By Bayne Hughes
The Decatur Daily
DECATUR, Ala. — First Response Ambulance Service wants to charge a $100 fee to a patient who refuses to be transported as part of a series of proposed rate increases and new itemized charges.
First Response submitted the request for rate increases, which range from 13 to 18 percent for existing fees, to the Emergency Medical Service Committee in April, but a scheduled meeting to review the request was canceled because of a lack of quorum.
The next EMS meeting isn’t scheduled until July. The Decatur City Council has the final say on the proposal.
The company wants to begin charging for a patient who refuses to be transported, also known as a PRT fee, and is seeking itemized charges on medical supplies and medication.
David Childers, First Response director of operations, said the fee for those who refuse transport would be passing along to the public the dispatch fee that Morgan County 911 charges his ambulance service.
“We’re being double-taxed,” Childers said. “According to (a state attorney general’s) opinion, an allotment for the 911 center appears on your phone bill whether it’s a home phone or your cellphone in addition to the charge every time we’re dispatched.”
Fire Chief Tony Grande, who serves on the EMS committee, said he’s not surprised Childers would propose a PRT fee.
“It’s a cost every time, whether it’s a fire truck, an ambulance or a police car, we go out,” Grande said. “You’re burning gas, putting wear and tear on the truck and our guys are using their time to respond.”
Councilman Billy Jackson said he will oppose any attempt by First Response to raise rates.
“Our citizens are not getting the level of care that they should be getting, so I will not be in favor of giving First Response any increases,” Jackson said.
Jackson said the proposal to charge a PRT fee “says about as much about First Response as anyone could say.”
Childers is seeking to increase by $125 each of five categories of service, ranging from non-emergency runs to Level 2 emergency runs. He also is requesting a $2 increase to $13 per mile for mileage.
“Most companies increase rates on an annual basis, but we haven’t had any kind of rate increase since we came to Decatur in 2012,” Childers said. “We just feel this is the appropriate time.”
Childers said he proposed itemized charges because “each patient doesn’t receive the same treatment or medication.”
Councilman Charles Kirby, who serves on the EMS committee, said First Response “probably deserves” the rate increases.
“We’re seeing costs increasing everywhere, and it’s been a while since they’ve had an increase,” Kirby said.
Council President Chuck Ard said he wants to hear from First Response before he takes a stance on the proposed rate increases.
Grande said he also wants to hear Childers’ justifications for the increases “and talk with the committee in an open meeting before I let anything out about how I feel about the proposals.”
Kirby responded that Jackson “has fought against First Response and David Childers every time he could. He never saw a problem with DEMSI until it blew up.”
In 2012, First Response moved into the city to compete against the long-established Decatur Emergency Medical Service Inc. DEMSI lost its city license and filed for bankruptcy in 2014, so First Response now has a monopoly in the city.
Jackson said the city should consider taking over ambulance services, like Shelby County, Tennessee, did earlier this year.
The Commercial Appeal newspaper reported Shelby County, which includes Memphis as its county seat, took over ambulance service for rural areas at a cost of $5 million a year. This included a $2.5 million one-time expense to buy 12 ambulances.
A $4 increase in residents’ fire protection fees was approved to pay for the new service. Shelby County expects to run the new services for about $1 million a year.
The Appeal reported the county was paying a private company $1.7 million a year, and that company had asked for an increase to $2.5 million a year because it said it was losing money.
The Memphis Fire Department has run its emergency medical services since 1966. In Madison County, ambulance services are provided by the nonprofit Huntsville Emergency Medical Services Inc.
“It will take some money up front, but then we could specify the criteria so our services stand up to the expectations we’ve set with our fire and police departments,” Jackson said.
Jackson said those expectations should be a fit staff, quick response times and a well-maintained fleet. These are all areas that Jackson said he believes First Response falls short on and can’t guarantee to the city.
Kirby said the city can’t afford to start its own ambulance service, which he believes could cost as much as $10 million.
“It’s a fact that sometimes the private sector can provide a more economical service,” Kirby said. “It’s simple economics.”
Ard said he’s willing to explore the idea of a city-run ambulance service, but he views fire, police and sanitation as the core components of what the city should provide to its residents.
“It’s something we need to consider,” Ard said. “I’m not saying it’s a bad idea, but we would have to be able to do it better and cheaper.”
Copyright 2017 The Decatur Daily