The city of Decatur's plan to handle new competition between rival ambulance services will dispatch the closest unit for emergencies while allowing non-emergency customers to choose a provider, but there's conflict over the new policies even as they're being implemented.
The Ambulance Regulatory Board approved the plan Tuesday, and Fire Chief Tracy Thornton, the ARB board chamber, said it'll go into effect immediately as Decatur Morgan Hospital’s new ambulance service begins operations.
First Response Ambulance Service began operating in Decatur in 2012 and has had a monopoly since 2014. The City Council approved the hospital’s certificate of public necessity and convenience to operate an ambulance service on Oct. 4.
Thornton said he and Emergency Medical Services Coordinator Ashley England presented the proposed plan to First Response, hospital representatives and Morgan County 911 officials recently.
“We all sat down and worked on the agreement, so I feel confident it will work,” Thornton said.
Hospital President Kelli Powers said after the ARB meeting that she’s pleased with the plan and her EMT director, Tyler Stinson, said, “We sat down in a meeting and both services agreed that was the best plan.”
However, First Response owner David Childers said they were allowed to give little input into the plan.
“We were presented with some documents and told this is how it’s going to be,” Childers said. “There weren’t any questions like how can we make this better, is there anything we need to correct or do you see any problems? Instead, we were told this is the plan.”
Thornton said Childers’ representation of the meeting wasn’t accurate. He said they went over the plan that England wrote and then asked if there were any questions or suggested changes.
“Mr. (Jason) Tindal (of First Response) suggested that, if an ambulance service carries a case to a location, that case remains with that ambulance service,” Thornton said. “That was the only point they brought up and we changed it.”
Stinson said Decatur Morgan Hospital is slowly building its operation. He said the hospital’s plan is eventually to run four ambulances on emergency calls 24 hours a day and two on non-emergency calls each day.
“We’re running two 24-hour trucks a day and a third 12-hour truck a day,” Stinson said. “As we hire more people, we’ll put more trucks on the road.”
First Response has two ambulances running that meet city requirements by having less than 250,000 miles on them. Childers said they purchased three from Canada but returned them because of issues with the seller's paperwork. Childers said his buyer is trying to find alternative vehicles to purchase.
Childers said he does plan to add two or three ambulances before Dec. 31.
The three-part plan for dispatching ambulances says:
• Emergency medical calls will be dispatched by automatic vehicle location to the closest, most appropriate EMS unit for the type of incident. Morgan County 911's computer-aided dispatch (CAD) system will determine the unit’s location.
• Each EMS company will be responsible for positioning its units throughout the city and police jurisdiction. The companies cannot post or park units within 200 feet of each other while available and awaiting assignments.
• Non-emergency, routine medical transports will be assigned to the closest EMS unit appropriate. A non-emergency unit will be chosen first. A person or business can request a specific EMS agency, and Morgan County 911 will not suggest a specific ambulance service. An ambulance service is responsible for notifying Morgan 911 of contracts it has to provide routine transports.
Another issue for city ambulance services involves a change to the ambulance ordinance approved in August. Rolled calls, a call in which an ambulance service is unable to respond, now count against required response times percentages, and this has started to count against First Response times. The company’s on-time response rate in August was 64.1% in the city and 77.8% in the police jurisdiction.
“They had 96 rolled calls in August,” Thornton said. “That’s why their fractal (response) times were so bad.”
The city requires that an ambulance reach a call scene within nine minutes in the city and 12 minutes in the police jurisdiction on at least 90% of calls. Financial and points penalties for failure to meet the 90% threshold are only assessed by the quarter.
However, no numbers for First Response were available in July, and Thornton said Morgan County 911 hasn’t released September’s numbers.
Childers said “there’s a big discrepancy in the numbers” reported at Tuesday’s ARB meeting.
An unresolved issue from the October-to-December 2020 quarter involves 10 points and a $5,000 fine assessed against First Response.
The ARB found that the company did not meet response time requirements in October, November and December and notified the City Council of the penalties.
First Response has not appealed the penalties to City Council or paid the fine. Company officials said it was the responsibility of Thornton or Emergency Medical Services Director Ashley Thornton to notify the City Council of First Response’s appeal.
Assistant City Attorney Chip Alexander said it is First Response’s responsibility to notify the city of its appeal, and the ARB agreed with him. The board voted Tuesday to give First Response 14 days to file an appeal.
Childers said his company “followed the rules" in effect during October-December 2020 that didn't set a deadline for appealing fines above $1,000. He said Morgan County 911 was preparing in December to upgrade to a new CAD program in 2021.
“There were a variety of problems with the numbers at the time,” Childers said.