The Jefferson County Commission was told during its committee meeting Tuesday that it needs to declare a public health and safety emergency when it comes to emergency medical service in the county.

Todd Sheridan is a senior associate with Fitch and Associates, the firm hired to research issues in ambulance response times in Jefferson County. His report today laid out a picture in which some parts of the metro area could have multiple ambulance services responding to a call while others could have none.

And some of those who do get responses may have to wait as long as 4½ hours.

At least 15 first responders circled the room where commissioners met. They heard Sheridan give four options for the commission. They ranged from purchasing ambulance coverage from external EMS agencies to centralizing purchases and creating a single provider system. “Option zero,” maintaining the status quo, “is no longer an option,” he said.

Commissioner Joe Knight, the chair of the commission’s finance committee, asked how much it would cost to bring a unified emergency medical service online. Sheridan said $10 million, and at least a few of the first responders on hand said that figure was low.

Jon A. Lord is fire chief of the Rocky Ridge Fire District. He described instances in which his department has answered calls in western Jefferson County, including Brighton, Lipscomb, Fairfield, McCalla, Johns, Adger, Birmingport, Concord and along the Warrior River.

“These are just a few that we have been to in the last two years to assist with transportation of a patient when no ambulance is available,” said Lord, who is president of the Jefferson County Fire Department Association and chairman of Jefferson County 911. “We need everybody involved and everybody to help “That’s what it’s going to take, and the commission are the ones that can lead it. Without them leading, we’re not going anywhere. That’s the bottom line.”

Josh Bryant is fire marshal with the Glennwood Fire District and a member of the Fultondale City Council. He said the biggest challenge to providing emergency medical service throughout the county is funding and staffing.

“Even if we had staffing, we don’t have the funding to pay them,” Bryant said. “But even with additional funding, we’re having a hard time finding staffing. There’s a lot of things that we would love to be able to do – across the cities, across the counties – to be able to make responses better.”

Echoing Lord, Bryant said covering areas outside of their own district leaves their home base areas uncovered.

“There’s nobody picking up that slack to cover the rest of the areas,” Bryant said. “I really think that’s where the commission can really take some leadership and say, “We’re going to do whatever it takes to cover those uncovered areas,” even if that means supplementing the districts in the cities that are already providing that – or even the private agencies that are providing it – to be able to supplement those to help with that funding and staffing issue.”

A related issue is getting more people to decide to be paramedics. “That’s a long-term problem that we can only fix with schooling and better pay,” Bryant said.

Commission President Jimmie Stephens appointed Commissioner Steve Ammons to chair a committee to study the matter.

Ammons said his focus has been regional cooperation, adding that the Jefferson County Mayors Association has already looked into establishing a regional 911 system. He added that fire chiefs in the metro area will examine the plan and give feedback.

“What does this mean for their individual jurisdictions? What does it mean for us as a whole?” the commissioner asked, saying they’ll need to determine which parts of the report and which of these options is focused upon first.

“We say it every time. We’re fractured. We’re siloed,” he said. “We have 35 municipalities and 14 PSCAPs (Public Safety Communication Answering Points).

“We can find ways to work together,” Ammons said. “These are just symptoms of a bigger issue, and we’re going to break them down and make sure that we can cure some of these. The issues they brought up in the Fitch report today (are) going to lead to another issue and another issue. We’re just going to have to take baby steps to coordinate to make sure that we get those taken care of.”

This story has been corrected to reflect that Josh Bryant is fire marshal with the Glennwood Fire District .