Decatur Morgan Hospital this week edged closer to running a full-scale ambulance service and the city took a step away from its seven-year reliance on a single ambulance service.
The Ambulance Regulatory Board on Tuesday unanimously recommended approval of the hospital’s application for a certificate of public necessity and convenience.
The ARB’s recommendation came after Assistant City Attorney Chip Alexander said, “It appears to me that they’ve met the criteria to go forward.”
The hospital’s CPNC application now must be posted for 10 days and, after holding a public hearing, the City Council would then decide whether to pass a resolution giving final approval.
Fire Chief Tracy Thornton, who serves as ARB chairman, said he “doesn’t see a reason” the application would be held up so it would likely go to the council in October.
If approved, Decatur would have two full-time ambulance services for the first time since 2014. The hospital ambulance service would compete with First Response Ambulance Service.
City Emergency Medical Services Coordinator Ashley England said the only question left for him about the hospital’s application is whether it meets the city’s requirement that at least 51% of the ambulance service employees are full time.
Tyler Stinson, Decatur Morgan Hospital's emergency medical services director, said the new ambulance service is up to 35 or 36 employees and 50% are full time. Two new employees were just added, so that number should push the hospital over the city requirement, he said.
“We believe we need 40 to 45 full-time employees (when full operations begin),” Stinson said.
England reported a city inspection found that the hospital has six ambulances. Stinson said one ambulance has 229,000 miles on it, a second has 197,000 miles “and the rest are under 15,000 miles.”
Stinson said the hospital has ordered two more new ambulances, with one scheduled for a late September delivery and the other coming sometime in October.
Morgan County 911 Director Jeanie Pharis said that, in her opinion, running six ambulances at a time is optimal, but a service could get by with five.
First Response owner David Childers said his company usually runs five units. Four of the units respond to emergency calls and the fifth runs non-emergency calls. A sixth unit is occasionally necessary if a patient has to be transported a long distance, he said.
The hospital, which is part of the Huntsville Hospital System that also includes the Parkway and West campuses in Decatur, began running a limited ambulance service in February.
At the time, the council approved a temporary resolution to allow the hospital to transport patients between Huntsville Hospital System facilities to alleviate delays and overcrowding caused by the coronavirus pandemic.
However, First Response began struggling in June to respond to calls because of a shortage of EMS staff, so hospital ambulances began running some emergency calls.
Decatur Morgan CEO Kelli Powers said this summer that they wouldn’t be starting an ambulance service if the city wasn’t having so many problems with First Response being unable to cover calls.
Powers said Tuesday that the hospital is “ahead of where we need to be” as it progresses toward its goal of starting an ambulance service. She said she's confident the city will be able to work out how it will juggle the competing ambulance services.
Pharis said they’ve discussed using 911’s automatic vehicle location system and assigning the ambulance that’s closest to a call.
Police Chief Nate Allen, a member of the ARB, said he’s concerned that this could give First Response an advantage because it could use the experience it has in posting ambulances in certain locations.
Allen suggested the city would be better off if it were split into geographic zones, with each ambulance service getting a zone.
However, Thornton and Pharis said this could create a problem with one zone getting more calls than the other, which could impact response times and the services’ finances.
Alexander said assigning the ambulance closest to a call was the way it was done from 2012 to 2014, when First Response began operating in the city as a competitor to Decatur Emergency Medical Services Inc. DEMSI folded in 2014.
Alexander said the two competitors initially “played hopscotch but then it worked itself out. The response times were then amazingly fast.”
Childers continues to express his concern that the hospital will control non-emergency calls. He said this is where an ambulance service makes its money because many of the emergency calls involve uninsured, indigent patients.
Thornton said he thinks “competition is good” and will only serve to improve the city’s ambulance response times.
“Competition will improve the safety of our citizens and that’s all I care about,” Thornton said.