Ambulance flap not over
An idea to update the ambulance policy originally drafted in 1994 has drawn some hesitancy by Loudon County commissioners on whether any changes could stifle commerce.
Loudon County Mayor Rollen “Buddy” Bradshaw said he brought the revision up during a workshop earlier this month to deter different ambulance services from trying to “cherry pick” patients, which despite the county entering into an agreement with Priority Ambulance in January as the primary provider, has still been an issue.
“It’s been going on and I honestly thought it would phase its way out as we transitioned into one primary ambulance provider and not happen,” Bradshaw said. “I’ve seen at least three other providers besides Priority run transports in our county.”
Bradshaw said the policy amendment would require any ambulance service conducting business within the area to have an office stationed in Loudon County 40 hours per week. The policy had been already in place, with exception to some tweaks made in the verbiage, but Bradshaw said for some reason hadn’t been enforced recently.
“I think the question was raised exactly what he (Bradshaw) means by cherry picking, and the way our contract’s set up with Priority, they are the only ambulance service that is providing emergency services for the county,” Steve Harrelson, commission chairman, said. “I think the only thing we’re dealing with as far as other ... ambulance services are concerned are the private individuals in the county that might be calling different organizations to transport them for whatever reason.”
Harrelson said requiring all ambulance companies to open an office within county limits, 40 hours per week, for people to pay bills or file complaints should not be required because “times have changed” from when the document was originally drafted in 1994.
“I think businesses and the way of paying fees and dealing with complaints and that sort of thing are handled in a different way or manner than they were 20 some odd years ago,” he said.
Currently, all calls passing through the E-911 Center are to be responded to by Priority Ambulance. Bradshaw said a resident looking for a transport, whether it be for dialysis or some other nonemergency situation, can still have another ambulance provider come pick them up.
“We aren’t looking to prevent others from doing business but Loudon County residents should never settle for anything but the best,” he said in an email correspondence. “If an ambulance company wants to serve Loudon County residents and visitors then they will have to adhere to the regulations. If they want to provide the service then it’s going to be full service. They can come in compliance with our regulations and run their service, but it needs to be by Loudon County rules.
“If we continue to allow just any company to come in and run calls, it will eventually get to a point where no company wants a contract with Loudon County because it’s a ‘free graze’ market,” he added. “When that happens, Loudon County will be the one to suffer.”
Commissioner Van Shaver said the document was drafted in 1994 when Loudon County provided its own ambulance service, and the document helped the county provider to “not have a lot of competition.” Once another ambulance service was brought forth into the county, the resolution became irrelevant, he said. 
“For me personally I have a problem with government passing the regulations on private business, yes,” Shaver said. “It certainly would stifle commerce when you prevent other companies from operating in your county whatever the case might be.”
Bradshaw said he didn’t think the changes would restrict enterprise within the county.
“I think there are some commissioners that are hesitant and the argument is that it restricts enterprise,” Bradshaw said in an email correspondence. “I disagree with that particular argument because we honored the free enterprise when we put the contract out to bid. I think Commissioner (Matthew) Tinker made a valid point when he stated ‘Why even bid it out?’ if we are going to let just any service come in.”
According to the proposed amended resolution, a provider would need to submit an affidavit to the mayor’s office confirming it is properly licensed, meets all the Department of Health regulations and provides proof of insurance via a certificate of coverage. The mayor would then be able to issue that provider a certificate of compliance to operate within Loudon County. Similarly, the mayor would be able to revoke a certificate of compliance if any violation should occur. The mayor or a designee would investigate all allegations and report back to commissioners.
“I think we’re ... potentially opening up a big can of worms where we’re — the Loudon County government’s — getting into regulating services and having to provide a certificate for private businesses to operate in the county,” Harrelson said.
Per the amended resolution, “the revocation may be appealed to the Loudon County Commission, and, if the revocation is not overturned then by the statutory writ of certiorari.”
The current version states a county emergency service director and regional emergency director should investigate all allegations regarding violation of regulations and present “patient care issues” to commission and the Loudon County executive.
“We don’t have an emergency services director, to my knowledge, so we need to put the authority in somebody’s hands,” Bob Bowman, county attorney, said. “... So, essentially it’s the same process.”
Commissioner Henry Cullen said he wanted to hear from Bowman before he made up his mind.
“I see where there’s some good to come from it, but before you jump into this we’ve got to have the lawyers take a look at this,” Cullen said. “I don’t know how to explain that any clearer. And if you’ve got an ambulance service, how do I stop (a person) from picking the phone up and calling the transport without going through 911? That’s an issue, too. Can you restrict free trade? Van ... was right on that.”
Bowman is expected to attend next month’s commission workshop to answer any questions commissioners may have, Harrelson said.
Bradshaw said he would be open to suggestions from commissioners.
“I’m not 100 percent opposed to — if there’s a citizen that wants to use a different provider, that’s fine but this provider’s going to play by the rules and that’s going to be opening up an office inside of Loudon County for 40 hours where people can come in and pay bills or address customer complaints or any issue along those lines,” Bradshaw said.