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Private Ala. ambulance company accused of delaying response

Allegations from fire and 911 dispatch officials say the company halted calls long enough to position its ambulances to be the closest units

By Eric Fleischauer
The Decatur Daily

DECATUR, Ala. — When a dispatcher refused to assign a First Response ambulance to a call because its competitor had an ambulance that was closer, a First Response official canceled the call, moved his ambulance so it was the closest and then repeated the call.

That was alleged in a letter this month by EMS Coordinator Ted McKelvey. That same letter raised questions about the relationship between City Councilman Charles Kirby and First Response.

“The service was delayed for 11 minutes while you moved one of your ambulances closer to the call so that it would be dispatched to you,” McKelvey, a battalion chief at Decatur Fire and Rescue, wrote in a Jan. 3 letter to David Childers, First Response director of operations. “While assets were being shifted, the patient was not receiving care and an ambulance was not en route.”

The Daily obtained the letter, which McKelvey also sent to the city’s EMS Committee, through a public records request. Childers, who said he wanted more time to research the issue, declined comment on McKelvey’s letter.

The incident occurred Nov. 17, when a Cloverdale Avenue Southwest resident called First Response, rather than 911.

When a Decatur resident’s call goes directly to one of the city’s two ambulance services, said Morgan County 911 Director Ryan Welty, city rules require the ambulance provider to immediately contact 911. Morgan County 911 then dispatches the call to the ambulance closest to the incident, which it determines through GPS devices installed in all ambulances available for calls.

On Nov. 17, Childers called 911 and was told the closest ambulance would be sent to the Cloverdale address, McKelvey wrote. Childers told 911 to disregard the call. Eleven minutes later, after a First Response ambulance had been moved so it was the closest unit to Cloverdale, Childers again called 911.

Childers has had other disputes with dispatchers over the same Cloverdale Avenue address, according to McKelvey’s letter, one of which involved Kirby.

On Dec. 21, the Cloverdale Avenue resident called First Response after a fall.

According to McKelvey’s letter, Childers called Morgan County 911 and requested that the call be dispatched to First Response.

“You were then advised by MC911 that they would send the closest ambulance, at which time you said you no longer wanted an ambulance sent to that location,” McKelvey wrote.

Six minutes later, Childers called again and repeated his request that the Cloverdale Avenue fall be dispatched to First Response.

“After several minutes arguing about the call, you told the supervisor that Councilman Kirby was on the line and asked if he could hear the information,” McKelvey wrote. “Mr. Kirby acknowledged that he was on the line. You then stated you would send one of your units anyway.”

In an email requesting that The Daily not mention his previous ambulance service, Med-Call Inc., in a story, Childers copied Kirby, and Kirby contacted The Daily. Kirby said he has no particular loyalty to Childers or First Response. He said Childers contacts him only to make sure dispatches are being made according to the ordinance.

“When he has problems — and we’ve had problems for two decades — he’ll contact me,” Kirby said. “Unfortunately, we depend on a number of different agencies working together to do what our code said to do. It’s poorly monitored and it’s poorly enforced.”

EMS committee

Dr. Larry Sullivan, chairman of the Decatur EMS Committee, said he is concerned about the relationship between Kirby and First Response.

“I thought that was totally inappropriate,” Sullivan said of Kirby listening in on the call between Childers and a dispatcher.

Sullivan said the relationship between Kirby and Childers has been a problem since at least 2012, when Childers successfully sought to obtain a permit allowing First Response to compete with DEMSI.

“It’s been clear to me that there was bias in favor of Childers from Mr. Kirby,” Sullivan said. “I’m reluctant to believe it’s just an altruistic free-market kind of passion, but I guess it could be. I don’t know the reason that relationship is there.”

Sullivan recently challenged Kirby on the issue, before a meeting of the EMS Committee began at City Hall.

“How many times have you listened on the phone to DEMSI?” Sullivan asked, referring to First Response’s sole competitor in Decatur.

“Anytime they’ve asked me, which so far has been none,” Kirby responded.

“Well of course they’re not going to ask you,” Sullivan said.

Kirby told Sullivan he did not favor one ambulance service over the other; he just wanted to make sure the rules were followed.

“I hate that Dr. Sullivan feels that way,” Kirby said last week, denying that he was biased toward Childers. “There is no relationship. Do I know him? Yes. Have I ever been to his house? No. Has he ever been to my house? No. Have I ever gotten any kind of benefit or campaign contribution from him to date? No.”

Kirby said non-emergency calls such as the one at the Cloverdale Avenue address should not be funneled through the 911 system and dispatched to the closest ambulance. If a resident calls First Response on a non-emergency, Kirby said, the ordinance allows First Response to handle the call. Any Decatur Fire and Rescue rule that said otherwise violates the ordinance, Kirby said.

Other issues

The incident involving a Cloverdale Avenue resident was not the first time First Response had argued with dispatchers about which ambulance should be dispatched, McKelvey wrote, leading to an October resolution in which First Response agreed that it would only dispute dispatches after an ambulance had been dispatched to assist the resident.

“The argument concerning the policy on this call clearly delayed the receipt of care by the patient, and that conduct is unacceptable,” McKelvey wrote.

Welty said policy disputes are inevitable with dollars on the line.

“This needs to be a Monday morning issue,” Welty said last week. “When ambulance personnel call dispatch and argue about how something is being handled, they’re delaying the call.”

McKelvey also said First Response was undermining efforts to make sure transport calls first go to 911, after which they can be dispatched according to a weekly rotation system. When investigating a call placed by Childers to 911 from Decatur Morgan Hospital, McKelvey wrote, it turned out that Childers’ personal cellphone — not 911 — was listed as the hospital’s first contact for transports.

Neither McKelvey nor the EMS Committee to whom he reports have authority to penalize First Response for its alleged conduct. If, after a hearing, the EMS Committee refers it to the City Council, the council can suspend or revoke First Response’s license to provide ambulance service in the city.

A revocation is unlikely, since First Response has more ambulances than its competitor and handles most emergency calls in Decatur.

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(c)2014 The Decatur Daily (Decatur, Ala.)

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