Siren Song

Siren Song

By Francis X. Gilpin

Associate Editor

Former Tampa City Council Chairman Ronald W. "Ronnie" Mason Sr. and local lawyer David M. Carr are familiar with E. Frank Griswold III.

Mason led the opposition to Griswold getting into the Tampa ambulance business almost a decade ago. Mason then took for himself the ambulance permits that Griswold sought.

Griswold's protests led to a 1998 federal indictment of Mason and Carr on extortion and conspiracy charges. The odor of Hillsborough County politics wafting from the whole Mason ambulance affair was hardly removed two years later when prosecutors inexplicably dropped the charges.

After another year and the confidential settlement of a lawsuit, Hillsborough officials finally gave Griswold six ambulance permits in 2001.

Now comes a new lawsuit from Griswold. Though Griswold won his permits, his lawsuit alleges, he still had won no favor.

Griswold's suit describes how, at a 2002 meeting of private ambulance operators and a county fire official, he announced that he was going to the U.S. Department of Justice unless local officials and his competitors abandoned a dispatching rotation that he claims was depriving his company of a fair share of profitable ambulance calls.

Mason, Carr and every other attendee at the meeting except Griswold walked out, according to the federal antitrust lawsuit filed in April.

Did Mason and Carr fear that Griswold was wearing a hidden microphone for the Federal Bureau of Investigation? Mason referred questions to Carr, who didn't respond to a message from the Gulf Coast Business Review before the newspaper's deadline.

Griswold says he wasn't wearing an FBI mike for that meeting. Later, though, he says he agreed to don one for an appointment with an ex-ambulance executive. But that meeting never occurred.

Three-and-a-half years after getting his county permits, Griswold's ambulance company is no longer answering calls. Med Evac Inc. is in bankruptcy court.

The Griswold lawsuit contends he was driven out of the ambulance business - at least temporarily - by some of the same players who delayed his entry into it during the 1990s.

Local government officials and rival ambulance executives who could be reached by the Review deny they did anything to harm Griswold. They suggest Griswold is a lousy businessman and just looking for scapegoats.

"We certainly didn't try to put him out of business," says Hillsborough Fire Chief William L. Nesmith, a defendant in the lawsuit. "He's been very successful at doing that himself."

The Griswold lawsuit, which claims economic damages of $26 million, isn't the only dejà vu element to the latest chapter in the Med Evac saga. The FBI has opened another investigation into the local ambulance business, according to Griswold.

Sara Oates, an FBI spokeswoman in Tampa, says she cannot confirm or deny Griswold's claim.

If Griswold's new allegations are true, the market for private ambulance service in Hillsborough continues to be inoculated against true competition. As a result, according to the lawsuit, injured patients might not be getting the fastest care at the best price.

A long wait

Few people can appreciate the joy that Griswold felt on Nov. 14, 2001, the day that he sent his first Med Evac ambulance on a run.

A retired U.S. Army major, the 54-year-old Griswold was trained as a medical-evacuation helicopter pilot in the military. He is also an emergency medical technician and a respiratory therapist.

Still, Griswold went through five years of regulatory and court hearings before Hillsborough officials gave him six of the 20 ambulance permits he sought.

Although Griswold sparked the earlier FBI inquiry, the federal conspiracy-extortion case against Mason and Carr didn't revolve around their relationship with Med Evac. Instead, the indictment focused on Mason's dealings, on behalf of his AmeriCare Ambulance Services Inc., with what became American Medical Response Inc. (AMR), formerly a subsidiary of Canadian transportation giant Laidlaw International Inc.

During a Jan. 10, 1997, meeting at the Tampa law office of Fowler White Boggs Banker PA, prosecutors say Mason and Carr threatened an AMR contingent. Besides his city council membership at the time, Mason formerly was Tampa fire chief. Now 74 and out of elected office, Mason resides in Plant City. Carr, 55, of Temple Terrace, served as Tampa City Council legal counsel during Mason's council tenure.

At Fowler White, Mason promised that his city's fire rescue service would cripple AMR in Tampa if the ambulance company opposed his bid to start AmeriCare, according to the government. Prosecutors say witnesses included Fowler White's powerful president and chief executive, Rhea F. Law, one of AMR's attorneys. Law didn't return a call before the Review's deadline seeking her recollection.

Rather than reporting Mason to authorities, the AMR contingent made a counteroffer, Carr later stated in a court filing. AMR would drop its opposition to AmeriCare's application to operate what are called basic life-support ambulances on two conditions.

AMR representatives wanted Mason not to oppose their long-held desire to provide a more lucrative form of ambulance service in Hillsborough called advanced life support. Also, AMR wanted to be given a right of first refusal, if Mason and Carr ever decided to sell AmeriCare.

In March 2000, then-U.S. Attorney Donna Bucella dismissed the Tampa indictment without explanation.

Months after the first ambulance probe was shut down, Griswold says, he encountered FBI agent George W. Randolph on the streets of downtown Tampa. Griswold says he didn't recognize Randolph, whose investigative work resulted in Mason's indictment. But Randolph remembered Griswold.

"He couldn't believe that the case got dismissed," Griswold says of his chat with Randolph, who is now retired from the FBI and couldn't be reached for comment. "I think it insulted no telling how many agents, who put in an awful lot of work."

Call rotation

By the spring of 2001, with Griswold's first lawsuit settled, the Med Evac owner re-submitted his ambulance permit application. A county transportation agency held a five-day hearing, one of the longest in its history.

Ambulance regulators had little choice but to approve Griswold's application. County Fire Chief Nesmith was begging them to introduce more basic life-support ambulance competition into the Hillsborough market, according to documents introduced at the hearing.

"It is definitely getting out of hand!" Nesmith wrote in a March 2, 2001, email to county transportation regulator Gregory B. Cox. "The two existing BLS providers are not being responsive."

Ironically, Griswold's teenage son died that summer - within days of his father receiving his BLS permits - after the county was allegedly slow to send an ambulance to where Jason T. Griswold had an asthma attack.

As it became obvious that Griswold would at last break up the private ambulance duopoly of AMR and AmeriCare, county regulators undertook a couple of new initiatives.

First, they let a fourth BLS provider into the market. TransCare, a psychiatric ambulance service of the non-profit Hillsborough County Crisis Center Inc., obtained county approval to expand beyond the transport of Baker Act patients.

The center, with a board of influential local citizens, is heavily subsidized by tax dollars. During fiscal 2002, for example, the center received 56% of its $5.4 million annual budget from government.

The second county initiative came from Cox. The transportation regulator convened a meeting of the now four BLS providers to set up a system of divvying up ambulance calls.

Griswold acknowledges he agreed to split calls with AMR, AmeriCare and TransCare on what he thought would be an equal basis. The call rotation system was supposed to give Med Evac every fourth call for a BLS ambulance.

But dispatcher's log records compiled by Griswold show Med Evac received just 8% of the calls from the county and 7% from the city of Tampa between November 2001 and December 2004.

The lawsuit contends local officials and the other ambulance owners got together without Griswold to decide how the rotation system would really work.

AMR was first to be called for all private ambulance needs on the west side of the county. AmeriCare would be first on the east side. Instead of getting every fourth call, Med Evac wouldn't receive a west side call until AMR and TransCare had no more ambulances available. On the east side, Med Evac had to wait until AmeriCare had exhausted its supply of ambulances there.

"After a number of months of operation, Med Evac and Griswold realized something was very wrong with the new plan of rotation," according to the lawsuit.

Cox declined comment, on the advice of his attorney, James L. Yacavone III of Dunedin. But Yacavone wasn't reticent about lambasting Griswold and his St. Petersburg attorneys at Kurpiers & Harland PA for advancing "a frivolous legal argument."

"Plaintiffs' businesses failed," wrote Yacavone in a legal motion, "not for the reasons alleged in the complaint, but for business errors, failure to pay their employees, the diversion of revenues of the corporation, misapplying and misrepresenting the resources of the corporation, failing to staff ambulances to respond to transportation requests by the emergency dispatch operation center and failing to market the business to the private sector."

Griswold withdrew from the Cox-brokered rotation schedule in 2002 and laid out his concerns in a letter to the Justice Department's antitrust division.

Packed into Suitcase City

It was October 2002 when Griswold says he cleared a room of competitors and a county fire official by announcing his contact with federal authorities. After the exodus, Fire Chief Nesmith offered a more equitable distribution of ambulance work if Griswold called off the feds, according to the lawsuit.

By December 2002, Griswold claims, ambulance operators and local public safety officials had cooked up another scheme to disadvantage his company. Officials cut the county into four portions and gave Med Evac a 42-square mile chunk.

What Griswold contends he didn't know was that his piece of the Hillsborough pie was dominated by a transient neighborhood, known as "Suitcase City," near the University of South Florida. Griswold says most of the calls from his territory were from the uninsured or others who cannot pay their ambulance bill. That was a much higher percentage of charity runs than other ambulance zones.

The financial uncertainty of answering injury calls often seemed to dictate the availability of a few competitors, says Griswold.

"Especially after we got into business," says Griswold, "I could sit there by the county radio and listen to the dispatches go out. And if it was a call for a person over the age of 65 who would probably be covered by Medicare, or if it was an automobile accident, or it was a work-related accident or injury, AmeriCare or AMR always had a unit available and would accept the call."

The response was quite different if the call lacked specifics or came from a low-income neighborhood, according to Griswold. "If it was an unknown medical, without any information about the age or anything," says Griswold, "or if it was in certain parts of the city or certain parts of the county, they never had units available."

Tomas Diaz, AMR's operations director for west Florida, told the Review that company policy prohibits him from discussing pending litigation.

Griswold questions why Hillsborough officials tolerate the selective ambulance responses. He further endeared himself to county officials by filing a lawsuit over his son's death in early 2003.

"When we started doing depositions, my call volume - as bad as it was - went in the toilet," he says.

Later that year, Griswold complained that some county dispatchers were moonlighting for AMR and AmeriCare. That created a potential ethical dilemma when those dispatchers had to choose whether to send their off-duty employer or a competitor to a call, Griswold says.

Hillsborough public safety official Larry Gispert assured Griswold that his dispatchers comply with a county conflict-of-interest policy. Gispert didn't elaborate in a letter to Griswold.

Confirmation for Griswold that he had been blackballed came from an unusual source. In May 2004, Griswold says, a former executive of one of his competitors called.

Griswold says the caller told him that the former executive had been present at secret meetings where ambulance and county officials decided how Med Evac would be "screwed deliberately." The former executive wanted to be compensated for supplying names, dates and places. Griswold says he was skeptical and paid nothing.

To Griswold's astonishment, the one-time competitor told him that Med Evac experienced about a 60% cancellation rate while en route to ambulance calls within the Suitcase City-dominated quadrant.

Only about one-third of the remaining 40% resulted in a hospital transport, Griswold says he was told. The ex-executive went on to state correctly that Med Evac collected payment for just half of those transports, Griswold says.

Griswold recalls his wife replying: "Has he been looking in our computer system?"

"I immediately went to the FBI," says Griswold, who adds that he was going to be wired up by federal agents for a meeting with the caller. But the meeting didn't take place.

Bank gets ambulances

The other ambulance companies reject Griswold's argument that they engaged in anticompetitive behavior. Even if they did, the companies add, they are protected by law.

Hillsborough officials are allowed to regulate their market for ambulance services, AMR attorney Richard G. Salazar argues in a court filing. "A pure competitive ambulance service market does not exist by the state's design," Salazar writes.

Furthermore, Salazar says, AMR and the other ambulance companies have wide latitude to lobby county regulators in such a controlled marketplace under the so-called Noerr-Pennington Doctrine. "Under this doctrine," Salazar writes, "joint efforts to influence public officials do not violate the antitrust laws, even if intended to eliminate competition."

Med Evac filed for bankruptcy reorganization last year. Along with allegedly rigged ambulance dispatching, Griswold blames Med Evac's demise on a billing vendor that cost his company more than $1 million by mishandling Medicare reimbursements.

Court records show Griswold plowed $706,000 - virtually all of his life savings - into keeping Med Evac going. Griswold borrowed another $10,000 from his father and an additional $7,500 from his brother, the records show.

Last December, Griswold pulled his Med Evac ambulances off the road and surrendered the keys to the Bank of Tampa, which was demanding repayment of a $484,122 loan his company used to buy the vehicles in 2001.

Even so, Griswold continued to pursue county approval for Med Evac to branch into advanced-life-support ambulance service, competing again with AMR and AmeriCare.

AmeriCare's David Carr passed along to county officials a stack of court records indicating Med Evac was in dire financial straits and unfit for ALS licensure.

Carr's attorney, Matias Blanco Jr. of Tampa, objects to Griswold mentioning that in the lawsuit.

"It borders on the incredible that the plaintiffs would actually cite, in a federal antitrust suit, defendant Carr's described conduct as evidence of his having violated federal antitrust laws," Blanco states in a court filing. "No more clear example of protected activity can be imagined."

Blanco finds nothing else to like about Griswold's lawsuit, either. That includes mentioning the passing of the Med Evac owner's son and his previous wife.

"The plaintiffs make an appalling and loathsome attempt to trade on the unfortunate deaths," Blanco writes, "by interjecting those tragic events into this complaint for the obvious purpose of gaining an economic advantage by a blatant attempt to elicit sympathy in these proceedings."

Hillsborough Commissioner Ronda Storms sees Griswold's situation differently.

Storms, a lawyer, says she has read Griswold's entire lawsuit. While declining to address the litigation directly, Storms told the Review: "I think Frank Griswold has suffered a great deal. I think he has suffered terrible, terrible personal blows and I think he has suffered serious injustices."

In May, as word of his latest lawsuit and rumors of another FBI ambulance probe spread, Griswold stood before an uncharacteristically united and accommodating county commission.

The wording of his provisional ALS certificate was drafted more restrictively than Griswold had expected. He noted that.

"We're not trying to bait-and-switch you," Storms told Griswold.

"I appreciate that," Griswold replied.

"We're just trying to get you started," said Commissioner Jim Norman.

The commissioners approved Med Evac's ALS application by unanimous vote, even though Griswold no longer has any ambulances.

AT A GLANCE

THEN: In the 1990s, Griswold accused Hillsborough County officials of heavy-handed and uneven regulation of private ambulances. His complaints led to a Tampa city

councilman's indictment. The indictment was later dismissed - without

explanation.

KEY PLAYER: Ronnie Mason is now retired from electoral politics. But the former Tampa city councilman has established himself in the local ambulance business.

CURRENT COMPLAINT: Frank Griswold claims in a new lawsuit that Mason, other competitors and local government officials violated federal antitrust laws by conspiring to drive his ambulance company into bankruptcy reorganization.