The Mobile City Council committee on Jan. 14 heard competing views over a proposed certificate of public convenience and necessity for Acadian Ambulance to operate in the city, but took no vote and laid the matter over to appear on next week's agenda.

City attorney Jonathan opened the hearing by summarizing the municipal code criteria the council must consider, including public need, the applicant's experience and finances, and the condition of vehicles and crews. Chief (Mobile Fire Rescue) told the committee staff re-worked Acadian's application to align with city ordinance and said that, based on recent data, current BLS providers have been meeting the city's 90th-percentile response-reliability requirement.

Danny Rickert, chief policy officer for USA Health's University Hospital, told the committee diversion occurs when hospitals cannot accept new patients because there are no available beds and said limited transport capacity to move discharge-ready patients is one component of that problem. "Transport is a component," Rickert said, estimating about 1,000 diversion hours in recent years, which he said translated to roughly "2,000 patients that we are unable to see." He said additional transport capacity could help throughput but described diversion as a multifaceted problem.

Kelly Hicks, director of emergency services at Mobile Infirmary, said her hospital's needs are currently being met and that scheduled discharges typically have arranged transport.

Acadian's representative argued the company's entry would help throughput and workforce development, noting training partnerships with local schools and CAST accreditation. The representative said some recent reliability gains may be temporary and that Acadian's presence spurred improvements from existing providers.

Corey Hughes, owner of Medevac, and Kenny Newman of Newman's Medical Services described the financial realities of running ambulance services. Hughes said interfacility transfers (which he estimated average about $500 per transfer and are collected roughly 70% of the time) generate the revenue that sustain additional trucks and staffing. "Until you add revenue, there's no adding ambulances," Hughes said, cautioning that adding a new company does not automatically increase the number of staffed ambulances.

Council members pressed staff about whether an RFP for a single BLS contractor would require a certificate beforehand; Chief said a contract could include issuance of a certificate and that staff are refining the RFP terms to avoid destabilizing the fragile EMS market. Councilmembers also asked staff to return with ordinance changes that would let the city better track transport volumes by hospital.

No formal action to approve or deny Acadian's application occurred at the committee meeting. The chair announced the item will appear on the council agenda next week for further consideration.

The committee's next step is to review any proposed ordinance or contract changes and to consider the Acadian application when it returns to the agenda; no certificate was issued at this session.