On Monday, July 27, at 6:00 p.m., Troy City Council will hold a special meeting devoted exclusively to evaluating EMS performance during the first six months of the City’s new ambulance contract.
This meeting needs to result in more than explanations. It must produce a clear corrective plan, meaningful transparency and an EMS system designed around the needs of Troy, not around the convenience of a private contractor.
The background
Troy commissioned an extensive EMS feasibility study because the previous system was not performing adequately. The study concluded that Troy could support a six-minute ambulance travel-time goal with four ambulances available around the clock. It recommended positioning those units at Fire Stations 1, 2, 3 and 5, with a fifth peak-demand ambulance because the source data did not fully capture calls handled by mutual or automatic aid.
That was the identified need: a properly staffed, strategically deployed and accountable EMS system.
What Troy purchased
Instead of requiring five dedicated ambulances during the day and four overnight, Troy entered into a performance-based arrangement. Star EMS proposed using “system status management,” dynamically moving units from its system-wide fleet according to demand, availability and proximity rather than maintaining a fixed number of ambulances at specific Troy locations. The performance-based price was $24,328 per month, compared with $64,262 per month for the fixed dedicated-unit proposal.
In exchange for that flexibility and lower subsidy, the contract requires ambulance response within six minutes for 90% of emergency responses.
That is the bargain. Star EMS was not required to maintain a particular number of fixed ambulances because it promised to deliver the required performance.
What Troy received
Using the emergency-response numbers published in the monthly reports (within six minutes) not accounting for the additional nearly 2 minutes of processing time:
| January | 70.6% |
| February | 83.6% |
| March | 72.4% |
| April | 82.6% |
| May | 75.5% |
| June | 76.5% |
The six-month total is 2,130 of 2,783 reported emergency responses within six minutes, approximately 76.5%.
That means the six-minute standard was missed during every single month of the contract. Of the reported emergency responses, 653 took longer than six minutes.
The reports prominently advertise an “average” emergency response time, 4:43 in June, but an average is not the contractual performance measurement. The contract requires 90% compliance, and June achieved only 76.48%.
There is another important issue: the citizen’s clock starts when someone calls 911, not when the ambulance company’s contractual clock starts.
For June, the report lists an average emergency call-processing time of 1 minute, 49 seconds, followed by an average ambulance-response interval of 4 minutes, 43 seconds. Adding those separately reported intervals produces approximately 6 minutes, 32 seconds from call processing through ambulance arrival, even before examining the calls that took substantially longer than the average.
The transparency problem
Despite the seriousness of these results, residents and Council are receiving only high-level monthly summaries.
We are not being shown, for each call:
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- The date, time and general geographic area
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- The dispatch priority
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- When 911 received the call
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- When the call was transferred to Star EMS
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- When an ambulance was assigned and began moving
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- Which unit responded and where it originated
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- How many ambulances were available in Troy at that moment
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- Whether the call was downgraded, excluded, referred or handled through mutual aid
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- Whether the responding ambulance was already inside Troy
The reporting provisions require information regarding response-time compliance, referrals, call downgrades and other records necessary to determine contractual compliance. They also permit the City to request the data electronically.
Yet the City previously stated that it does not independently log basic call data such as dates and times unless a police officer is assigned and a police report is created. The contract also allows an independent audit of the raw data when the provider’s information conflicts with actual field information.
Without de-identified call-level data and deployment records, neither Council nor the public can independently verify the summaries, identify geographic gaps, determine whether insufficient ambulance availability caused the delays or evaluate whether the dynamic deployment model is working.
What needs to change
Troy should immediately require:
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- Monthly release of de-identified, call-level data containing every major timestamp, call priority, responding unit, general location, downgrade, exclusion, referral and mutual-aid response.
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- Daily and shift-level deployment reporting showing how many ambulances were assigned to Troy, where they were positioned and how often no Star EMS unit was available within the city.
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- Measurement of the entire emergency-response chain, beginning when 911 answers—not simply when the vendor’s contractual clock begins.
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- A formal corrective-action plan with monthly benchmarks, deadlines and consequences for continued failure to reach 90% compliance.
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- Independent validation of the raw CAD and response data, rather than relying exclusively on summaries prepared by the company whose performance is being evaluated.
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- A change in deployment if the current model cannot perform. That may mean requiring the fixed four-ambulance, 24-hour deployment identified by the feasibility study, adding the recommended fifth peak unit or seriously advancing a Troy-operated EMS system.
This is not criticism of the paramedics and EMTs doing difficult work in the field. It is about whether Troy has designed, funded, supervised and enforced the system necessary for those professionals to reach patients quickly.
Troy has approximately 90,000 residents, a daytime population that can approach 200,000 and enormous daily traffic volumes along I-75. We cannot manage emergency medical care like a small town, and we cannot judge performance through glossy one-page summaries and carefully selected averages.
The residents, workers and visitors of Troy deserve an EMS system that is adequately staffed, strategically positioned, independently verifiable and held to the standards the City promised them. Public safety cannot be governed by hope. It must be governed by data, transparency and accountability.