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Thursday, November 12, 2009

Commissioner Branch “Boots” Ambulance Service Owner Out of Commission Meeting

“Sir, You Are Out of Here! Leave Immediately Or I Will Have You Arrested!,” were the words of a stern faced Board Chairman, Jeremy Branch.

By Sid Riley

During the County Commissioner’s public hearing on the issues relating to a proposed new county ordinance which would essentially prohibit outside ambulance services from coming into Jackson County to provide patient transfer services, a trigger was pulled and fireworks began to go off. It all came about as Mrs. Elena Stackowicz, who works in the County Human Resources office was speaking before the board in support of the Jackson County Fire and Rescue and the proposed ordinance.

She related how her seriously ill husband had to be transported from Jackson Hospital to Dothan due to a serious, declining health issue. When the transport ambulance crew arrived after about a thirty minute wait, she was surprised to find a man dressed in an orange outfit waiting to drive the ambulance. “I didn’t recognize him as part of the ambulance crew since he was dressed in an orange outfit….which normally prisoners wear.”

This statement was the trigger that ignited the fuse of Mr. Pilcher, owner of Dothan Ambulance Service. Tensions were already at a peak level for the involved parties, and this statement was apparently perceived by Mr. Pilcher as a remark which demeaned the professionalism of his ambulance crew.

“We are not convicts! We are NOT convicts!” he yelled to a startled commission room audience.

“Sir, You are out of here! Leave immediately or I will have you arrested!, ” Chairman Branch yelled back in a stern voice.

“She said we looked like convicts!,” Pilcher said again.

“Call the Deputies, I want this man out of this meeting room,” Branch instructed the staff. By the time he had finished this sentence Pilcher was storming out of the room.

After this outburst, Mrs. Stackowicz continued to relate how she would have preferred for Jackson Fire and Rescue to have transported her husband, but she was told that the hospital was now using Dothan Ambulance Service for all transfers.

The meeting had begun on a quieter, more serious note as Chief Wesley provided statistics claiming that Fire and Rescue had made 442 transfers for Jackson Hospital in 2007-2008, with only 16 of those being billed back to the hospital instead of to the patient. In 2008-2009 the number of transfers was 513, with 19 being billed through the hospital. This data refutes claims that the hospital was required to collect from patients in a large number of the transfers.

Wesley also claimed that the ambulances used by Dothan Ambulance Service are not as well equipped as the ones used by the County, and the staff is not as highly trained. “Since they have entered into a contract to accomplish all of these transfers from Jackson Hospital they are taking money which should be coming to Fire and Rescue”, Wesley complained. “We have surveyed many of those transferred by our crews, and have found less than 1% have any complaints about the quality of our service,” Wesley concluded.

“Has the hospital ever expressed any dissatisfaction with your services?,” Commissioner Spires asked. “No” was Wesley’s response.

“Over the past 17 years while I have been a Commissioner there has been no history of complaints from the citizens to me about our ambulance services,” Commissioner Lockey said in support.

The new Hospital Administrator, Larry Meese, who has only been on the job for a few weeks, was called forward to answer questions from the Board.

“Who do you call when a transfer service is needed”, asked Spires. “Jackson County”, Meese answered. “Is there a policy to call Dothan Ambulance Service first?” Asked Lockey. “No”, was the response. “We want to maintain a good relationship with the county and with the Jackson County Fire and Rescue,” Meese reiterated. Spires chided him for being evasive in his answers.

In all fairness, all of these arrangements and the history of problems the hospital staff may have had with the ambulance service all occurred long before Mr. Meese arrived on the scene. It is only natural that he would be careful in voicing an opinion in these matters. Most of the actions which has led to the changing of services had been taken under the term of the previous interim Administrator, Dick McConahy.

Next, Jimmy Rigsby, Administrator of the Graceville Hospital spoke to the Board. “Our hospital is completely satisfied and happy with the work of the Jackson County Fire and Rescue”, he said in support of the county service.

Doctor Rick Brunner, dressed in greens from the operating room, was next to speak. He stated that a note had been placed on the bulletin board in the ER telling the staff that for all patient transfers, Dothan Ambulance Service was to be called. This action had taken place under the term of the previous interim Administrator. “Costs were one of the primary issues, and there were times the service was very slow,” Bruner stated. “I feel that Fire and Rescue should be willing to negotiate rates for transfers with the hospital. Their charges should be close to the Medicare rates.” Bruner agreed that a county-hospital panel should be appointed to assist in coordinating ambulance service issues.

Jim Cowart, of Compass Lake in the Hills, stated that both parties, the hospital and the county Fire and Rescue are needed and necessary. He urged solutions to the problems instead of a combative relationship. “We are not being combative, we are seeking answers to problems”, Lockey corrected.

Sid Riley, (who can rarely keep from saying something in these types of situations) spoke briefly as a private citizen. “The main issue as far as I am concerned is maintaining a freedom of choice for the citizen. In all of these discussions the rights of the patients, their families, and the Doctor have not been mentioned. They should have the right to choose any ambulance service they wish to use, and should not be prevented from doing so by a monopolistic ordinance which imposes decisions made by a government authority and removes the citizens right to choose. I feel the ordinance should be worded to assure any ambulances providing services are properly equipped and staffed with qualified personnel, but it should not create a county wide monopoly for the benefit of the county Fire and Rescue.

At that point a vote was taken and the ordinance was approved unaminously.

After the meeting this writer received a telephone call from Mr. Joe Pilcher, owner of Dothan Ambulance Service and Mr. Ron Durham, the company Operations Manager. Mr. Pilcher began by expressing his remorse over his outburst at the Commission meeting. “It was very unprofessional, and I regret my behavior very much,” he began. “When that lady made the remark about mistaking my workers for convicts, I just lost it. Our staff is comprised of some of the most qualified professional paramedics and EMTS in the Southeast. I instinctively stood up for their honor…And by the way, we chose orange as the color of our men’s jump suits in order to reduce the chances of them being hit by a passing car while saving someone’s life on a dark roadside.”

“We are not trying to take over the ambulance services in Jackson County. In fact, all we want to do is provide services as a back up to the county service…to be there when they can not provide the service,” Pilcher continued. “It was not our company who approached Jackson Hospital looking for an agreement. However, when they felt we were needed, we did attempt to fill their desires.”

Then the Operations Manager, Ron Durham began, “People down there don’t realize it but Mr. Pilcher was born in Jackson Hospital. Our firm has been in the ambulance business since 1965. In fact, back in the early 1970’s we provided all of Jackson County’s ambulance service…before Fire and Rescue even existed.

Chief Wesley made some remarks about our equipment not being as good as theirs. He apparently doesn’t realize it but we have the latest state of the art ambulances, with 12 lead, transmitting EKG capabilities along with many other wonderful life saving features. Our equipment is as good as it gets. Also, our staff is rated among the top 10% in the Southeast.”

They ended the conversation on a conciliatory note, stating that they regretted the disagreements at the Commission meeting, and looked forward to working with the Commission, the Hospital, and with Jackson County Fire and Rescue to bring the best possible overall service to the citizens of the county.

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