After months of negotiation, Madison County supervisors inked a contract with a new ambulance provider aimed at lowering response times and dedicating more ambulances to the county.

The county dropped its current provider, AMR, by not extending a contract and instead signed up with Pafford Emergency Medical Services. Pafford plans to be up and running by May 10.

County Administrator Tony Greer said Pafford has agreed to provide four advanced life support (ALS) ambulances in the county 24/7. With AMR, only one ambulance was stationed in Madison County.

In addition, Pafford will supply basic life support (BLS) ambulances equipped with EMTs instead of paramedics for non-emergency transfer runs.

Greer said the BLS units would be useful when transporting patients from a nursing home to a hospital for example.

Pafford has agreed to station one ALS unit in Canton, one in Flora, and the other two in the Madison-Ridgeland area.

Keith Carter, Pafford COO, said they had not determined yet where the Madison and Ridgeland ambulances would be stationed but they would hope to be able to create a larger sub-station to house the two near the city lines.

"We have two options on the table to put one larger substation at the Madison-Ridgeland line or we may have to separate that into two substations," he said.

Pafford will be required to have response time of 10 minutes in Ridgeland, Madison and Canton 90 percent of the time. In Flora and the rest of the county that time is expected to be 20 minutes or less 90 percent of the time.

The contract includes five exceptions to response times: adverse or extreme weather conditions, excessive traffic events, train crossings, excessive loads from mass casualty events, and excessive ER wait times.

District 3 Supervisor Gerald Steen asked about Gluckstadt and response times being 20 minutes opposed to the 10 for other cities in the county.

"Glückstadt is 20 minutes and it's growing and growing," he said. "That concerns me a little bit."

Carter said Gluckstadt is primarily rooftops and people are gone from 8 a.m.-5 p.m. during surge times.

"The volume in Gluckstadt today or next year does not justify (that)," Carter said. "If we find in the future and that continues to grow...we would have to put an ambulance there. During the day there's no population there."

Carter added that he hopes to add more ambulances in the county as the years go by.

District 4 Supervisor David Bishop questioned if patients would have the opportunity to pick which hospital they went to.

Carter said the patient has final say in where they go but they have relationships with medical providers and will make suggestions based on the type of call.

The new contract was approved 4-0 by supervisors, with Board President Trey Baxter absent from the meeting.

Supervisors also made changes to its countywide ambulance ordinance to accommodate the new contract.

The 20-year-old ordinance that was in place had amongst other things a $50 million insurance umbrella policy requirement.

"The insurance requirement has been changed to affect a $1 million to $2 million liability," Greer said. "Nobody uses $50 million as an umbrella coverage. In fact, the state requirement is substantially less."

Other language stripped out required the county to have a licensing agent and licensing procedures for ambulances.