Johnson City, Tenn (WJHL)- Ballad Health has released new details on when and how they plan to realign trauma services in the region.

Last fall, Ballad announced their plan to consolidate level one trauma services in Johnson City and downgrade services at Kingsport’s Holston Valley Medical Center and Bristol Regional Medical Center.

MORE: Ballad Health CEO Alan Levine answers questions about changes to trauma care

According to Ballad officials, Holston Valley will transition to a level III trauma center on October 1, 2019.

Bristol Regional Medical Center’s level II trauma center is expected to transition to a level III in 2021.

Ballad officials said, “The timing for each location as determined by factors related to staffing, input from the physician-led trauma steering committee, and ongoing enhancements at Johnson City Medical Center. ” They added in a statement to News Channel 11, “We want to reassure community members that all emergency rooms in Sullivan County are open and will remain open. Holston Valley and Bristol Regional will continue to provide trauma care going forward and will be well equipped to address any type of medical emergency. Anyone with a medical emergency should always go to the nearest emergency room or call 911.”

PREVIOUS STORY: Ballad planning to make changes to regional trauma care

Ballad Health’s Senior Vice President of Market Operations Eric Deaton said a very small percentage of what he called “major traumas” will be transported to Johnson City.

Tim Bradshaw, a volunteer EMS provider, raised concerns about the impact longer transport times could have on local agencies.

He said the trip to Johnson City could put strain on EMS, putting vehicles out of circulation and jeopardizing response times in a service area.

“Slow down and give the processes time to work and give the agencies that are going to be effected time to address how they’re going to implement their response plan,” Bradshaw said.

Deaton said they’ve been collaborating closely with EMS providers since announcing their changes to mitigate delays.

“Ballad has kept us informed from the beginning on this,” said Sullivan County EMS Chief Jim Perry. “There has not been a lack of communications with EMS.”

Bradshaw disagreed, saying he’s been trying to set up a meeting with Ballad leadership for months, an offer he said they recently declined.

“Ballad Health has had the opportunity to engage and communicate and work with the community and they have repeatedly declined and brushed us off,” said Bradshaw.

Deaton said Ballad recently hired an EMS liaison to reach out to local agencies.

He said they’re also open to helping them expand their transport resources ahead of implementation.

“No one has approached us about needing additional vehicles. We’re very open to any conversation that EMS wants about helping us support them,” he said.

Deaton said Ballad has already put in place a centralized call center to make field to facility communication more efficient.

“It’s a big improvement because the folks in that communications center are dedicated to answering the radios for EMS at all times,” said Perry.

On August 1st, Deaton said Ballad will also finalize a Healthcare Resource Tracking System, a digital platform EMS providers can use in the field to track availability of specialists and other hospital resources in real time.

Deaton said Ballad is also planning to make upgrades to Johnson City Medical Center’s Emergency Department to prepare for a potential influx of patients.

He said they’re adding an additional helipad to speed air traffic flow, for example.

The renovations are expected to be complete by late spring 2020.

When asked why Ballad isn’t waiting to downgrade Holston Valley’s services until after these upgrades are complete, Deaton said they wanted to make the transition before the state re-certifies trauma levels on January 1, 2020.

Ballad said it’s also imperative they stick to the October 2019 timeline due to recent staffing changes at Holston Valley.

Deaton confirmed that two trauma surgeons recently resigned after their contracts ended in June.

He said one of them is staying on through September to help with the transition and they’re receiving additional support from surgeons at the University of Tennessee in Knoxville.

Deaton said, when the Holston Valley is officially downgraded to a level three trauma center, some general surgeons will operate on trauma patients.

“General surgeons are trained to take care of trauma patients as well, it’s the way it’s done in Bristol right now,” said Deaton. “We’re not going to force general surgeons to take any calls they’re not comfortable taking.”