- Oliver Parini
- Ryan Ferris
In September 2019, Ryan Ferris opened his new emergency medical services company, now called Garnet Health. Six months later, the business nearly flatlined. Why?
Its customer base virtually disappeared.
Garnet's ambulances and medical crews are licensed and equipped like those of any EMS rescue squad in Vermont, but they don't respond to 911 calls. Instead, they transport patients from one medical facility to another throughout New England and northern New York, provided those patients start or finish their trips in Vermont.
"When the pandemic hit, the hospitals didn't move patients unless it was absolutely necessary," explained Ferris, Garnet's cofounder, president and CEO. "In the EMS industry, you don't make money unless you have billable services, and billable services means patients on board."
Within weeks of COVID-19's arrival in Vermont, transports by the for-profit company, headquartered on the GlobalFoundries campus in Essex Junction, fell by half. For a time it looked like the business might succumb, and Ferris wasn't sure how to save it.
Nearly a year later, Garnet hasn't just fully recovered. It's grown to more than 80 employees and is now the state's largest commercial provider of COVID-19 testing. It tests travelers arriving at Burlington International Airport and provides in-home swabs of high-risk patients for the University of Vermont Medical Center.
Garnet also operates the state's two busiest testing sites, in Burlington and Middlebury, and has a contract with CIC Health to screen inmates and staff at the Vermont Department of Corrections. The company provides testing for corporations, summer camps and individuals. Ferris estimated that in December, Garnet performed more than 1,000 swabs per day.
"I'd be lying if I told you that [COVID-19 testing] didn't have any effect on keeping the business solvent," he said, noting that the company avoided layoffs and only reduced pay for its top management. "As awful as COVID is, and as much as I want it to be over as the next person, quite honestly, it saved the business from going under."
It's been a meteoric rise for Ferris, who didn't set out for a career in EMS. The 35-year-old Montpelier native earned a degree in television studies from what's now called Northern Vermont University-Lyndon. During his first year, he trained as an emergency medical technician; later in his college years, he rode with Lyndon Rescue, then CALEX Ambulance Service in St. Johnsbury.
Ferris freelanced for ESPN after college, planning to follow in the footsteps of his great-great-uncle, legendary Vermont broadcaster Jack Barry. But after the 2008 recession, when broadcasting jobs evaporated, EMS work became his lifeline.
In 2010, Ferris took a job with the UVM Medical Center's critical care transport team while training as a paramedic. For several years, he worked in Seattle for Remote Medical International, providing medical services to the oil and gas industry. In 2015, he returned to Vermont — where, two years later, he began working on Garnet's business plan.
The new, for-profit ambulance service faced resistance in Vermont's EMS community. In a 2019 letter to the Vermont Department of Health, the nonprofit Essex Rescue voiced concern that Garnet would undercut its revenue stream by taking 911 calls and would have "widespread destabilizing effects" on Vermont's EMS system, according to the Essex Reporter.
"We were seen as a threat," Ferris recalled. "There was this fear that we were going to come in and start taking over, which couldn't be further from the truth."
To get licensed by the state health department, Garnet needed recommendations from other regional EMS providers, including competing for-profit ambulance services. Garnet Transport Medicine, as the company was initially named, eventually got the green light.
Then came the pandemic.
Garnet's foray into COVID-19 testing happened almost by accident. Ferris was working late one evening when a call came in from an assisted-living facility requesting an ambulance to transport an infirm woman to and from a testing site. Realizing that this would be a very expensive ride — at least $500, by his estimate — Ferris contacted the UVM Medical Center to see whether, together, they could devise a more cost-efficient solution.
Ultimately, Garnet didn't transport the woman, Ferris said, but the call prompted discussions with the hospital and the state, which eventually gave Garnet permission to do mobile in-home testing. This approach isn't just cheaper, Ferris explained, it's safer for patients, especially those with mobility issues and underlying health conditions.
By June, Garnet was providing mobile testing to summer camps throughout Vermont and Maine, processing 300 to 400 campers per day. The service was so popular that Garnet had to turn down requests. In October, it started offering rapid-result testing at the airport and direct-to-consumer testing to corporate staffs and individuals.
Protecting Garnet's patients and staff from the coronavirus has been costly and time-consuming. When the pandemic heated up last March, the company bought its employees durable respirators, which are similar to gas masks. Having them also safeguards Garnet from supply-chain shortages of the disposable N95 masks.
The company implemented other safety measures. Ambulances that transport known COVID-19 cases — such as the patients from Burlington Health & Rehabilitation Center whom Garnet transported during last spring's outbreak — are thoroughly disinfected. All equipment is wiped down by hand and decontaminated with hydrogen peroxide foggers, then taken out of service for 48 hours before being disinfected again.
"Maybe it's overkill ... but obviously it's done us well," said Ferris, none of whose employees has contracted COVID-19 from an occupational exposure.
The company hit other bumps in the road. Weeks after Garnet Transport Medicine changed its name to Garnet Health, in June, a corporate health care system in New York's Hudson Valley adopted the same name. That company made news in January for allegedly administering COVID-19 vaccines to board members and fundraisers of its hospitals — who, not being clinical staff, were ineligible under New York's vaccine prioritization system.
"We are most certainly not affiliated with them," Ferris clarified. He said another name change is likely.
The new moniker could reflect Garnet's still-expanding mission, which will involve even more mobile services. Last week, Garnet's crews began administering 50 doses of COVID-19 vaccines to homebound and high-risk patients too weak or infirm to travel. As Ferris put it, "We're looking at bringing back the house call."
More evidence that what doesn't kill us makes us stronger.
Correction: March 5, 2021: An earlier version of this story misidentified Garnet Health as the state’s sole commercial provider of COVID-19 testing. CIC Health, of Cambridge, Mass., also provides commercial testing in Vermont.