By Bayne Hughes
The Decatur Daily
DECATUR, Ala. — The Ambulance Regulatory Board unanimously rejected an appeal by the Decatur Morgan Hospital Ambulance Service on Tuesday, upholding a $5,000 fine and the imposition of penalty points for its failure to meet required response times in the last quarter of 2022.
The board would not overturn Emergency Medical Services Director Chris Phillips’ recommendation for the penalties even after hearing hospital officials’ appeal in the monthly meeting.
The ambulance service is accused of failing to meet the city’s response-time requirements in the police jurisdiction during the final three months of last calendar year.
A city ordinance requires the ambulance service to respond to at least 90% of its calls in the police jurisdiction within 13 minutes. It’s required to respond to at least 90% of its city calls within nine minutes.
Phillips said the hospital responded within 13 minutes to 85% of the calls in the police jurisdiction during the October-December time period. He said the ambulance service had 87 calls, and its responses to 18 of those calls took longer than 13 minutes. Five of the delayed responses were not counted against the hospital.
Tyler Stinson, the hospital’s ambulance service director, told the ARB in the appeal hearing that his ambulance service only missed meeting the city’s requirement by four calls.
“Those four calls were on the very far edge of the police jurisdiction,” Stinson said.
Stinson said three were on Neel School Road. The ambulance service has to use Kirby Bridge Road, part of which runs out of the police jurisdiction, to get to Neel School Road.
“They had a 14-, a 15- and a 16-minute response time on those three calls,” Stinson said.
Stinson said the other call was on Indian Hills Road near Hartselle.
“It had an 18-minute response time. It’s just a long haul,” Stinson said.
Fire Chief Tracy Thornton, the ARB chairman, said it concerns him that those homes have Hartselle and Danville addresses.
Hospital Chief Executive Officer Kelli Powers said the hospital has staffing shortages in nursing and the ambulance service, but they’ve made improvements by taking steps such as offering more money and incentives to attract employees.
“You can see that since then (in the first three months of 2023) they’re doing very good at meeting their times,” Powers told the ARB.
Stinson said the night shift is where they have struggled to get employees, so the new hires started on this shift. He said his ambulance service is up to about 80 employees. They’re running five to seven ambulances during the day and four or five at night.
“With the incentives we’re offering, we’ve had more full-time employees willing to pick up extra shifts at night,” Stinson said. “We still have times where we struggle but it has helped us.”
City Attorney Chip Alexander said the appeal hearing “is just a review of the facts to see if the penalties are justified.” He said there is precedent on both sides, as the ARB has in the past both upheld penalties and overturned them.
Alexander said the EMS coordinator doesn’t have discretion to dismiss a penalty, but the board can uphold the penalties, change them or overturn them.
“There’s not a set thing to look at,” Alexander said. “It’s just y’all’s feelings on what the allegations are.”
Board member Jennifer Hempfling said the ambulance service did well in improving its performance in the first two months of the year after not making its police jurisdiction times in the fourth quarter of 2022.
“They took steps to rectify this,” Hempfling said. “It’s not a chronic problem as of yet. I don’t see that they need to be fined when they’re doing all that they can to make sure their times are met, their staffing is there and their vehicles are taken care of. I think they’ve done a fine job with that.”
Board member Dede Hayes pointed out the ambulance service did have penalties brought up once before, but Hempfling said that occurred in March 2022 when First Response Ambulance Service abruptly shut down with no notice. The ARB overturned the penalties.
Sgt. Rick Archer suggested they should look at adjusting the response time requirements, but Alexander said they’ve already been increased from 12 to 13 minutes in the police jurisdiction and from eight to nine minutes in the city.
“If it’s not a reasonable time, maybe we need to look at the requirements,” Archer said.
Board member Lilly Pike said the board made “reasonable adjustments” in the past. She said she recognizes the hospital made improvements but she feels the board previously set a standard that it needs to follow.
Hempfling initially said she wanted to amend her motion to uphold the penalties, but then changed her mind and let the motion stand. The ARB then voted unanimously to uphold the penalties.
Afterward, Powers said the hospital plans to appeal the decision to the City Council. She said the ambulance service made its response-time requirements in the first quarter of 2023.
“We want to comply with the rules,” Powers said. “We just wanted them to know why we didn’t meet the requirements and we’re trying everything we can to meet the rules.”
Powers said after the meeting she may talk to the Ambulance Regulatory Board and the City Council about adjusting the 13-minutes requirement in the police jurisdiction.
“Is that a realistic time?” she said.
Thornton said the board had go by what the city ordinance says.
“The board didn’t have any other choice than to do what they did today,” Thornton said. “I think there is room for forgiveness or a compromise but that needs to come from the City Council.”
If an ambulance service reaches 26 points, it could lose its license to operate in the city. The ordinance provides for penalties if an ambulance service does not meet the city’s response-time requirements, for failing to keep enough well-maintained ambulances in service and for other infractions.
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