Sale Won`t Save Embattled Ala. EMS Agency`s License

Feb. 15--Embattled ambulance company Decatur Emergency Medical Services Inc. may be for sale or even been sold, Assistant City Attorney Chip Alexander said Friday.

But that won't help the company avoid the threatened revocation of its license to operate in the city.

"We have heard that a purchase is imminent. We've heard the sale has already taken place," Alexander said. "We can't verify it, though, and nobody's applied for a CPNC."

A CPNC -- certificate of public necessity and convenience -- is the license that allows DEMSI and its sole competitor, First Response, to operate in Decatur.

City Councilman Charles Kirby said an acquaintance within the EMS community told him Thursday that Shoals Ambulance had purchased DEMSI.

Barney Lovelace, attorney for DEMSI, did not return calls Thursday or Friday.

Shoals Ambulance, based in Lauderdale County, lost a bid Thursday to expand its ambulance services into Muscle Shoals. CEO Bryan Gibson did not return calls on whether he was eyeing a purchase of DEMSI to expand into Decatur.

Last month, a DEMSI spokesman said the company was pursuing a merger.

"The new company or the new ownership would have to go through the CPNC process and get licensed," Alexander said.

Decatur Fire and Rescue Battalion Chief Ted McKelvey, the city's EMS coordinator, initiated a procedure Monday that could result in revocation of DEMSI's license.

McKelvey claimed DEMSI violated an agreement with the city when a Feb. 7 work stoppage -- by employees who said they went unpaid -- caused the company to remove its ambulances from service for about three hours. In a letter to DEMSI owner Roger Stanmore, McKelvey said the company also fell below a three-ambulance minimum on Feb. 8 and Feb. 9.

The Decatur EMS Committee will consider McKelvey's allegations and DEMSI's response at a hearing Feb. 21.

Outdated ordinance

The process is complicated by a dated ordinance that says nothing about how many ambulances DEMSI must maintain, Alexander said. It requires DEMSI to have the financial ability to provide ambulance services, but it allows the city to inspect company finances only in an annual audited report.

"The purpose of the annual report is to try to verify that they have the ability to stay in business, that we won't come in one day and find their doors padlocked," Alexander said. "But I'm not aware of any mechanism for getting the financial information, other than to wait for them to file the annual report."

The ordinance does not expressly allow revocation of the CPNC for violation of any of the 83 pages of rules passed by the EMS coordinator with the approval of the EMS Committee, although Alexander said the City Council has that authority. A requirement that each company have two ambulances in service at all times and a third on duty 12 hours a day is included in EMS rules.

The ordinance gives the EMS Committee no enforcement powers. All the committee can do is advise the City Council on how it should penalize an ambulance company. Alexander said the ordinance was designed for an EMS system that had only one ambulance service -- DEMSI had a monopoly from 1998 until July 2012 -- and is in desperate need of amendment or replacement.

"The City Council is going to have to change it," Alexander said. "When there was just one service, it was a completely different mindset. Even if there was a violation, you had to operate from the standpoint of getting it fixed. You couldn't really close the company, because that left you without an ambulance service."

The competition that began in 2012 also means both DEMSI and First Response are trying to use the ordinance as a weapon to increase market share.

"Because the two are in competition, the reports of wrongdoing have grown exponentially," Alexander said. "One will say the other is doing something wrong, just back and forth. You've got people trying to dig up something on each other. Neither company has clean hands on that."

The process for penalizing a company is slow. After the EMS coordinator notifies the ambulance service of a possible violation, the company has 15 days to meet with the coordinator to determine if "a mutually agreeable resolution" can be reached. If not, the coordinator must wait another 10 days to present the matter to the EMS Committee, which can recommend CPNC revocation at the next City Council meeting, in this case March 3.

To speed up the process, McKelvey's letter to Stanmore focused not on DEMSI's alleged violation of the ordinance, but its violation of a November agreement after one of its ambulances broke down. The agreement reiterates the three-ambulance requirement. By alleging breach of the agreement, rather than violation of EMS rules, Alexander hopes to expedite the City Council's opportunity to vote on revocation.

When McKelvey made the same allegation in January, however, the EMS Committee took no action.

High stakes

The stakes are high. DEMSI's sole territory is Decatur, so revocation of its CPNC would put it out of business. If the City Council decides to revoke the license, Alexander said he would not be surprised if DEMSI asked a court to review the decision.

"Things get reviewed all the time," Alexander said. "If they reviewed the revocation of the CPNC, absent some kind of egregious conduct by the city, I don't think there would be liability for the city. Most administrative appeals are focused on whether the correct procedures are followed, rather than whether the correct decision was made. The court isn't deciding if it would rule the same way as a city council."

City Councilmen Roger Anders and Kirby said they are ready to act on Alexander's call for a change in the ambulance ordinance.

Anders, who is liaison to the Morgan County 911 board and to Decatur Fire and Rescue, said the ordinance needs to give the EMS Committee more authority.

"We need a system in place that reacts quickly when there's a need," Anders said. "I'm ready for Legal to work something up, an ordinance that has more teeth."

Kirby, the liaison to the EMS Committee, said he wants the ordinance to give the EMS coordinator more power. The ambulance companies should have the ability to appeal the coordinator's decision, Kirby said, but McKelvey's decisions should stand until overturned by the committee or the council.

"I don't think the process needs to wait on the committee," Kirby said. "To some degree the committee has been afraid to act. Even if it wants to act, however, the committee can do nothing. Ted McKelvey doesn't need to be put in a position of waiting. If citizens' lives can be at risk, we need to put a process in where he can act immediately."

Eric Fleischauer can be reached at 256-340-2435 or eric@decaturdaily.com. Follow him on Twitter @DD_Fleischauer.

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