Local governments have the power to determine whether a business is “needed” in their communities or not, and the COVID-19 pandemic has, according to two writers in a South Florida Sun-Sentinel opinion piece published June 15, stopped an ambulance service provider (Brewster Ambulance Service) from transporting the sick and disabled in handicapped accessible vans or ambulances because Lee County officials saw a “lack of need.”

In determining whether the need existed, Anastasia Boden and Sal Nuzzo, the authors of the opinion piece, noted that local government officials “ask the existing providers to weigh in. This is like McDonalds having a say in where Burger King can open.”

When the Lee County Board of Commissioners voted not to grant Brewster a certificate of need, the board made a decision that is “especially problematic in the middle of a pandemic,” Nuzzo and Boden wrote.

“A quarter of Florida’s population is over the age of 60, and more vulnerable to the ravages of an outbreak," they said. "By forcing Brewster [and others] to wait to operate until they can prove that other ambulances are overburdened and that wait times are lagging, the certificate of need law puts Floridians at risk. Health care needs can change rapidly. As one ambulance company warned, if one employee gets sick, entire shifts may be forced to quarantine. Lee County’s residents — and all Floridians — will be served best if health care providers can respond to calls as they come, rather than depending on bureaucratic whim.”

The writers argued this makes even less sense considering that the Florida legislature removed regulations for certificates of need in 2019, except when it comes to ambulance services.

Brewster asked Gov. Ron DeSantis in May to join the states that have at least temporarily addressed certificate of need issues for ambulances, and the Department of Health issued emergency rules that suspend certificate of need requirements for ambulances for the duration of the COVID-19 pandemic. 

Boden and Nuzzo say work still needs to be done on these rules.