First Response seeks slower response requirements, older ambulances

Feb. 23—First Response Ambulance Service wants to be allowed longer response times and older trucks under a Decatur ordinance, and seeks a dramatic drop in financial penalties for its violations of the ordinance.

The proposed ordinance amendments were made in an email to Decatur Fire & Rescue Chief Tracy Thornton from David Childers, president and owner of HealthCare Investment Group, which owns the city's sole ambulance service. The Decatur Daily obtained the email in response to a public records request to the city.

The ordinance went into effect in September 2019, and First Response has consistently met response-time requirements since then. The previous ordinance had the same response-time requirements, but did not include an enforcement mechanism. First Response frequently violated the previous ordinance's response-time requirements.

Childers seeks the following changes to the 2019 ordinance:

—Change the required response times on in-city calls to nine minutes, down from the eight-minute standard that has been in place for years. The current and previous ordinances require that an ambulance arrive at the scene within eight minutes on 90% of its in-city calls.

—Change the response time requirement in the city's police jurisdiction to 20 minutes. The current and previous ordinance requires a response time within 12 minutes on 90% of the calls in the PJ, an area extending 1 1/2 miles beyond the city's border.

—Reduce the monetary penalty for the failure to meet the 90% threshold on required response times in a quarter from $10,000 to $2,500 for the first quarterly violation, and from $20,000 to $5,000 if First Response fails to meet the response-time requirement in a second consecutive quarter.

—Delete the points penalty system. Under the current ordinance, response-time and other violations accumulate points that roll off in two years. The accumulation of 26 points is grounds for revocation of its certificate to operate in the city.

—Remove the requirement that an audited financial statement be submitted to the city each year. The company said its certified public accountant could submit an unaudited financial report each year at the city's request.

—While the ordinance requires ambulances to be no more than six years old and have no more than 200,000 miles total, Childers proposes that the ordinance be amended to allow use of ambulances that are 10 years old, with no more than 200,000 miles since an an engine or transmission has been replaced.

Childers proposed that non-emergency (second line) units have no age or mileage limit, but be required to pass an annual mechanic's inspection.

Childers in December sent an email to the city with so many suggested changes that it would have meant a total rewrite of the ambulance ordinance.

However, Thornton told him at the Ambulance Regulatory Board meeting in January that they would not recommend a total rewrite and that Childers should come back with a few suggested changes.

Childers' email on his recent suggestions went to Thornton and to Councilman Hunter Pepper, who tried to present the proposed changes at the Feb. 8 City Council meeting.

However, Assistant City Attorney Chip Alexander said Childers didn't follow protocol by sending the suggestions to the chief or Pepper, and the rest of the council agreed.

Alexander said Childers should have sent the email to EMS Coordinator Ashley England, who would then present the proposals to the ARB. The board would then consider making a recommendation to the City Council, which has the final say on any ordinance changes.

Childers said he sent the email to Thornton because he is the ARB chairman.

Thornton said he still plans to present the proposals to ARB, which was scheduled to meet last Tuesday but icy weather forced it to cancel the meeting. The proposals are now on the board's March 9 agenda.

Thornton said he's been asking Childers "for over a year for specific details" on suggested ordinance changes.

"I'm willing to discuss some of his suggested changes," Thornton said. "We all want this to be a good ordinance for whoever has a CPNC (certificate of public necessity and convenience)." A CPNC is the license authorizing an ambulance service to operate in the city and its police jurisdiction.

First Response officials have been vocal for years about the city's response-time requirements.

City officials have consistently refused to consider changing the response-time requirements.

Thornton said he is willing to discuss changes to response times "if they're something that's unrealistic and nobody can do it. We want an ordinance that works well."

However, the fire chief pointed out that First Response has been meeting time requirements since the current ordinance with financial penalties went into effect.

Incentive to comply

Childers said he suggested $2,500 and $5,000 penalties "as a good faith effort" that shows he's willing to work with the City Council.

Alexander, who wrote the ambulance ordinance, said the fines were a necessary addition because the council found previously it couldn't enforce response times.

Under the previous ordinance, the only enforcement mechanism for violation of response-time or other requirements was revocation of the CPNC, which Alexander said was "too extreme."

Northport's penalty is $11 per minute in which a call exceeds the response-time criteria, if the ambulance service doesn't meet criteria in 90% of its monthly calls. The maximum penalty per call is $165.

Decatur is unusual in that the required response times are specified in an ordinance, but several counties and municipalities nationally incorporate the required response times in contracts.

Alexander said the dollar amount of the penalty for response-time violations were established in an effort to make them high enough that they would cost "more than it would cost to put a new ambulance on the road." Adding an ambulance, he said, would reduce response times.

Points system

Alexander said the city's previous ambulance service, Decatur Emergency Medical Service Inc., found it could put one less ambulance on the road and fall just short of the 90% response time requirement at 87% or 88% to save money.

He said First Response was making the 90% response requirement while competing with DEMSI, but then started falling short in response times after DEMSI folded.

Childers said he thinks penalizing his company with points for the same infractions that result in financial penalties is unfair.

Penalties can be awarded for truck problems, not meeting regulations and not meeting response requirements.

"We wanted to give the City Council a way to see how the ambulance service is doing," Alexander said. "If they've only got two or five points, there's nothing to worry about. If there's 16 or more points, they need to look and see what the problem is."

Thornton said he's willing to discuss the fines and come up with a lower amount but he thinks Childers' suggestions are too low and he's not willing to eliminate the point penalties.

Childers said it costs $15,000 to $20,000 a year to do the additional audit required by the city when the city officials can get the information they need from the company's annual financial statement.

"That's money I would rather spend on helping our EMS service and the patients," Childers said.

Thornton said he is also willing to discuss the possibility of changes to the vehicle maintenance requirements and financial reporting issue.

— bayne.hughes@decaturdaily.com or 256-340-2432. Twitter @DD_BayneHughes.