By Milton Kirby | Decatur, GA | November 20, 2025
DeKalb County leaders have approved a five-year, nearly $78 million contract to strengthen ambulance coverage, boost emergency medical staffing, and continue lowering EMS response times across the county.
The Board of Commissioners voted unanimously Tuesday to adopt the new contract with American Medical Response (AMR), setting a maximum value of $77,773,900 based on performance. County officials say the agreement will support long-term growth, expand coverage, and build on the measurable improvements achieved over the past year.
Daily Ambulance Coverage to Reach 600 Unit Hours
The new contract increases daily unit hours—the number of hours ambulances are staffed and in service—to 600 per day, the highest in county history. The agreement also launches several major upgrades, including:
- More ambulances in service daily
- Improved response-time compliance through additional units and resources
- A supplemental ambulance provider during peak call times
- Expansion of the Nurse Navigator program and social-services outreach
- A whole-blood program for trauma care
- A third ambulance deployment center
- AI-based analytics to improve ambulance posting and enhance patient care
County officials said these investments will help stabilize the system, especially during peak call periods and high-demand events.
County Leaders Say the System Is Moving in the Right Direction
CEO Lorraine Cochran-Johnson said the new contract continues the county’s push to build a modern, high-performing EMS system.
“As we continue to reimagine how EMS is provided in DeKalb County, I am excited at the progress we have made and expect this contract will allow us to better serve our residents,” Cochran-Johnson said. “We will have a world-class emergency medical service.”
Fire Chief Darnell Fullum also praised the results from earlier investments and said the new agreement positions the county for long-term success.
“I am excited about the positive outcomes we’ve achieved since the beginning of the year,” Fullum said. “This contract is a roadmap for success.”
Commissioner LaDena Bolton, who chairs the Employee Relations and Public Safety (ERPS) Committee, said the final agreement reflects community concerns raised during last year’s debate over an extension.
“Earlier this year I voted against an 18-month extension with AMR to push for a competitive RFP process that would secure a long-term contract meeting the service delivery our community deserves,” Bolton said. “Tuesday’s agreement not only ensures improved emergency response, but also provides real-time support for non-emergency calls and alternative ambulatory options. Through deliberation and compromise, we have positioned DeKalb County to deliver excellence in emergency medical services for the next five years.”
Improvements in 2025: Faster Response Times and More Unit Hours
In 2025, the county implemented an AMR contract extension that included a $4.9 million subsidy to increase ambulance availability. The investment immediately raised average daily unit hours from 456 in 2024 to 583 in the third quarter of 2025—a 28 percent increase.
According to county officials:
- Response times for critical emergencies, such as heart attacks, are now 23 percent lower than at the peak of the COVID-19 pandemic.
- All major emergency call types recorded their fastest response times since early 2020 through September 2025.
County leaders credit the gains to more ambulances, the Nurse Navigator system, additional county-funded EMS staff, and improved deployment strategies.
Audit Showed the System Was Underfunded
In 2024, DeKalb County hired Fitch and Associates to conduct a full review of EMS operations. The assessment found that the system was underfunded and recommended an investment between $12.6 million and $16.5 million, depending on the preferred design.
Key recommendations included:
- Ensuring long-term financial and operational sustainability
- Improving response-time performance
- Reducing hospital offload delays
- Expanding unit availability during peak hours
- Updating EMS unit deployment locations
County officials say these findings guided both the 2025 contract extension and the new competitive RFP process that shaped the five-year agreement approved this week.
Years of Concerns Led to System Overhaul
DeKalb has spent years working to resolve concerns about slow ambulance response times. In 2024, leaders in Brookhaven and Dunwoody raised alarms after emergencies sometimes exceeded 20 minutes—well above the 12-minute benchmark for high-priority calls. Some residents reported waits of more than 25 minutes.
Earlier issues date back to 2018, when the county negotiated staffing and reporting reforms with AMR following service-related complaints.
But by mid-2025, county reports showed major improvement. A June 2025 update documented ambulances arriving nearly three minutes faster on average than before February 2024.
What’s Next
County officials say a press conference is planned for next week to outline the implementation timeline, explain upcoming deployment changes, and discuss additional components of the AMR contract.
The new agreement takes effect in 2026 and is expected to guide the county’s emergency medical services strategy for the next five years.
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