Certificate of Necessity Hearing: Proposed Ambulance Service in Mobile

The Mobile City Council Committee convened on January 13, 2026, to hold a public hearing regarding Arcadian's application for a Certificate of Public Convenience and Necessity to provide ambulance and medical transport services in Mobile. The committee reviewed the six statutory factors under Municipal Code Section 634, examined current BLS response reliability data provided by Chief Glenn, and heard extensive testimony from hospital representatives and existing ambulance service providers regarding BLS coverage versus inter-facility transport capacity. A consensus emerged that while current BLS response reliability has improved to the required 90th percentile over the last six months, significant challenges remain regarding hospital bed diversion, patient throughput, and the financial sustainability of private ambulance providers due to low reimbursement rates for transport services.

Consent Calendar

• No routine approvals or unanimous actions were listed or discussed during this public hearing.

Public Comments & Testimony

• Danny Rickert (USA Health, Chief Policy Officer): Expressed position that diverting patients and keeping hospital occupancy high is a critical issue. Stated that USA suffers from approximately 1,000 hours of diversion per year, impacting roughly 2,000 patients, primarily due to a lack of available transport resources to move discharged patients to their next destination (home or rehab). Argued that increased transport availability would help reduce diversion and improve quality of care.
• Kelly Hicks (Mobile Infirmary, Director of Emergency Services): Expressed position that their organization's needs are currently being met by existing services. Stated that patient transport waits are rarely extended and that the current system allows for effective scheduling of discharges.
• Arcadian Representative: Stated position that the current improvement in BLS response rates is largely due to the market pressure created by their potential entry. Argued that there is an underlying need based on data suggesting 40-45% of BLS calls were previously unmet. Expressed full support for their own proposed model, highlighting their commitment to workforce development (collaborating with schools and colleges) and CAS accreditation as key benefits to solve the EMS personnel shortage.
• Corey Hughes (Medivac, Owner): Expressed position that adding another ambulance service does not necessarily increase the number of ambulances available, as revenue is tied to transport calls which pay for the BLS coverage. Stated that transport is the financial backbone of the business while BLS calls often result in losses. Expressed concern that splitting the transport revenue among more providers would destabilize the existing sustainable models.
• Kenny Newman (Newman's Medical Services, Owner): Expressed position that their family is deeply committed to the city with an 86-year history. Stated that while they faced challenges, they have resolved communication issues with the Fire Department and are meeting reliability standards. Argued that the primary issue is hospital bed capacity and administrative payment issues (specifically citing Spring Hill's refusal to pay), rather than a lack of ambulance companies.
• Council Member Small: Expressed skepticism that a single certificate approval would solve structural financial and operational issues. Highlighted the complexity of the market, noting that hospitals are competing for the same transport revenue and that the current model lacks certainty for providers to invest in new assets. Stated a position that broader conversations regarding financing, billing, and community education on 911 usage are necessary before approving new entrants.

Discussion Items

• Statutory Factors & Ordinance Review: The City Attorney reviewed the six factors for a Certificate of Public Convenience and Necessity, focusing on public need, service quality, applicant experience, financial ability, and the character of the ambulances. The committee noted that while the current ordinance covers these factors, questions were raised regarding the 10-year expiration of certificates and the lack of penalties for falling below 90th percentile reliability.
• Current BLS Reliability Data: Chief Glenn presented data showing that for the six months ending December 2025, out of over 7,000 BLS calls, only approximately 100 calls were not answered by private providers, resulting in a response rate meeting or exceeding the 90th percentile. He attributed recent improvements to better coordination with hospitals and reduced wall times.
• RFP and Single Provider Consideration: Councilman Penn and Councilman Woods inquired about a potential Request for Proposal (RFP) for a single BLS provider. Chief Glenn clarified that the goal would be to assign the entire BLS load to one company with a strict contract requirement to meet the 90th percentile, but he noted the ordinance currently lacks enforcement penalties for failure to meet this standard. The RFP process is pending finalization due to recent administrative changes.
• Hospital Diversion and Transport Capacity: Council members questioned USA Health and Medivac representatives regarding the relationship between hospital on-diversion status and transport availability. USA Health confirmed that their diversion is driven by an inability to discharge patients due to a lack of external transport resources, not just a lack of incoming ambulance capacity. Medivac and Newman's explained that transport calls are financially necessary to sustain BLS operations and that the market is too fragmented to easily absorb additional entrants without risking financial collapse for existing providers.
• Workforce Development: Arcadian emphasized their plan to partner with high schools and vocational schools to address the national EMS workforce shortage. Councilman Woods queried existing providers on their recruitment plans; Newman's confirmed they are already paying for student EMT/paramedic courses but cite a lack of willing candidates post-COVID rather than a lack of training availability.

Key Outcomes

• Deferral to Next Agenda: The committee voted to continue the matter to the next regular council meeting (scheduled for the following week) to allow for further deliberation on the ordinance, the RFP process, and the complex financial dynamics of the EMS market.
• Administrative Action: The administration is tasked with finalizing the RFP process within a couple of weeks and addressing the ordinance regarding certificate expiration and reliability penalties.
• Data Verification: Council members are advised to verify the Chief's data regarding BLS response rates (7,000 calls, 100 unanswered) and the status of Spring Hill Hospital's payment practices during the continued discussion.
• Committee Action: President Small indicated that the committee will review the conflicting testimony regarding the necessity of the service versus the financial risks of splitting the revenue pool before making a recommendation to the full council.