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Ala. ambulance service faces possible fine for failure to meet response time requirement

Fire Chief Tracy Thornton said the city could decide to grant some exemptions for the Decatur-Morgan Hospital Ambulance Service


Bayne Hughes
The Decatur Daily

DECATUR, Ala. — The Decatur-Morgan Hospital Ambulance Service failed to meet the city’s required response times in the police jurisdiction during the final quarter of 2022, according to preliminary data, a potential ordinance violation that could subject it to a fine and other penalties.

An official determination of its response times for the fourth quarter won’t be made until the Ambulance Regulatory Board’s next scheduled meeting on Feb. 14.

The city ordinance requires that the response time on 90% of emergency calls in the police jurisdiction during a quarter must be 13 minutes or less. The police jurisdiction is an area that extends in Morgan County from the Decatur city limits to a point 1 1/2 miles beyond the city limits.

Violating the response-time requirement in one quarter results in a $5,000 fine and five points, although the provider can appeal the penalties to the City Council. Accumulating 26 points within two years would lead to a requirement that the EMS coordinator recommend revocation of an ambulance service’s license to operate, a decision that ultimately is up to the City Council.

Tyler Stinson, director of the hospital ambulance service, said his service responded within 13 minutes on 64% of police-jurisdiction emergency calls in December, well shy of the ordinance’s required 90%. It responded within 13 minutes on 79% of calls in October and 88% in November.

The ordinance provides a procedure through which an ambulance service can seek to exempt individual calls “for good cause only.” When an exemption is granted, that call does not count against the ambulance service’s quarterly total. Stinson requested 11 such exemptions in the fourth quarter, but the city’s Emergency Medical Services Coordinator Chris Jones denied four.

Within the city limits, the ordinance requires a nine-minute response time on 90% of the emergency calls during a quarter. The ambulance service responded within nine minutes on 88% of in-city calls in December, 91% in October and 94% in November.

Fire Chief Tracy Thornton said the city could still decide to grant some exemptions requested by the ambulance service in the police jurisdiction, which could improve its percentage of timely calls.

Stinson told the ARB last week that he is working on an “action plan that addresses our issues in the police jurisdiction.” He said he also found some discrepancies in the report that he wants to discuss with Morgan County 911 officials.

Stinson said he is looking at where to place ambulances so they can respond more quickly to PJ calls. He said they may also put at least one more ambulance into service, which would mean hiring eight people, two per shift, to cover all of the shifts in a week.

Thornton said it’s important that the Decatur Morgan Hospital Ambulance Service, which has a monopoly in the city, meet required times in the police jurisdiction, but whether they did or not won’t be certain until a final determination has been made.

“We will do as the (city) ordinance says, the same as we’ve always done,” Thornton said. “I want them, as any ambulance service, to meet the required response time and provide good service for our residents. The ordinance says these are the response times that have to be met.”

The ambulance ordinance gives the ARB final discretion on whether to impose points as a penalty for violations and authorizes appeals to the ARB of financial penalties exceeding $1,000. The City Council’s involvement in the appeal process comes only if the ARB denies an appeal of a fine exceeding $1,000, or if the ARB recommends revocation of the certificate to operate.

The hospital appealed two previous potential penalties imposed by the EMS coordinator and the ARB overturned them. The board chose not to penalize the hospital in May after it didn’t make response time requirements for the PJ in the first quarter of 2022.

Stinson told the board then that the new ambulance service was competing with First Response Ambulance Service for most of the quarter until First Response shut down and left the city in March. The hospital was also still building its ambulance service and hiring new employees during the first quarter.

The hospital and First Response both had appeals upheld by the ARB in December 2021 for the fourth quarter of 2021.

First Response accumulated $15,900 in city fines for not putting enough ambulances on the road from Jan. 14, 2021, through March of that year. Owner David Childers claimed call volume and per-call revenue were too low for the company to meet the city’s requirement.

Thornton said Monday that First Response has not paid these fines since it’s no longer operating in the city.

The Ambulance Regulatory Board voted unanimously in February 2020 to impose a $10,000 financial penalty and 10 points against First Response for failure to meet response-time requirements in the city’s police jurisdiction during the fourth quarter of 2019.

First Response appealed, and the penalties were overturned by virtue of a 2-2 City Council vote.

First Response filed a federal lawsuit in December 2021 against the hospital alleging that the hospital conspired with the city to damage First Response. Motions filed by both the city and hospital to dismiss the lawsuit are pending.


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