For quite some time, long before the Vernon Parish Police Jury November meeting, there have been rumors and allegations circulating in Vernon Parish regarding Acadian and Med Express Ambulance Services currently operating here.
In an effort to bring the facts to light and eliminate the rumors, the Leesville Daily Leader has conducted several interviews and a thorough investigation.
RUMOR: "Med Express was the ambulance service who operated here in the 1990s and left with no warning, leaving the Parish without ambulance service for 24 hours."
FACT: At a Vernon Parish Police Jury meeting April 20, 1998, Cecil GuilbeauVP of Operations at that time, informed jury members that Acadian would be acquiring LifeCare on May 1 and asked the jury to grant the company a permit to operate in Vernon Parish. Acadian had been providing services in the parish since April 18, 1998. During the meeting, Acadian was granted a permit to operate in Vernon Parish and has been continued ever since.
Med Express was not active in Vernon Parish prior to 2007. They were granted a permit from the City of Leesville to have had a unit stationed here to assist with Sabine Parish operations and to assist with out of town transports from Fort Polk. From time to time over the years when Acadian was not available or an additional unit was needed they were requested to assist but they have never been on the 911 rotation list.
RUMOR: "Med Express has a history of bankruptcy and tax liens."
FACT: Med Express was discharged from a Chapter 11 bankruptcy several years ago. Following Hurricane Katrina, they were assessed penalties by the IRS regarding DOD contracts and Medicare. They are making their agreed-upon payments monthly and as the balance is reduced the IRS removes a lien.
Med Express does not hide this fact. It is disclosed to lenders, DOD contracts and institutional contracts.
RUMOR: "Acadian is the only legal ambulance provider in the parish."
FACT: Both Acadian and Med Express are certified and licensed through the Louisiana Department of Health and Hospitals, Health Standards Section (HHS) (LAC 48:1 Chapter 60) to provide service throughout the state.
It is then at the discretion of each town, city and parish to issue a license to operate within their boundary if they have ordinances in place requiring them.
Currently, Acadian does not have a contract with Vernon Parish to provide ambulance service. According to several sources they did in the past but when that contract expired Acadian did not apply for a new one.
Med Express has a valid occupational license with the city of Leesville.
RUMOR: "We don't need another ambulance service here."
FACT: "The number of units assigned to Vernon Parish is not based on the number of residents in the parish, they are assigned based on the necessity of the service and patient volume." said Paul Fuselier, Community and Government Relations Manager with Acadian. Currently Acadian has two units assigned to Vernon Parish during the day and one at night.
They monitor the patient volume and will increase or decrease units based on need. If additional units are needed in Vernon Parish units from Rapides, Allen and Beauregard Parishes will respond.
The issue at the center of this mess is the fact that some residents who live in the more rural areas of the parish often experience long wait times when an ambulance is needed.
Many of them, like residents in Slagel and Hicks, would rather drive themselves to the hospital instead of calling the ambulance.
The average response time parish-wide for Acadian during the first half of 2017 was 13:48. Their response time increased to 14:09 in the second half of 2017.
From January 2018 through October their response time decreased to 13:43 and since the November Police Jury meeting, it runs between 13:50 - 14:00 minutes.
Med Express has had a unit available in Leesville since the end of October. In the first week they were in operation Med Express responded to eight calls where Acadian was unable.
In the month since the Police Jury meeting, they have responded to nearly 50.
Med Express recently signed a lease to open a station house in Anacoco in January. However, in order for Med Express to be dispatched by 911, a responding deputy or fire department official has to verbally request a Med Express unit to be dispatched because they are not on the 911 rotation list.
Many residents of the parish feel there is a need for additional ambulance units if they are forced to endure longer than "normal" wait times because Acadian is not able to respond in an emergency.
Vernon Parish is just the latest battleground for what has been called an "ambulance war" between Acadian and Med Express Ambulance Services.
For more than 20 years both of these providers have been active in multiple parishes throughout Louisiana.
Many times they have worked side-by-side providing excellent, quality care to communities both large and small.
However, many times since the early 1990s Acadian and Med Express have faced-off in local courts, the Louisiana State Supreme Court and the Court of Appeals.
The majority of the issues for these face-offs have been over who has the right to operate within a territory.
Acadian was providing service parish-wide in Evangeline Parish in October 1994 when Med Express submitted an application to provide service.
In January 1995 the Emergency Medical Service Advisory Board determined that there was no need for an additional ambulance service in the parish and Evangeline Parish Police Jury denied the permit.
Med Express filed a petition for an injunction to prevent Evangeline Parish from prohibiting them from operating in the parish.
Essentially this case was filed on the basis that Evangeline Parish ordinances "prohibited fair competition" and violated that "right to free enterprise" by denying Med Express the permit to operate in the Parish.
It was ruled by the Louisiana Supreme Court (La. 96-CA-0543) that the Evangeline Parish codes were not unconstitutional and the Police Jury was not required to issue a permit to operate within the parish.
Acadian is the only ambulance service provider in Evangeline Parish at this time.
In another case (Lege v. Abbeville City Council, 787 So. 2d 1228 (La. Ct. App. 2001), Med Express had been providing service in Abbeville in Vermillion Parish for some time when at a City Council meeting in April 2000 an unscheduled vote was made to grant Med Express a permit to operate within the city of Abbeville.
Acadian then filed a suit alleging that the Council violated its own code of ordinances by granting a permit without Med Express obtaining the required "Certificate of Convenience and Necessity" that is issued by the Emergency Medical Service Advisory Board.
Med Express filed a countersuit seeking at least $1,000,000 in damages for from Acadian for unfair and deceptive trade practices.
It was alleged that Acadian was attempting to obtain a permit to operate in the Abbeville and push Med Express out. Ultimately on June 6, 2001, the Court of Appeal sent it back to the District Court for decision.
On September 4, 2001, Vermillion Parish adopted an ordinance (Ordinance #2001-O-15) regulating private ambulance services.
In this ordinance, it required ambulance services operating in the parish to obtain a permit and provide services for one year or be fined.
Med Express then applied for and was granted a permit following the adoption of the ordinance on September 4, 2001.
In June 2002 Acadian again began providing service in the parish and entered a non-compete agreement which required Med Express to cease operations. Med Express complied with the agreement and stopped operations in Vermillion Parish on June 11, 2002.
Vermillion Parish then imposed a fine on Med Express for failing to fulfill its full-year contractual agreement, which they refused to pay and filed suit.
These two cases were heard back and forth in District court and appeals court several times over many years.
Eventually, it was decided that Med Express was not liable for the fine and to date, Acadian is the sole provider of ambulance services in Vermillion Parish.
In July of this year, Acadian filed a suit in the12th Judicial District Court asking for a judge to rule on the validity of a contract Avoyelles Parish Sheriff Doug Anderson made with them years ago to provide ambulance service parish-wide.
This was never an issue until Med Express and St. Landry EMS began providing services and sought to obtain a permit form the parish.
Acadian contends that their contract is legal and gives them the right to operate exclusively.
Med Express officials believe the residents have the right to choose which company to use.
In every legal case that has been reviewed for this article, it appears that all of the issues between Acadian, Med Express and other ambulance providers boils down to money. Statutes and ordinances around the state provide for the creation of monopolies.
When one provider is granted a permit or license to operate within a town, city or parish their ordinances often create a single-provider service that prohibits another service from operating regardless of the need.
In order to correct this, ordinances need to be changed, and this takes time.
Vernon Parish Police Jury President Jim Tuck said: "the jury will do what is best for the parish." Let's hope that when it comes to the matter of life and death, Vernon Parish does not become another battleground in the "ambulance wars."