A First Response Ambulance Service official says the company remains unable to obtain a $2 million performance bond required by Decatur's new ambulance service ordinance and denies the first complaint filed under the regulations.
David Childers, First Response director of operations, presented the Ambulance Regulatory Board at its inaugural meeting Tuesday with a letter from Valent Group, a Decatur-based insurance company, that rejected his company’s latest attempt at getting the required bond.
Childers said the city recommended Valent recently after his attempts to get a performance bond from other companies were unsuccessful.
Childers said there are several reasons for the denials. The bond companies want a contract and they want to know how a bond would be cashed in, whether it would be a one-time draw or payments spread over time, he said.
Childers said the gross revenues created by his ambulance service from its operations in the city aren’t enough to justify a $2 million bond and said the city “has a problem proving a $2 million loss.”
Police Chief Nate Allen asked Childers what can be done to remedy the issue.
“We can keep searching (for a bonding),” Childers said. “And there may need to be changes to the ordinance to reflect the need for a contract and possible reduction in the bond amount.”
The new ordinance took effect Sept. 22.
Fire Chief Tony Grande, the board chairman, asked Childers to provide a copy of the Valent letter to the city’s Legal Department, which he suggested might be able to help First Response obtain the bond.
Grande said afterward that Tuesday's session was an organizational meeting so the board wasn’t ready to begin enforcing the new ordinance, which includes financial and point penalties for failing to meet required response times.
He said the ordinance began at the end of the fourth quarter of 2019, so he expects the board and the new EMS coordinator, Decatur Fire and Rescue Battalion Chief Ashley England, to begin enforcing response time requirements in the first quarter of fiscal 2020, which began Oct. 1.
“We’re already tracking response times,” Grande said.
In other business, Decatur Morgan Hospital filed the first formal complaint under the new ordinance against First Response. The family of the patient also complained to Grande.
The complaint read by England focused on a 7 p.m. Sept. 24 incident in which First Response took more than two hours to pick up a patient on a non-emergency call.
Huntsville Hospital’s beds were full so the patient, who had a neuro-emergency issue, needed to be transferred to UAB Hospital. UAB already had a room and a doctor waiting to tend to the patient.
England said the complaint, which could mean a 2-point penalty under the new ordinance, says First Response twice went to the hospital and left. England said that until he was called to intercede and First Response officials got involved, the patient was not picked up by the ambulance company.
Childers said the hospital had not filled out the necessary paperwork properly so his company could get reimbursed by Medicare for the non-emergency transport.
“If it’s an emergency call, we’ll take the call even if we have to take a loss,” Childers said. “But we’re not willing to change paperwork and be involved in what could be fraud.”
The new ordinance allows the ambulance service to turn down non-emergency calls.
Grande said there appears to have been a conflict between a doctor and a paramedic on deciding whether the patient needed to be transported.
“A paramedic should never overrule a doctor,” Grande said.
Childers said the paperwork must be accurate on non-emergency calls or his company can get in trouble with the state.
Childers said he doesn’t want his employees making decisions on whether to provide a transfer. He suggested the hospital needs to employ an administrator who makes sure its paperwork is filled out properly.
Grande suggested Childers place someone at the hospital who oversees the paperwork.
Councilman Charles Kirby attended the meeting, and he said afterward it was ridiculous to suggest First Response place someone at the hospital.
“They should tell the family the hospital screwed up,” Kirby said. “But they want to get on the company that didn’t cause the problem. It’s the hospital’s job to get the paperwork right.”
Childers told the ARB that he met with hospital officials and plans to continue meeting with them in an attempt to solve the paperwork issue.
Grande said afterward he may discuss the complaint again at next month’s meeting if there’s not a resolution between the two parties.