First Response Ambulance Service wants the city to stop allowing Decatur Morgan Hospital ambulances to operate in the city, but the hospital’s CEO on Friday said the hospital may seek a city license to expand its ambulance operations due to concerns that First Response’s service is inadequate.

“I want the citizens here to have the best ambulance service possible,” hospital CEO Kelli Powers said Friday. “Just think about it, when you call 911, you need to know that truck is on its way. I’m not sure that’s happening today.”

She said the Huntsville Hospital System would have to approve it, as would the Decatur City Council, “but we are willing to” apply for the certificate of public necessity and convenience needed to establish permanent ambulance operations in the city.

The hospital began running ambulances after Feb. 1, when the City Council passed a COVID-related resolution authorizing Decatur Morgan Hospital “temporarily and based on the critical situation at this time” to transport patients to and from other Huntsville Hospital System facilities.

The resolution expressly states that the hospital’s ambulances may not be dispatched by Morgan County 911 on emergency or non-emergency calls “except as required in the event of a mutual aid or mass casualty event,” but they have begun taking 911 calls when First Response has no ambulances available.

Powers said she requested the transport authorization because during the pandemic First Response was unable to quickly transport patients out of the hospital, which meant there was no hospital space to admit new patients. 

First Response fought against the resolution at the time and continues to oppose it because it reduces the number of non-emergency transports it handles. Transports tend to be more lucrative than emergency calls because many emergency calls involve uninsured patients.

At a City Council meeting last week, First Response director David Childers said the COVID-19 crisis that was the reason for allowing hospital ambulances to make transports has ended, noting that the Alabama state of emergency has expired. First Response had a monopoly on the city’s ambulance service until Decatur Morgan Hospital began the transports.

“We would like to formally ask that this (Feb. 1 resolution) be rescinded so we can go back to business as normal, have our full staffing and continue to provide service for the city,” Childers said.

Decatur officials, however, responded that the city is increasingly dependent upon hospital ambulances because First Response frequently has too few ambulances to respond to emergency and non-emergency calls.

Missed calls

Decatur Fire & Rescue Chief Tracy Thornton said First Response often misses multiple calls a day, forcing Morgan County 911 to call other ambulance services, including the hospital’s, to respond to emergency calls.

Thornton said patients have had to wait several hours for a response to an ambulance call when First Response has too few units in operation.

EMS Coordinator Ashley England said First Response is having to “zero out” frequently, meaning it is unable to respond to a call. The company has been running two or three ambulances in a day when six or seven usually provide city coverage, England said.

“Between June 21 and June 29, they rolled 11 calls,” England said, meaning 911 dispatched a different ambulance service because First Response was not able to respond. “That’s a lot.”

Thornton said First Response zeroed out 13 calls on June 26. He said other ambulance services picked up some of these calls or there were long waits for First Response to become available and respond.

Some of those “rolled calls” are going to Decatur Morgan Hospital’s ambulances, according to Powers, who said she was contacted by city EMS personnel asking that the hospital accept calls when First Response fails to respond.

“What happens now is that if First Response can’t respond, it rolls to Lifeguard (Ambulance, which serves much of Morgan County outside Decatur). If they can’t respond it rolls to us,” Powers said. “I don’t think we can get out of that unless First Response steps up to the plate.

"We are going ahead with the full 911 service so we can help the city with this.”

While the city’s ambulance ordinance generally requires all ambulances to have a certificate of public necessity and convenience (CPNC), which only First Response has, it creates an exception for a “major emergency when the ambulances authorized to operate in the city by CPNC are either insufficient in number or inadequate for any other reason as determined by the (Decatur Fire & Rescue) chief or EMS coordinator.”

Powers said Decatur Morgan Hospital has four operational ambulances, all of them equipped as advanced life support units. Three of them are older units donated by other hospitals in the Huntsville Hospital System, but Decatur Morgan bought a new truck two to three weeks ago that is in service and accepting 911 calls not handled by First Response.

First Response had only two emergency ambulances in service on Thursday and two non-emergency vehicles in operation, Thornton said.

'Poaching our employees'

Childers said First Response is having a problem with Huntsville Hospital and other ambulance services “poaching our employees. It’s very difficult for a private company to pay $20 an hour.” 

England said the employee problem is the only reason Childers has given for the high number of rolled calls.

Powers said Decatur Morgan Hospital has been hiring ambulance staff, "but I don’t think we have very many First Response employees hired as of today. Now that doesn’t mean they haven’t applied.”

Assistant City Attorney Chip Alexander said First Response could be penalized under the city ordinance for a rolled call by counting the call against the requirement that an ambulance must respond and reach the call scene of 90% of the emergency calls within eight minutes in the city limits and 12 minutes in the police jurisdiction.

However, enforcement of the response-time requirements is in limbo. Morgan County 911 is switching to a new system and that switch is into its third month of implementation. The new system is not yet tracking response times for First Response. Morgan 911 also doesn’t track the number of rolled calls and there isn’t a penalty under the ordinance when First Response says it can’t respond to a call, England said.

Childers said he sent two complaints to the Alabama Department of Public Health’s Office of EMS against Decatur Morgan Hospital for allegedly running emergency calls without the proper license. The Daily could not confirm the complaints were filed.

England said he’s aware of one of the complaints, which the city dismissed as not valid. The hospitals’ critical care truck was being repaired so it had to use an ambulance not certified for critical care to transport a patient to UAB Hospital.

“The truck had a special (critical care) crew that was sent by a physician,” England said.

Thornton said First Response’s second complaint came after the hospital ran a call in Decatur. Again, Fire Department officials didn’t think it was valid because the hospital's ambulance was called in after a patient was held up too long waiting for an ambulance.

“They had to wait for hours,” Thornton said.

Powers said complaints from Childers and First Response are not unusual.

“He’s called the state on many occasions on us, and so far they’ve all been unsubstantiated,” she said.

In the meantime, changes in the city ordinance that were recommended by the Ambulance Regulatory Board two months ago have not been presented to the City Council for consideration.

Some of the recommended changes include eliminating the required performance bond, increasing the amount of time an ambulance has to respond to emergency calls in the city and the police jurisdiction and a reduction in the fine amounts.

Alexander said he is working on making the recommended changes to the ordinance before he presents them to the council.

Council President Jacob Ladner said he hopes those recommendations will be presented at Monday’s work session so the council can consider them on July 19.

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(11) comments

joseph walker

Mrs. Ha Ha, I apologize for mis-gendering you but it is hard to determine from your "screen name." I do know about the long hospital waits and I do not approve of D.G. management, but their waits on average or not that much worse statistically than any other hospital. But, to say that Mr. Childers hasn't had problems for years with his business and the city is just sticking your head in the sand. He can sue the city, whom I am also not a fan of, but when the waits and run times come out for his business it won't help him. And yes, competition is better in every business and that is proven time and time again. Wages rise and service are better. It's also better for the employees due to their being choices of employment. I guess we just have to disagree. I thank you for your service though.

Charlie Specoli

Mr. Childers has consistently managed his company by way of the cheapest way possible. Their trucks are wore out junk and have a rough ride, and he is strongly reluctant to purchase new ones. However his trucks at his Columbus Georgia operation appear to be newer than the trucks he has here. His company has always paid a lower wage than other surrounding services, and he cries each and every month as to how unfair it is to run an ambulance service in the City of Decatur. The question I have is if First Response can't take a call why is rolled over to Lifeguard that does not have any ambulances in Decatur, now that Decatur Morgan has a service. Does that make sense? When seconds count on an emergency now that Decatur Morgan has trucks why are they not the second service that is called? Lack of common sense?

Ha Ha

Columbus truck are the same as Decatur trucks except they got a paint job. I want a unit to respond that is in good mechanical condition. Next First Response Decatur pays higher than anyone else don't believe me? ask about the pay at HEMSI.. First Response Decatur pays even more than Decatur Fire. Lets put all of the BS aside and call it like it really is DECATUR FIRE AND THE HOSPITAL wants First Response gone. They are working together to make it happen. About response times... look at the proof that comes from the 911 center, First Response has made the 90% since 2012... remember don't believe what you hear but only what you can see.. request the records from 911 they are public.

Charlie Specoli

Well, then they are used junk trucks too aren't they? it's not a secret that maintenance is lacking on the first response fleet, it's pretty bad. yes let us put all the BS aside. First response has been digging a hole that it cannot get out of. You like to quote and brag on 911 records, explain all of the "zero out" calls as of late. Again all of the BS aside Childers and his partner have ran this service as cheaply as possible for higher profits If you have ever been in one of their trucks brace up for a rough ride, maintained? yea right and apparently you either work there or have a vested interested. Competition is good make an investment and be competitive

Ha Ha

rough ride? all ambulance ride rough, yes I work there. Do you want to be in pain laying on my stretcher for 3 hours inside the hospital while they find one of the two nurses working to see you? do you know how many people I transport each day that don't have insurance? 60-70%... you want to talk about zero out? what does that mean to you? I worked at HEMSI and we had response times of 35 mins and did you hear Huntsville Fire complaining? NO.. Decatur Fire is mad because they can't run a ambulance service so they control First Response. Mr. Childers provides trucks and people and DFR calls all the shots... so write them a letter and tell them they don't know what they are doing.

joseph walker

All for DG running an ambulance service. The more ambulances there are the better service for the citizens of Morgan County and Decatur. Don't understand Mr. Childers being afraid of a little competition. It's not what is better for him but what is better for the citzens.

Ha Ha

Competition? how is it competition when the hospital controls all the transports? if you want more trucks then please tell everyone where are you going to find the employees? in case you didn't know there has been a EMS shortage for 7 years.

joseph walker

Mr. Ha Ha, there is a shortage of workers everywhere since the govt pays people to stay at home. Also, No one is saying the hospital should be the only ambulance service. No one is trying to put Mr. Childers out of business. I know for a fact that 911 runs out of ambulances on the daily. So there is a shortage of ambulances. It sounds like you have a vested interest in Mr. Childers business. Competition breeds better service. There is a reason that monopolies are illegal in America, remember Ma Bell.

Ha Ha

Mr. Walker first I am a Miss, but you are right I have a interest I work there and that's how I pay my bills. I get to see things first hand and not the BS that this paper prints...let me ask you you think that it's right for the hospital to be able to hold a ambulance and patient on a stretcher in the ER for 1hour, 2 hours, 3 hours? Well I have been there and done that.. the hospital has caused this problem.. because they can't find workers, well pay more or you shouldn't have fired them in the pandemic. I make more at First Response than I have ever made and I have worked at HEMSI. Decatur Fire is in bed with the Hospital and want to take my job from me. Also competition don't breed better service in EMS, people paying their bill breeds better service. that ain't happening in Decatur either. When First Response sues Decatur then you will see that this has been a plan for nearly 2 years. DIRTY

Charlie Specoli

No they don't all have a rough ride. Your boss is here complaining about competing pay so his pay scale obliviously isn't where it use to be. Again all BS aside your company is a laughing stock with other ems companies. First Response has created this problem for itself Mr. Chliders has cried like a baby everytime there is an EMS meeting. Long waits in the ER, there we can agree it is uncalled for ! But that is just one problem Childers creates others by buying used trucks (I think two were bought new) with high miles COME ON already make the investment and upgrade and compete and stop whining.

Ha Ha

it's obvious that your ignorant to EMS.. if the trucks are so bad then why is First Response in the tope 3% fastest Ambulance providers in the nation? that's an insult to all of us employees... How many Ambulances have you rode in? did you pay your bill? or is it free lip service like you give on here... The hospital is the problem... answer me this since your so aware, why is Huntsville not complaining about 35-40 min response times?

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