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County considers ambulance monopoly

With the loss of ProMed Ambulance Service last month, Warren County officials are now considering cutting out future competition by instituting monopolistic power over the county’s ambulance needs.
The discussion was held Monday night during a county Safety Committee meeting.
“As I understand the law, each county government is given the right by the state to either run the ambulance service itself or contract that out to someone else,” said Warren County EMS director Brian Jennings.
The information regarding monopolistic powers came from Ben Rogers, county government consultant with County Technical Assistance Service (CTAS), and Tennessee Annotated Code.
“The law provides that the governing body of the county may provide and maintain and do all things necessary to provide ambulance service as a public service,” says Rogers.
Challengers have taken other counties to court and have lost.
“In my opinion, Tennessee has clearly shown an intent with respect to ambulance services to allow county governments to replace open competition with regulation or monopolistic power,” Rogers said. “Therefore, the refusal to grant a franchise to an ambulance service would not be reviewed by the courts unless a challenger can prove fraud or abuse.”
Jennings inquired about the county’s responsibility in providing an ambulance service after ProMed, which was the only privately owned ambulance service company based in Warren County, lost its permit to run an ambulance service in the county.
In 2006, county officials passed a resolution that allowed private and nonprofit ambulance services to base in Warren County. The application fee was set at $500, as well as a permit fee of $4,500. Permits are good for one year.
ProMed failed to pay its application fee in December. In March, officials decided to set a deadline for payment. When payment was not received, the permit was canceled.
In an interview with the Standard last month, ProMed general manager Michael Henderlight said the county changed the focus of its own ambulance service and began taking the majority of the non-emergency transports from River Park to other facilities, which prevented the business from being financially viable.
“We used to provide about 90 percent of those calls,” he said. “When the county began offering the service about two years ago, our calls went from about 250 each month to between 60 and 88. We can’t keep the doors open when our income has been cut by more than half. Since then, we have been struggling financially.”
At that time, Henderlight was hopeful the business could work out an agreement with the county to reduce the fees and work out an agreement with the runs in order for the business to stay.
During Monday’s meeting, Warren County Executive John Pelham says he received no calls from ProMed about an amicable solution.
“I received no calls about sitting down and trying to work this out,” he said. “Did you Mr. Jennings?”
Ambulance service director Brian Jennings denied receiving any calls about negotiations, but says they would not have done any good.
“We cannot lower the cost of the application fee or permit fee for a business,” Jennings said. “Those fees are set down in a resolution, so there’s nothing we could do. If we did that for ProMed, we would have to do that for every business that asks.”
Commissioner Les Trotman says the county held approximately six meetings when it began looking at the resolution that would allow ambulance service businesses to base within the county and set the fees.
“We wanted to make sure everyone who based here would be a benefit to this county and to make sure certain standards were followed. We invited everyone interested to attend the meetings. When we discussed setting those fees, we were told they were more than fair.”
If the county moves forward with monopolistic power over the county’s ambulance service, other businesses would be prevented from establishing a base in Warren County and to operate here.
By state definition, a business that operates in a particular county is one that picks up and drops off within that county. In order to operate in a particular county, the state requires businesses to obtain a state license.
Given possible legal issues in instituting monopolistic power over the county’s ambulance service, officials sent the information to the county’s legal counsel for its consideration.


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