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By Carey Reeder | Managing Editor

Regional Paramedical Services presented the Chilton County Commission with a initial proposal at a work session held on Sept. 17 to give commissioners more options when it comes to providing residents with a guaranteed ambulance service. The meeting, which was arranged by Commissioner Allen Williams, was designed to give details on the option of going with an independent ambulance service to provide care in the county as delegates continue to explore all options.

Eric Pendley, Chief Operations Officer of Regional Paramedical Services and President of the Alabama Association of Ambulance Services, made a presentation to county commissioners, county delegates, county emergency personnel and the public who were in attendance. It showcased the issues that RPS is facing in Chilton County, the data behind it and finally an initial proposal from RPS.

Pendley’s initial proposal to the commission was forming an ambulance oversight committee. The committee would have one representative on it appointed from each of the following entities — Chilton County Commission, Chilton County Firefighters Association, Chilton County Healthcare Authority, BREMSS (Birmingham Regional Emergency Medical Services System) and the Alabama Association of Ambulance Services. This selection would give good representation to all parties that should be present in making the decision for ambulance services in the county.

“Before we look at costing the taxpayer’s money or anything, let’s look at the data and let’s form an oversight group committee … Let’s get together at a table and look at the data, look at the issues and then let’s come up with a plan,” Pendley said. “There are a lot of just and unjust things being said, so let’s look at the plan and make a plan to see what is best for Chilton County.”

The committee will look at the data in Chilton County such as the number of calls they receive, what the nature of those calls are, where those patients are being transported to and if there are any unnecessary calls that do not need an ambulance. After that, standards for Chilton County can be put in place by the committee that they want to see upheld like response times, and then find ways to provide a service that meets those standards.

The longevity of the oversight committee, if formed by the commission, is up to them. Pendley said he has seen the formation of the committee be effective in other counties in Alabama, and it proved to be beneficial to counties after an ambulance service was put in as well.

“It is up to (the commission) if they want to start a committee, and we have seen that in so many counties being very efficient because there is accountability on both sides, and that is what we need,” Pendley said. “I do (see issues in Chilton County). Any time you have a long response time, and we have seen those creep up around the state, not just here. It is a concern for everybody. If it is your family you do not want to be waiting 30 minutes for an ambulance, so there is definitely a need and an issue to resolve here in Chilton County.”

In the end, regardless of the route the county chooses to take for an ambulance service, additional funding will need to be provided, and Pendley agreed. He added that it all goes back to funding, especially in rural areas in Alabama. He believes that if RPS can start running calls they need to, not have residents misuse 911 and use resources better, then issues like response times can be cut down in the county.

RPS and the county’s contract ran out in 2021 and a new one was not resigned. However, RPS continued to provide services in the county after 2021, extending the partnership between Chilton County and RPS since 1999. During his presentation, Pendley started by recapping issues faced by ambulance services around Alabama that are exactly the same as the ones RPS has faced in Chilton County over the last few years. The problems such as 911 calls going unanswered are faced by rural areas like Pickens and Greene Counties, but also areas like Jefferson County where it is not as rural and spread out. These problems exist in other areas, and are not exclusive to Chilton County.

Other problems highlighted by Pendley in his presentation were staffing shortages due to low pay, the overworking of employees and the abuse or misuse of 911 by callers. In Alabama, if a 911 call comes in for an ambulance, the paramedics must show up and they must take the patient to whatever medical facility they desire whether it is in the county or not. The funding for staffing is also limited, while at the same time costs for salaries and liability insurance for ambulance services are skyrocketing.

Pendley moved on to highlight some ways those issues can be combated. He provided ways to be efficient with funds with the limited resources ambulance services have. Those included priority dispatch to people who truly need emergency assistance as opposed to just a ride to the hospital, treating patients in place to avoid transporting them to a medical facility and transporting people to the closest appropriate medical facility.

Data in Pendley’s presentation put numbers behind the issues in Chilton County specifically. The data showed that RPS runs about 18-20 emergency calls per day in the county with transport coming at 42% of those. The other 58% of calls RPS is responding without transport. If a patient was transported, only 37% of those were taken to St. Vincent’s Chilton Hospital. 40% were taken to a Shelby County facility, and the rest were spread out across 22 different medical facility destinations.

In addition, the wall time, or the amount of time that EMS personnel spend waiting to transfer a patient to a bed or chair once they arrive at an emergency facility, is troubling. On 20% of the transports RPS makes out of the county, the wall time lasts 50 minutes or longer, sometimes up to two hours. This puts an ambulance out of commission from another call for a large amount of time, and with limited resources, staff and ambulances, it is easy to see how that can create a problem quickly.

Pendley admitted during his presentation that RPS has some things to grow on too when it comes to services in Chilton County, and they are currently working on that. Ways he plans to help expedite that process is cutting down on mutual aid to nearby counties and growing the communication between RPS and the county’s representatives. Pendley recently placed Kevin Driver, a local Chilton County resident and RPS employee, in a representative role for the company in Chilton County. Driver will operate as a middle man between the two entities to work on things as the potential partnership grows.

Williams was pleased with the presentation from Pendley and thought it provided solid, factual information on the issues going on in Chilton County. He added that the meeting was important to have to make sure the public knows about this option of ambulance service the commission is exploring.

“Ambulance service was brought to me right when I got elected, and the obvious thing was money, and money is still going to be the obvious thing and how we are going to get to where we need to be and sustain it,” Williams said. “Whatever we go with, we are going to have to sustain it. I appreciate all of this crowd being here, and Eric and RPS working in the county with no contract.”