City approves ambulance service with private entity

From left: Director of Operations for Pafford EMS Freddie Parker and Starkville Fire Department Chief Charles Yarbrough answer questions from the Starkville Board of Aldermen during their meeting Tuesday. (Photo by Logan Kirkland, SDN)
Staff Writer

The Starkville Board of Aldermen approved the contract with Pafford EMS, to provide an ambulance service within the city limits during its meeting Tuesday.

Aldermen approved the contract with a vote of 5-2. Ward 1 Alderman Ben Carver and Ward 5 Alderman Patrick Miller voted against the contract.

The approval of the contract is contingent on Pafford agreeing to three different section revisions of the contract, which was initially rejected by the company. The approval of the EMS district is also contingent on the approval of the contract.

The first revision is for an indemnification provision, which means if Pafford, or someone associated with Pafford did something to create liability, then Pafford would defend the city and pay off any judgement.

The second revision is that Pafford would release and discharge the city for any liability that may come up associated with the agreement.

The final revision is a waiver of subrogation in favor of the city, meaning Pafford won’t ever subrogate.

If Pafford refuses to accept the revisions, there will not be a deal. If accepted, the preliminary start date is Aug. 1 of this year.

Pafford proposed it would provide four advanced life support ambulances within the city with three housed at Fire Stations One, Two and Five.

Those ambulances would be stocked with ALS equipment and would have automatic ventilators and CPR tools. Along with equipment, it would provide extensive training, equipment and protocols to the Starkville Fire Department, making SFD an ALS first response agency.

Pafford will pay for the required remodeling of the three fire stations to house the ambulance and crew.

The proposed idea from OCH Regional Medical Center was to station three OCH ambulances at three fire stations. This would minimize the number of fire truck responses, while continuing to provide the citizens the benefits of OCH EMS.


Carver said he felt the city should award the service to OCH for a year, and have a daily call log to identify response times.

He said if the board is not happy with the results, then it could move to an agreement with a private sector.

Another concern Carver had was the cost associated with a private entity in terms of rates. He said the higher rates could set back families and people who are of low income.

“We need to be careful for those individuals,” Carver said.

Carver said the board should give OCH the chance at the service, and to cut their response times because he trusts the physicians and director of the ambulance services.

“I think this is something that has been brought into the light,” Carver said. “I think either way Oktibbeha County will benefit from this discussion.”

Ward 3 Alderman David Little said prior to the potential ambulance service being brought to the board for discussion, he was unaware of response time issues.

“Outsourcing I think is not a bad idea,” Little said. “Just because we’ve done something for 40 years doesn’t mean it’s the right way to do it, there may be a better way.”

As for an increased rate, Little said in emergency situations, rates do not matter. He said information brought to the board from Starkville Fire Department Chief Charles Yarbrough showed 20-minute response times to calls.

“If I’m needing an ambulance, if a loved one needs an ambulance, I don’t care what the rate is, “Little said. “I want to hear a siren quick and not 42 minutes later.”

Ward 2 Alderman Sandra Sistrunk said it is the board’s responsibility to have the interest of the community for both public health and safety.

“I believe that we can all agree that we are underserved with the number of ambulances,” Sistrunk said. “That is not a reflection on the hospital, it’s probably a reflection of what it costs to operate ambulances.”

Sistrunk also referenced the data Yarbrough brought to the board. The information was a recap of response times in three months.

“He found that 25 percent of the ambulance calls had a response time of over 10 minutes,” Sistrunk said. “Minutes matter, particularly in a medical emergency.”

Sistrunk said if the county provided more funds to help the hospital provide the services, she would like for it to stay with OCH.

“That’s not the reality,” Sistrunk said.

She said the reality is, there has not been the funding available to OCH from the county to expand services to meet the city’s current needs.

Yarbrough was asked by the board to give his recommendation and he wanted the board to go with Pafford’s proposal.


Director of Emergency Medical Services Michael Hunt said he was upset with the board’s decision, but OCH will continue its mission of providing quality health care for residents.

“We still believe we provide a whole lot better service, and we’re still going to be here for the people,” Hunt said.

When asked about the concerns of response times, CEO and Administrator of OCH Regional Medical Center Richard Hilton said since his time at the hospital began 1983, he has not heard of there being any issues.

“There has not been one time where our emergency room doctors have said response times is affecting patient care from the scene of the accident to the time of arrival at the hospital,” Hilton said.

He said if there were concerns, the board should have had discussions with their physicians if patient care had been compromised.

Hilton said the decision will cause financial harm to the hospital, but it will also affect the revenue stream for Pafford.

Moving forward, Hilton said he hopes this agreement with Pafford works for the city, but he does foresee some issues.

“I think in the long term, there will probably be some adjustments made down the road,” Hilton said.