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TUESDAY, JUNE 19, 2007

Ambulance service may lose Decatur monopoly
City Council's vote indicates one-provider system may end

By Eric Fleischauer 340-2435

If Monday's City Council vote is any indication, Decatur EMS may lose its nine-year monopoly on ambulance transport in Decatur.

The council voted 3-2 against a recommendation to cancel a drawn-out request-for-proposals process that evaluated six ambulance services wanting to do business in Decatur.

The city EMS Committee wants to continue the ambulance monopoly. It initiated the request for proposals to determine whether Decatur EMS should remain sole provider of ambulance services in the city, or whether that mantle should go to a different ambulance service.

By proposing cancellation of the request-for-proposals process, and by continuing its practice of recommending against the licensing of competing ambulance services, the EMS Committee signaled its desire to continue Decatur EMS's monopoly.

Continuing proposal process

But the City Council's vote to continue the proposal process means other ambulance services can seek to displace Decatur EMS as sole provider of ambulance services. Individual council members said they soon may end the Decatur EMS monopoly by awarding licenses to other ambulance services.

The request for proposals does not specify whether the winning ambulance provider would receive an exclusive contract.

Assistant City Attorney Kelly Butler, who coordinated the two-year proposal process for the EMS Committee, asked the City Council to cancel it. An EMS Committee panel report ranked Decatur EMS last, with Care Ambulance ranked on top.

"This process has been incredibly frustrating," Councilman Ronny Russell said, after listening to Butler's cancellation request. "I can't support this."

"The only way we can accomplish (improving ambulance service) is with competition," Russell continued. "We need a second ambulance service."

Joining Russell in opposing cancellation of the request for proposals — and thus opposing uncontested continuation of the Decatur EMS monopoly — were councilmen Ray Metzger and Gary Hammond. Council President Billy Jackson and Councilman David Bolding voted to cancel the request for proposals.

The issue will come to a head when the City Council considers the EMS Committee's recommendation to deny certificates of public necessity and convenience — a license that is a prerequisite to operating an ambulance within the city — to the most recent applicants, Care Ambulance and Med-Call.

EMS Committee members indicated at a meeting last week that their denial recommendation resulted not from the quality of the ambulance services, but from their desire to maintain a one-provider system in the city.

The committee's formal recommendation on the certificate applications is expected in the next 30 days.

If the request-for-proposals process plays out to the end, the council would select one of the six ambulance providers and enter into contract negotiations with that provider.

Decatur EMS lawyer Barney Lovelace, who said the request-for-proposals process violates state competitive bidding laws, has suggested his client would file suit if the end result of the negotiations was an exclusive contract with a provider other than Decatur EMS.

After the council meeting, Jackson said his concern with allowing other ambulance services in the Decatur market is that they will struggle financially. That could erode service and, in the worst case, lead to the financial failure of all private ambulances in Decatur, he said.

Jackson said he does not care which ambulance service has a monopoly on Decatur service, provided one does.

"People are so desperate to maintain this monopoly that they are torturing logic to death," said Hammon.

Hammon said a monopoly on ambulance services prevents the city from enforcing safety standards.

"If they don't meet these standards, what are we going to do with them? We can't suspend their license for three months," Hammon said, "because we don't have another ambulance service in the city."

If the city had several providers, he said, it would have the leverage to demand that any one of those services meet the standards.

Lovelace said last week the city has no right to revoke his client's certificate, an argument that effectively would preclude a one-provider system with any other ambulance service.

The ordinance upon which he relies, however, provides the city can revoke a certificate of public necessity and convenience by finding "the public convenience and necessity no longer warrant such operation."

For years, the city has denied certificates for other ambulance services because they were not warranted for "the public convenience and necessity" in light of Decatur EMS's presence in the market.

Care Ambulance Director of Operations Dell Gamble, during the EMS Committee meeting, proposed a system in which the city ends the monopoly on ambulance services, but competitively bids a contract for 911 services.

City Attorney Herman Marks said that option would pass legal muster if the council opted for it.

"Municipalities have a statutory right to contract with an ambulance company of their choosing, through a competitive process, for emergency service provision," said Butler last week.

"To me that means they have a right to contract for the calls that come out of dispatch," Butler continued. "That doesn't mean other companies can't operate. There are other kinds of calls besides dispatch calls."

A benefit of that approach for the city is it would avoid the legal issues involved in revoking Decatur EMS's certificate. Even if it lost the ability to handle 911 calls, Decatur EMS still could perform other ambulance services in the city.

"It's not a matter of kicking somebody out of business," Butler said.

Another approach, advocated by Med-Call President David Childers, is a wide-open system in which 911 dispatchers simply contact the licensed ambulance closest to the patient. The technology for such an approach — already used in Morgan County — is in place.

EMS Committee member Steve Hall said that creates a risk of ambulance services losing money and possibly going out of business.

Hammon said that's no different than any business, and it's a reason for more services being in the city.

"If we allow another ambulance service in Decatur, will Decatur EMS make less money? Yes, it will," said Hammon. "Unless there's some overwhelming reason not to use it, the free enterprise system generally works best."

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