Ryan Davisson

After Proposition M failed last November, Metro, addressing a $50 million deficit for 2010, decided to make some difficult cuts in services. It has cut services to west and south Saint Louis County, lessening the frequency of buses and MetroLink trains (by 44 percent and 32 percent, respectively), and plans to reduce 25 percent of its workforce. Furthermore, “Call-a-Ride,” another public mode of transportation used by many disabled individuals within the greater Saint Louis area, discontinued service outside of I-270 in March.

Stretcher vans are an alternative option for individuals with disabilities who live outside the service area. However, private stretcher van services — which are categorized as non-medical transportation services — cost, on average, much more than public transportation, likely because of strict regulations and licensing laws. Stretcher van services are subject to required licensure by Saint Louis County law, and must use two employees per van. License restrictions also stipulate that at least one of the employees must have completed Emergency Medical Technician (EMT) or paramedic training.

At first glance, one might think that although this requirement may hinder the market, it is still justified because it provides protection for the disabled. In reality, however, these restrictions do more harm than good. Written into the ordinance are a number of measures that define stretcher vans as a non-medical mode of transportation. The statute specifies that a passenger cannot need medical equipment or monitoring, require routine transportation for medical appointments, need treatment during transport — whether en route or taken to a hospital — or be a patient who is acutely ill, wounded, or medically unstable. Given that such lengths are taken in an attempt to ensure the initial well-being and stable condition of the passenger before they even step into the van, it seems only logical that an EMT requirement for the driver is an unnecessary measure — and, more importantly, an unnecessary cost. One disabled individual testified before the county council during the public hearing for this measure: “I am not sick, I just can’t walk.”

During the 2001 debate over this bill, many expressed reservations about the EMT training requirement. Some people in the industry voiced opposition, pointing out that stretcher van services provide solely non-emergency transportation. Because the ordinance does not specifically define passenger health, an EMT requirement is excessive for non-emergency service. State law has grandfathered in some stretcher van companies that are licensed in other counties, but businesses serving unincorporated Saint Louis County are harmed by this requirement.

If Saint Louis County rescinded the EMT licensure requirement, companies that provide stretcher van transportation would be able to hire employees from a larger applicant pool, which would significantly reduce business costs. Disabled individuals who use these services would benefit from the absence of these unnecessary restrictions, by having access to a less costly service. Those residing outside the I-270 perimeter will still experience increased transportation costs as a result of Metro’s cuts, but these costs would be substantially mitigated if these unnecessary licensure provisions were eliminated.

Ryan Davisson was a spring 2009 intern with the Show-Me Institute. He recently graduated from Saint Louis University, where he studied economics.

About the Author

Ryan Davisson