By Bayne Hughes
The Decatur Daily
DECATUR, Ala. — Decatur- Morgan Hospital’s ambulance service failed to meet required response times in the city during the second quarter, but the Ambulance Regulatory Board recommended renewal of its certificate of public necessity and convenience.
Ashley England, Decatur Fire & Rescue’s emergency medical services coordinator and deputy chief, recommended a $5,000 fine and 10-point penalty because the ambulance service met the required response time on only 87% of its city calls in April, May and June.
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The city ordinance requires ambulances to arrive within nine minutes on at least 90% of 911 emergency calls in the city each quarter. In the police jurisdiction, ambulances must arrive within 13 minutes on at least 90% of emergency calls. Response time is measured from the time 911 dispatches the call until the ambulance arrives on scene.
The ambulance service met the required response time on 794 of 908 city calls during the second quarter. In the police jurisdiction, it met the standard on 61 of 62 calls, or 98%.
Decatur’s police jurisdiction extends 1 1/2 miles beyond the city limits.
England said the points penalty is automatic while the fine can be appealed. He said it was the service’s second response-time violation within five years, increasing its penalty total to 15 points.
Under the ordinance, accumulating points can eventually jeopardize an ambulance provider’s ability to renew or retain its CPNC. A provider with 16 or more points must present an acceptable corrective-action plan before it can seek renewal. At 21 points, it cannot submit a renewal notice, and at 26 points, the EMS coordinator must recommend revocation of the CPNC to the Ambulance Regulatory Board. Points remain active for two years after approval.
In the third quarter of 2024, the ambulance service did not meet the required response times in the police jurisdiction.
Fire Chief Nathan Springer said the hospital has failed to meet the required response-time standard only a few times, either in the city or police jurisdiction, since beginning ambulance service in Decatur in 2021.
In some of those instances, points were assessed but the Ambulance Regulatory Board denied the associated financial penalty. Points from the earlier violations have expired, except for those tied to the most recent violations.
England said five points are scheduled to expire in November, but the ordinance still requires the hospital to submit a written plan explaining how it will correct the response-time problem.
The Ambulance Regulatory Board voted unanimously to recommend the fine and renewal of the hospital’s CPNC to the City Council.
Hospital EMS Director Tyler Stinson said the hospital will not appeal the fine.
“Volume was a little higher than normal,” Stinson said. “But the trucks weren’t posting (parking in a key spot as they wait for a call) like they probably should have been and we realize that. We’ve made those changes, and everybody’s doing a better job of making sure they’re where they’re supposed to be.”
Stinson said the service operates 13 to 16 ambulances during peak deployment times Monday through Saturday and 11 to 13 on Sundays. Decatur -Morgan now provides ambulance coverage throughout Morgan County. He said all but about five ambulances typically remain in Decatur, although any unit can respond to a call in the city or county.
Stinson told the board the ambulance service met the required response time on 93% of its city calls in August and on all 28 calls in the police jurisdiction.
Assistant City Attorney Chip Alexander said the ambulance-services ordinance adopted by the City Council in 2019 requires providers to reapply for a CPNC every five years.
The ordinance says a CPNC is valid for five years and cannot be renewed unless the provider gives notice that it intends to reapply, completes the entire application process, receives approval from the Ambulance Regulatory Board and is issued another CPNC by the City Council.
The ordinance, Alexander said, “makes an ambulance apply from scratch every five years.”
Alexander said Decatur-Morgan Hospital’s CPNC expires Oct. 1 , but the hospital has met the criteria and filed all required application materials.
“Fortunately, not a lot changed from the initial one (CPNC application) that we submitted, other than we just added the new equipment and personnel,” Stinson said.
Decatur Emergency Medical Services Inc. held a longtime monopoly before First Response Medical Services began operating in 2012. DEMSI closed and filed for bankruptcy two years later.
First Response’s tenure included disputes with the city that helped lead to adoption of the stricter 2019 ordinance, which established response-time, vehicle and equipment standards and financial and point penalties for violations.
Decatur-Morgan Hospital, owned by Huntsville Hospital Inc., began a part-time competing ambulance service in 2020. First Response closed March 15, 2021, leaving Decatur -Morgan as the city’s only ambulance provider, and the hospital expanded to full-time service in October 2021.
First Response filed a lawsuit against the city but later settled out of court.
“I have to say I’m the only one here to deal with the last three ambulance services, and it has been a joy to work with them,” Alexander said.
England also recommended renewal of Decatur-Morgan Hospital Ambulance Service’s CPNC.
Springer said he expects the CPNC renewal to be on the City Council’s Monday agenda. There is no application fee, but an ambulance company must have a city business license to operate, he said.
England said Decatur Fire & Rescue met the required response time on 97% of its city calls and 100% of its police-jurisdiction calls during the second quarter.
The department met the standard on 96% of city calls and 100% of police-jurisdiction calls in July, and on 99% of city calls and 100% of police-jurisdiction calls in August.
“This group has come in over the last five years and really provided good, successful EMS to this region and the city,” Springer said. “From working with them, we’ve seen the success, and we’ve gotten good feedback from the patients and the community. Huntsville Hospital has really invested a lot into the EMS delivery in this city, and it’s an example of what a successful EMS system looks like.”
Springer said he’s not concerned about the fine or point penalties “because I know that’s something they’re handling within their organization. We don’t see this as an ongoing issue or something we need to be highly concerned about with their service.”
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