DeKalb County Board of Commissioners approves $78M contract extension for emergency medical services, targeting improved response time

DECATUR, GA– The DeKalb County Board of Commissioners in a unanimous vote on Nov. 18 approved a new five-year contract.with American Medical Response (AMR) for emergency ambulance services. The total maximum value of the new contract extension based on performance is $77,773,900.

“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,” said CEO Lorraine Cochran-Johnson. “We will have a world-class emergency medical service.”

The new contract will increase unit hours to 600 per day, along with other initiatives including:

• Increased number of ambulances in the system daily
• Improved response time compliance through additional units and resources
• Supplemental ambulance provider to support peak call times.
• Expansion of the Nurse Navigator program and social services support for residents
• Whole blood program for trauma injuries
• Addition of a third ambulance deployment center in the county
• Use of AI analytics to enhance the unit posting system and improve the quality of care

“I am excited about the positive outcomes we’ve achieved since the beginning of the year,”  added DeKalb Fire Chief Darnell Fullum. “This contract is a roadmap for success.”

Improvements in 2025

The 2025 contract extension, which included a $4.9 million subsidy to the AMR, has already boosted ambulance availability in the county, with the daily unit-hour average rising to 583 in Q3 of 2025, compared to 456 in 2024. This 28% increase in unit hours has led to shorter response times across all call types. 

In 2024, DeKalb County contracted with Fitch and Associates to review the overall EMS service delivery, which identified opportunities to improve the service model. The Fitch and Associates report provided the county with performance guidance, best practices, and projected costs to implement improvements in the EMS system. 

The report indicated that the EMS system was underfunded and would require a larger investment of “between $12.6 and $16.5 million,” based on system design.    

Key findings and recommendations: 

• Ensure long-term fiscal and operational sustainability for the provision of EMS
• Evaluate and select the desired system design and response time objectives
• Improve the EMS system at the hospital (ambulance patient offload time)
• Improve EMS system response time performance and availability of units
• Alternate EMS unit locations and deployment

This guidance helped DeKalb County implement a contract extension in January 2025 with AMR and manage the Request for Proposal (RFP) process. 

Response times to critical calls (such as heart attacks) are 23% lower under the current contract extension compared to the pandemic’s peak. Overall, all emergency call types (like difficulty breathing) have experienced their fastest response times since the beginning of the COVID-19 pandemic through September 2025.