Florida Judge Rules on County Ambulance Dispute

Private agreement with TransCare Medical Transportation Service does not limit company expansion


BILL VARIAN, Tampa Bay Times | | Monday, September 23, 2013

TAMPA - A state judge appears to have cleared one long-standing hurdle for a company seeking to bring greater competition to Hillsborough County's ambulance industry and potentially lower costs for customers.

Circuit Judge Steven Scott Stephens found that a private agreement between TransCare Medical Transportation Service and another ambulance company in 1996 to limit TransCare's business to psychiatric patients did not prevent it from seeking to expand into other areas.

For years, the two other major companies that provide ambulance service in Hillsborough County have used that agreement to block TransCare's expansion. And as recently as this summer, the Public Transportation Commission, which regulates for-hire vehicles in Hillsborough, has accepted the argument in denying TransCare's expansion ambitions.

"That would be a tortured and unreasonable construction of the agreement's language," said Stephens, who ruled the PTC is not bound by a third-party private contract anyway. The PTC is supposed to simply weigh whether a new provider would promote a "public convenience and necessity."

The ruling is sure to provide ammunition for detractors of the PTC, which also regulates cabs, limos and tow trucks. Those detractors, including some state legislators looking into whether to modify or disband the agency, say it works to preserve monopolies and thwart free-market competition and entrepreneurship.

TransCare, a subsidiary of the Crisis Center of Tampa Bay, responds to nonlife-threatening ambulance calls in Tampa and is a backup to the other two companies in unincorporated Hillsborough County. Since 1996, it also has transported patients who are mentally ill.

The company says the non-emergency ambulance service for 911 calls is a money loser because many customers don't have insurance and calls are often canceled. So for years it has been seeking to compete for nonmental-health patients who need to be transported between medical centers, which is a more lucrative business.

The companies now providing that service, American Medical Response and AmeriCare Ambulance Service, have vigorously fought TransCare's repeated applications before the PTC.

AMR, which signed the 1996 agreement with TransCare, says it prohibits the company from seeking to expand into the inter-facility transport business in exchange for getting to transport psychiatric patients.

Judge Stephens noted that in 2010, AMR argued against a TransCare application because its Crisis Center parent receives public subsidies, arguing that it gave the nonprofit an unfair advantage. A hearing officer for the PTC agreed.

Stephens said AMR objected "for the remarkable reason that allowing (the) Crisis Center to compete openly in the market might result in lower prices for customers."

TransCare's most recent application was the subject of a four-day debate before the same hearing officer, who is charged with making a recommendation to the PTC.

This time, he recommended that the PTC board, made up of members of the Hillsborough County Commission and representatives from the county's three cities, wait for Stephens' court ruling.

The application remains pending after the PTC deadlocked in a 3-3 vote this summer over whether to approve it.

"For over a decade, (the other providers) have maintained that the Crisis Center has been bound by a contractual agreement not to ever compete in the inter-facility market," said Steve Anderson, an attorney for the Crisis Center. "They have been able to impose that argument on the PTC and on the hearing masters for all those years.

"But the judge has ruled they have no basis to do that."

Seth Mills, an attorney for AMR, did not return a phone call seeking comment.

County Attorney Chip Fletcher, whose office represents the PTC, cautioned that the ruling is not a final decision on the lawsuit between the Crisis Center and AMR. AMR was seeking to force TransCare into arbitration over its most recent application, based on terms of the 1996 agreement. TransCare was fighting that request.

In addressing the question, the judge was forced to also answer the question of whether the 1996 agreement has any bearing on TransCare's current application. His answer is it does not.

Fletcher said his office is still evaluating what the ruling means for TransCare's application, which is tentatively scheduled to go back to the PTC in October.

Hillsborough County Commission Chairman Ken Hagan, who sits on the PTC and supports TransCare's request, thinks the board should now approve it.

"It's my hope that this would encourage other board members to reconsider their position," he said. "To defer any decision until the dispute is resolved is absurd."

County Commissioner Victor Crist, the PTC chairman who has previously opposed TransCare's application, said the ruling may indeed persuade him.

"The argument that the existing two ambulance have put forward is there is this civil contract," Crist said. "That was probably their primary argument this time around. This action by the court kind of blows that up."

Bill Varian can be reached at varian@tampabay.com or (813) 226-3387.

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