New regulations under consideration by the Loudon
County commission could limit the number of
nonemergency ambulance services operating in the
county.
"We're not telling anybody they can't do business in
the county, but they have to meet the new
regulations," said Mayor Buddy Bradshaw.
According to Tennessee state law, to protect the
public health and welfare, any county or city may
adopt and enforce reasonable regulations to control
the provision of private or nonprofit ambulance
service. Regulations in Loudon have not been updated
since 194, Bradshaw said.
In addition to rules about equipment, supplies and
training, the new regulations could include
requiring every ambulance company operating in the
county to staff a local office at least 40 hours per
week.
Ambulance vehicles would be limited to no more than
five years old with no more than 200,000 miles. "We
think Loudon citizens deserve the best. We don't
want them using a 1985 Country Squire station wagon
as an ambulance," he said.
Bradshaw also said he thought the county would get
better service with fewer ambulance providers. Too
many providers reduces the profitability of all
providers and subsequently reduces the quality of
service for the citizens, he said.
New regulations, which will be voted on in
September, would put the monitoring of any ambulance
service operating in the county under the direct
supervision of the County Mayor's office. Ambulance
companies would have to get a certificate of
compliance to operate.
At a recent commission workshop, Chairman Steve
Harrelson questioned whether it was a good idea for
the county to get involved in regulating ambulance
service.
Commissioner Van Shaver said he believes that
citizens are capable of deciding which service
provider they would like to do business with.
"I'm for the free market system," he said.
Ron Cunningham, a spokesperson for American Medical
Response, said it's important that consumers have a
choice when making important health care decisions.
"You should be able to choose your provider," he
said.
Shaver questioned whether the county has the legal
right to sign exclusive contracts that might disrupt
the ability of other private businesses to operate
in the county.
Commissioner Leo Bradshaw, former Loudon County
purchasing director, told commissioners it is legal
and not unusual for county governments to enter into
exclusive contracts with service providers.
According to Shaver, providing exclusivity reduces
competition, which can cause an increase in price to
the consumer. There is no guarantee quality
increases without competition, he said.
Priority Ambulance currently has an exclusive
contract for all emergency and nonemergency
transport dispatched through the 911 system.
Priority also has exclusive contracts for emergency
and nonemergency transport with the city of Loudon
and Lenoir City, said Rob Webb vice president of
Tennessee Operations. A lot of rural counties have
exclusive contracts for both emergency and
nonemergency ambulance service, he said.
Webb said he agrees that having too many service
providers can reduce the quality of service because
the other companies might not be profitable enough
to provide quality service.
A lot of rural counties don't generate enough
transport business to make it profitable to operate,
he said. Nonemergency transports are more profitable
because they can be scheduled in advance, requiring
fewer resources.
Emergency transports are less profitable. Some of
the emergency transports generate no revenue if the
patients are indigent or do not pay their bill, yet
the contract with the county requires they be
transported, Webb said.
Priority, which handles about 100 nonemergency calls
a month in Loudon County, might not require any
additional resources to take on all the additional
nonemergency transports, he said. "We can also pull
additional resources from Knox County," he said.
Rural/Metro Ambulance formerly provided emergency
transport in Loudon County and currently provides
nonemergency transport service. Rural/Metro
transports patients from Covenant Health and Fort
Loudoun Medical Center.
Rural/Metro filed suit against Lenoir City last year
after the city signed the exclusive contract with
Priority. The suit was withdrawn when Lenoir City
agreed to allow Rural/Metro to continue to work with
Covenant.
The November 2014 emergency ambulance service
termination agreement between Rural/Metro and the
county, the county must still allow Rural/ Metro to
provide nonemergency services and is prohibited from
taking action to revoke or interfere with that
right.
The agreement also stipulates that Rural/Metro
comply with Loudon County's regulations governing
ambulance service. Rural/Metro declined to comment
on the new requirements.
According to a statement from Covenant
administrators, Fort Loudoun Medical Center and
Covenant Health defer to patients' preference
regarding their choice of nonemergency transporter.
Fort Loudoun is committed to providing excellent
patient care and will work with any ambulance
provider chosen by the community's elected officials
to accomplish this goal.