ARLEY - Both the Arley and Addison town councils voted this month to encourage an additional ambulance service to operate in their towns. Currently, the primary ambulance service operating in Winston County is Regional Paramedical Services (RPS).
Arley Fire Chief James Rickett, Helicon Fire Chief Neil Feist and other firefighters from their departments addressed the Arley Town Council at its Jan. 9 meeting about what they consider to be insufficient ambulance service on the eastern side of Winston County and requested that the council invite an additional ambulance service to base an ambulance in Arley.
“We’ve been having a lot of trouble with our ambulance service,” began Rickett. “(One problem is) the extended times, averaging 30 minutes to an hour, maybe sometimes over an hour. That's a lot of time. That’s a lot of lives that's going to be changed because of the delays.”
These long waits occur because RPS does not station ambulances anywhere east of Double Springs.
“A lot of times, if we've got something major (and) we know that ambulance is gonna be 45 minutes, an hour away, we'll go ahead and call a helicopter. We have loaded (a patient) in the helicopter and (had) the helicopter be gone by the time that ambulance gets here,” Rickett said. “What’s the most important is patient care. The quickest we can get them out of here and on the way to the hospital, (the better),” he said. “I don't care if it’s on the back of a pack mule, if that’s the quickest way to get them to hospital, that’s what we're gonna put them on.”
Another problem the firefighters reported experiencing with the current service is the absence of paramedics on some RPS ambulances.
There is a nationwide shortage of both EMTs and paramedics (who are more highly trained and can administer more treatments and medicines than EMTs), according to the American Ambulance Association, whose survey of 119 EMS organizations found that 30 percent of full-time paramedic positions and 55 percent of part-time paramedic positions were unfilled in the summer of 2022. The survey also found that 39 percent of part-time EMT positions and 11 percent of full-time EMT positions were unfilled at that time.
Feist said that no ambulance is based in Arley even though he believes, based on the radio calls he hears, that Arley Fire Department runs more medical calls than any other fire department in the county.
In 2022, according to Rickett, his department responded to 287 medical calls and 49 fire calls. By comparison, in 2022, the Helicon and Lynn Fire Departments responded to 130 medical calls, Addison Fire Department responded to 69 and Double Springs Fire Department responded to 207, according to Feist, Lynn Fire Chief Derreck Cagle, Addison Fire Chief Mark Wilson and Double Springs Fire Chief Erik Gilbreath. (The Haleyville Fire Department does not receive medical calls.)
Rickett did note that not all of Arley FD’s 287 medical calls required an ambulance; he said later that 35 or 40 of them were probably lift assists for which an ambulance wasn’t needed.
Rickett later said his department receives a lot of medical calls particularly in the summer when more lake homes are occupied. “The population probably quadruples here, and it’s one (call) right after another,” he said. “We’ve had days we’ve had 6 or 7 in one day.”
“Stroke, cardiac and trauma: they all are time-demanding responses,” observed Brian Kuntz Arley FD training officer.
“In the summer when the lake folks are here, trauma cases are (more numerous),” Rickett explained.
“When they do send (an ambulance), it doesn't have a paramedic on it,” Feist continued at the council meeting. He went on to say that he knows the company currently serving Winston County has been trying to staff enough paramedics but that it has not been able to do so.
The absence of paramedics on some RPS ambulances sometimes causes an additional problem for firefighters who are paramedics, Feist noted. If a fire department paramedic provides paramedic care to a patient on scene and there is no paramedic on the arriving ambulance, he or she must then accompany the patient to the hospital in the ambulance, he said.
Rickett said that Arley FD often calls Helicon FD to assist on calls involving a major medical emergency, such as heart attacks and strokes because “they've got everything on their truck that our ambulance service has right now.” However, HFD does not have the ability to transport a patient to a hospital.
“(The Winston County Firefighters Association) can't choose who comes into the county,” Feist told the Arley Town Council. “We can only ask that the provider rise to the level of care that we require or request, and if the current provider can't, we will then say, ‘Who can?’ And we know something that can.”
That would be the company he and Rickett asked the Arley Town Council to invite to operate in the town. According to Rickett, this ambulance service is the only other company that has been receptive to requests, even pleas, to begin operating in Winston County.
Feist said that unlike most ambulance services that, to his understanding, insist on receiving a subsidy to work in a rural area, this company is willing to operate here without one. (RPS does not receive subsidies, according to its Chief Operations Officer Eric Pendley.) Feist said that it costs this company $1,000 a day to operate a single ambulance and that it needs to “make that money up in transports,” primarily non-emergency ones, such as transporting patients from Pine Place to doctors’ appointments.
Feist said having an ambulance based in Arley would benefit nearby towns and communities because it could respond to calls in Helicon, Houston and Addison as well.
Rickett said that the Arley Fire Station can be a base for the new ambulance service. “We’ve got the facilities. We’ve got the bathrooms; we’ve got the showers. We just have to find them a place to sleep,” he said. “We put the trucks where we could leave (an ambulance) an empty spot; everything fits great. It’s gonna work. It's gonna work if we can just get them here and get the paperwork done.”
The Winston County Fire Firefighters Association had called an emergency meeting for Tuesday, Jan. 17, at which its members planned to discuss the need for more ambulance service in east Winston County and vote on whether or not to invite an additional ambulance service to operate in the county. However, that meeting had to be postponed when many of the first responders attending had to leave to assist with the standoff with an armed suspect on Highway 278. The matter will now be on the agenda at the association’s monthly meeting on Tuesday, Jan. 31.
On Jan. 9, Feist told the Arley Town Council that it would speed up the process of the additional company beginning operations in Winston County, ahead of any action taken by the firefighters association, if the Arley and Addison councils invited the company to operate in their towns.
Feist said that he thought the company would put a truck in both towns for now, if the towns were to make this request. If the firefighters association later decides it wants the company to operate throughout the county, he said, the company might then “disperse” ambulances (possibly five in total) to locations around the county so as to try to achieve a 20-minute response time.
Rickett said, “They’re just going to have to see how everything goes once they get started,” noting that the number and placement of trucks in east Winston would depend on what worked best. “Just getting started (on bringing an ambulance to Arley) tickles me to death,” he added. “I can’t wait.”
Arley Mayor Chris Tyree asked Rickett whether, if this company did begin to operate in the area, it would do so for the longterm, and Rickett indicated with a nod that he thought it would.
Council Member Brian Fincher thanked the firefighters in attendance for their efforts. “I think I speak for everybody: We really appreciate what ya’ll are doing to get a truck over here. It will save lives. Very excited. I think the town will work with you in any way, (do) what we need to do on our side as far as giving them permission to use the fire department or whatever. We really appreciate the time and effort ya’ll are putting into getting this done. It’s very much needed.”
Council Member Robert Williams made a motion to provide a formal letter of support inviting the ambulance service to operate in the area and allowing it to be stationed in Arley. Council Member Brian Fincher seconded the motion, and all members voted in favor.
Rickett later said, “It’s not anything against RPS. It’s just they’re overwhelmed right now. It’s competition for them, and it’s going to have us an ambulance in our community that helps our folks. That’s all it is. It’s nothing against them.”
“For the most part, if you’re in Jasper, Double Springs or Haleyville, you got a good response time, but here, (we spend) 45 minutes sometimes waiting, and then you only get an intermediate (EMT, also known as an advanced EMT) because the paramedic is chasing behind,” said Kuntz.
Rickett reiterated that quickly getting patients transported to a hospital is his department’s top priority. “We don’t care who does it, as long as it’s somebody that’s reliable and (somebody) we can trust,” he said.
“If we can get (the additional company) here, we’re tickled to have them,” he remarked, noting that he has found a contractor who is willing to renovate the second story of the fire station into living quarters at cost.
On Monday, Jan. 16, the Addison Town Council voted to give an additional ambulance service permission to operate in the Town of Addison.
Addison Police Chief Brett Rodgers told the council that a certain company had a goal of stationing ambulances in both Addison and Arley. He said that Winston County E-911 had agreed to dispatch these ambulances and to make them the primary service for calls in those towns.
Rodgers spoke about the absence of paramedics on some of the ambulances currently serving the county. “Sometimes you’re getting an advanced EMT (instead). Well, if you’re having a heart attack and you get an advanced (EMT) there, you’re still no better off, because that advanced EMT cannot push drugs on you. They can’t give you nothing. If it’s a major medical, they can’t do nothing. There’s not a paramedic on their truck like there needs to be. They’re running BLS instead of ALS.” That would be Basic Life Support instead of Advanced Life Support.
He said that the unnamed company has mutual aid agreements with other ambulance services, including Cullman EMS, which would mean that if both of the ambulances it stations in Winston were on calls and another was needed, these other ambulance services could respond.
The council members and Mayor Marsha Pigg then discussed where to accommodate any ambulance service employees who might be on duty in Addison in the future. Council Member Brandon Womack suggested the former rescue squad building. Rodgers said the town could clean out an office in that building that is currently serving as storage space and make it into a nice base for the ambulance service.
Addison Fire Chief Mark Wilson said, “We’d be willing to let them use our facility, too, because it’s benefiting us and our community.”
Council Member George Palmer suggested examining and making any needed repairs to the rescue squad building.
“We’ll do some maintenance on it and the community center,” said Pigg.
“We need something bad,” said Rodgers, referring to better ambulance service. “Arley voted on it last Monday night, and they went 100 percent (for it), providing what they’re wanting is a non-subsidizing contract, which means when they come in, the town is out nothing. The town owes them nothing. The town pays them nothing. They’re here. The town just gives them permission to stay here and run calls inside.”
Womack made a motion to give permission to the ambulance service to run calls and place a service within the town limits. Palmer seconded the motion, and all council members present voted in favor. Council Members Michael Long and Timothy Cooper were not present.
See complete story in the Northwest Alabamian.