Ambulances are parked at University of Mississippi Medical Center in Jackson on Friday, Jan. 28, 2022. Credit: Eric Shelton/Mississippi Today

Some major Mississippi cities that have used the same private ambulance contractor for decades are reconsidering that relationship in light of questions about response times and potentially deadly consequences. 

Leaders in Biloxi, Gulfport and Jackson have discussed American Medical Response’s ambulance response and the contracts with that service during recent city council meetings. They have said that forming city-specific ambulance districts is a step toward pursuing city-specific ambulance contracts, rather than being part of  countywide contracts.  

It’s a step Jackson resident Donna Echols sees as encouraging. On April 27, she waited 90 minutes for an AMR ambulance to come to her home to help her ex-husband, Jim Mabus, who was found to have suffered a series of strokes and died less than a week later. 

“It magnifies the problem that we experienced in that 90-minute wake,” she said. “It tells me people are dealing with the same issues and problems and they want to get something done.” 

Councilwoman Angelique Lee, who had read Mississippi Today’s story about Mabus, invited Echols to speak at a June 22 Jackson City Council meeting. 

Lee read the company’s explanation in the story for the 90-minute wait – staffing – and said long response times like the one Mabus faced are unacceptable and inexcusable. 

AMR spokesperson Nicole Michel told Mississippi Today that the central Mississippi service area was at a level zero on April 27, with eight ambulances and two sprint medics already responding to other calls, and during the nine o’clock hour, AMR received six service requests, including one for a heart attack. 

“If AMR cannot handle the call, if they don’t have the manpower, then they need to be replaced,” Lee said during the meeting. “And I just want to know how many people are going to need to die before we do something about it?”

Mayor Chokwe Antar Lumumba said steps are being taken to reconsider the city’s ambulance service. Jackson has already formed its own ambulance district and the city is preparing to put out a request for proposals for ambulance services. 

Lumumba said these efforts would give city control of a contract, and it can make sure to incorporate a mutual aid clause, which Echols believes may have helped Mabus get medical attention sooner.  

The night she called 911, Echols tried to get Pafford Ambulance, which is contracted with Madison and Rankin counties, to come to her home, but she was told that company needed permission from AMR to cross into Hinds County where AMR operates. 

Ryan Wilson, operations manager for AMR Central Mississippi, said the company has been the county’s contractor since 1991. Analysis of any ambulance issues and plans must be in line with the Hinds County Board of Supervisors.

Hinds County officials did not respond to a request for comment. 

Wilson also cautioned Jackson about taking independent steps that could have potential consequences that impact other cities, towns and unincorporated areas of the county. 

“It is AMR’s hope that all governmental entities will come together to address ambulance-related issues, jointly,” he said in a statement. “Such a collaborative effort would inspire a countywide examination of the current state of EMS, as well as add understanding to the causes of current challenges, leading to an informed discussion of options to a path forward.” 

Wilson also said blaming AMR for its staff shortage is misguided due to a nationwide shortage of EMTs and paramedics, and bringing in another provider won’t necessarily address staffing. 

In Jackson, family and friends are preparing to hold a celebration of life service for Mabus Saturday to reflect on the life he lived and the person he was. Days later, on July 18, is Mabus’ birthday. 

Jim Mabus, left, is pictured with his family at Christmas family photo left to right, daughter-in-law Mary Katherine Mabus, son Jake Mabus, and Denver Mabus with Donna Echols’ dogs Credit: Courtesy of Donna Echols

Echols wants the celebration to be a happy occasion, but she knows her sons are grieving and she still feels angry about what happened. While it is difficult to retell, she sees sharing the story of what happened as a way to turn a tragic experience into a way to help others. 

Similar discussion about ambulance service, city-specific EMS districts and potential contracts are also happening on the Gulf Coast. 

At a June 20 meeting, the Gulfport City Council discussed a resolution to establish an EMS district, but members voted to table it. 

Mayor Billy Hewes said the city plans to put out a request for proposals for ambulance services, which could result in Gulfport choosing AMR again, but it would mean city leaders can negotiate. 

“Sometimes we have to take moves like this to ensure we have a voice in something that is very important to our constituents, and quite frankly, the citizens of Gulfport deserve better ambulance services than they are getting,” he said during the meeting. 

Neighboring Biloxi approved a resolution to set up a city-specific EMS district at its June 13 meeting as part of its consent agenda. 

Fire Chief Nicholaus Geiser said a city-specific RFP and contract are the next steps. 

He said the city has seen some delayed ambulance responses from AMR, especially between 2020 and 2022, when there would be a large number of calls all at once and not enough staff to handle them, but that is happening less now. 

There have been times when a life-threatening call in a different area of the county has been prioritized, which led to an hour wait or longer, Geiser said. 

He sees AMR has taken steps to work to improve its response times in the county, such as having a dedicated ambulance in Biloxi, which was determined after analyzing data and the city’s busy times. There are also supervisors going out who can relieve fire department crews. 

Dwayne Tullos, regional director for AMR’s parent company Global Medical Response, said AMR has served the Gulf Coast for nearly 50 years and believes there is no other provider that can deliver higher standards of care and innovation. 

“If the cities decide to contract for their own ambulance services, we look forward to the opportunity to work with city leaders on a customized proposal for each that includes new innovative solutions that only AMR can provide to the citizens of Biloxi and Gulfport,” he said in a statement. 

Even if the cities continue to stay within the Harrison County EMS district, AMR is open to working with them to find solutions that ensure the best ambulance service for residents and visitors, Tullos said. 

Firefighters, including in Biloxi, Gulfport and Jackson, are often required to train as EMTs and some have gone further and become paramedics. However, that training doesn’t give them the ability to transport people to the hospital. 

Geiser, the Biloxi fire chief, said 80% of the department’s calls are for medical service. He said building codes have helped prevent many large-scales fires from happening, so crews are called to fires less often. 

He read the Mississippi Today story about Echols’ experience waiting for an ambulance and said what happened to Mabus was unfortunate. 

“It’s plain and simple: It’s life and death,” he said. “That’s what we’re trying to prevent here.” 

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Mina, a California native, covers the criminal justice system. Before joining Mississippi Today, she was a reporter for the Clarion Ledger and newspapers in Massachusetts. Her work has appeared in the Los Angeles Times, Boston Globe and USA Today.