City changes ambulance service to improve wait times

The city of Homewood made a major change with the new fiscal year, opting to fund a contract with Lifeguard Ambulance Service to ensure dedicated ambulances could serve the city’s residents and cut down on long response times.

Due to what appears to be a widespread staffing shortage, response times for those needing an ambulance in the city of Homewood had become too long, city leaders said.

“Time delays became an issue,” Fire Chief Nick Hill said.

The Problem

The city, until recently, was one of many municipalities  in the area that worked with Regional Paramedic Services to obtain transport for those in need. While Homewood Mayor Patrick McClusky stressed it wasn’t indicative of poor work on their part, response times began to lag for multiple reasons. There is a widespread staffing shortage, Hill said. In addition, RPS handles many calls around Jefferson County, Shelby County and possibly parts of other counties, Hill said. So if a call came in from Homewood, the ambulance might have to come from Jasper or Alabaster, he said.

“They have been fantastic,” Hill said of RPS. “It’s just the nature of the beast.”

Councilman Nick Sims said the problem was exacerbated by the pandemic, and residents have reached out to share their frustrations with him. In one instance, a child fell at Edgewood, but an ambulance never came, leading the parent to drive the child to Children’s of Alabama hospital with head trauma, Sims said.

If a third-party provider cannot meet the needs of the city, he wants the city to reconsider taking on liability and offering ambulance services themselves, he said.

“Liability is a risk, … [but] we have goals that are greater than the financial bottom line,” Sims said.

Jefferson County Commissioner Steve Ammons said there are multiple issues in the county.

“People have gotten accustomed to calling 911 for non-emergency reasons like a stubbed toe or a doctor’s appointment,” Ammons said. “If an ambulance shows up for a non-emergency, they still have to transport if people want to go to the hospital. They also have to stay with the patient until they’re accepted by the hospital.”

At a time when emergency medical technicians and paramedics are hard to find, that creates a problem, Ammons said.

“Nobody wants to be in public service anymore,” Ammons said. “We have to look at how we pay our first responders for the difficult job they do.”

The Solution

With the staffing shortage and long wait times, it became apparent the city needed to either find a third-party provider or take on transporting residents themselves, the latter being the choice of neighboring cities Mountain Brook and Vestavia Hills.

In order to provide ambulances themselves, the city would have to purchase ambulances and personnel, which gets expensive quickly, McClusky and Hill both said. It also means taking on the liability of transporting patients to the hospital.

One day, while at his job at the Community Food Bank of Central Alabama, McClusky stepped outside and noticed Lifeguard down the street, with ambulances in the parking lot. McClusky approached and gathered information about their service, starting the process of connecting Lifeguard with the city.

Josh Spencer, regional director with Lifeguard, said the business has been around for 35 years and is one of the largest ambulance services in Alabama, with locations throughout the state. In Birmingham, Lifeguard provides interfacility transport for UAB Hospital.

Lifeguard plans to offer a 24-hour ambulance and one 12-hour ambulance, Spencer said. Those two ambulances will both be fully staffed by Lifeguard, Spencer said, and there could be more ambulances added if the need arises.

The initial contract is for a three-year period at a cost of $328,500 per year, increasing 3% each year. There is a max extension term of two years should the city opt into it, said City Clerk Melody Salter. The contract can be paid in monthly installments.

In addition to the staffing, Lifeguard handles all of the billing. Residents will still call 911, which will go through the city’s dispatch center. Those calls will then be directed to Lifeguard, Spencer said.

Spencer said he hopes having dedicated ambulances to city residents will provide peace of mind and a better presence for Homewood.

While Lifeguard has experienced staffing shortages like everyone else, Spencer said he is not worried about staffing the ambulances for Homewood.

“Most EMTs and paramedics only want to do 911 calls, and we offer that,” Spencer said.

Staffers for Homewood’s ambulances won’t have to do interfacility work and can focus on taking care of patients, he said. The company also offers a good work-life balance, Spencer said.

“We’ve actually done pretty well in staffing ambulances,” Spencer said.

The business is currently hiring and working to prepare for the start of its service, which will come on Jan. 1 or possibly a little earlier, Spencer said. Lifeguard was still working to secure office space in Homewood as of mid-November.

Hill said having faster response times is key for giving people appropriate medical care. Time is of the essence with strokes, heart attacks, burn patients and more, he said. The same goes for head trauma, as it is paramount to determine if a patient has a brain bleed.

Sims said he is hopeful things will improve with Lifeguard’s help. “I really, really hope it does.”