooltewah is close, "but not in the county."

Commissioner Davis placed the resolution on the Nov. 18 agenda.

In other business, the County Commission:

• Raper recognized Crye, Thompson and Commissioner Milan Blake for their service in the U.S. military; the meeting was held one day after Veterans Day. Raper also thanked those in the audience who have served in the military.

Thompson thanked Raper for his remarks about veterans, and he also appreciates those who served in the military.

Crye also said he appreciates recognition of his service as a veteran.

"It means a lot," he said.

Commissioner Davis said she is also thankful for veterans and their sacrifices.

Peak also thanked veterans for their service: "You guys are priceless," she said.

Alford also expressed his appreciation of veterans, noting his father and brother both served in the U.S. Army.

Epperson thanked veterans "for our freedoms that we all enjoy."

Chairman Johnny Mull also thanked veterans for their service.

The next meeting of the Bradley County Commission is scheduled for noon on Monday, in the County Commission Courtroom of the Courthouse.


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