Gold Cross Ambulance crosses into Arizona without authority, agencies say

February 26, 2017 Utah Channel 3

ST. GEORGE — A Utah-based ambulance company has been responding to emergency medical calls in the Beaver Dam and Littlefield, Arizona, region without a license, interlocal agreement or agency request for assistance, competing with the agency licensed for those areas and depriving it of revenue.

More importantly, it’s illegal, said Fire Chief Jeff Hunt of Beaver Dam/Littlefield Fire District, whose licensed jurisdiction covers Beaver Dam and Littlefield, Arizona.

Map showing Beaver Dam/Littlefield Fire District ambulance coverage area, n.d. | Image courtesy of Arizona Department of Health Services, St. George News | **Click on image to enlarge**

This issue first came to the attention of St. George News in November 2016 during a rollover incident response on Interstate 15. Beaver Dam/Littlefield Fire and Rescue ambulance out of the department’s Station 1 in Arizona responded to the crash to transport patients. When it arrived, however, the injured parties were no longer at the scene. The responders found that patients had already been transported to Dixie Regional Medical Center in St. George by Gold Cross Ambulance out of St. George.

Further investigation into the situation revealed that this was not the first time Gold Cross responded to initiate treatment and transport in another agency’s jurisdiction without an agreement, Hunt said. As a matter of fact, he said, it is standard practice for Gold Cross to enter Beaver Dam/Littlefield’s territory without permission or the legal authority to do so and has been for the last three years.

As this report publishes, Gold Cross Ambulance has not responded to several requests for comment on the matters stated.

Under Arizona law, any individual or entity operating an ambulance cannot enter the state to render emergency medical care or transport patients unless they are licensed in Arizona as outlined by statute.

Title 36, Section 2216 of the Arizona Health and Safety Code states: “It is unlawful for any person to operate an ambulance in this state which does not comply with the provisions of this article or the rules adopted by the director under this article; any person who violates subsection A is guilty of a class 1 misdemeanor.”

To lawfully operate an ambulance service in Arizona the company must apply for and be issued a Certificate of Necessity, register with the state, pay the appropriate fees and provide a surety bond. All of those requirements must be met before a license is issued and only if the division director decides that the need justifies the service.

This applies to any ambulance service that wishes to operate in Arizona, regardless of whether it is a nonprofit fire department or a private company.

Ithan J. Yanofsky, deputy chief of the Bureau of Emergency Medical Services and Trauma Division in Arizona, the agency that oversees certification and licensing for ambulance services operating in the state, Gold Cross is not licensed to operate in Arizona.

“To my knowledge Gold Cross does not have a Certificate of Necessity filed with this division, which is required unless both agencies have an agreement,” Yanofsky said.

Arizona law does allow for exceptions under specific circumstances, such as transporting a patient from one state to another or in the case of a major catastrophe where there are insufficient licensed ambulance services in this state to respond to such an emergency.

Another exception is when an outside agency enters into a mutual aid agreement with the agency that has jurisdiction. In this case such a signed agreement would be kept on record with the Beaver Dam/Littlefield Fire District. Such an agreement would allow one agency to assist another under certain circumstances, thereby allowing the outside agency to operate within the other’s jurisdiction.

Certificate of Necessity filed with the Arizona Department of Health Services allowing Beaver Dam/Littlefield Fire District to operate within a designated area, Beaver Dam, Arizona, Feb. 24, 2017 | Image courtesy of Beaver Dam/Littlefield Fire Chief Jeff Hunt, St. George News | **Click on image to enlarge**

Such an agreement did exist between Beaver Dam/Littlefield and Dixie Ambulance at one time when Dixie Ambulance provided service to St. George and surrounding areas. But on March 27, 2013, Gold Cross was awarded the license. Dixie Ambulance ceased doing business on April 14, 2013, after serving the area for more than 30 years.

“Once that change occurred any agreement we had with Dixie Ambulance was no longer in effect,” Hunt said.

Beaver Dam/Littlefield has an automatic mutual aid agreement with St. George Fire Department, which allows both agencies to be dispatched simultaneously to crashes and other emergencies that occur primarily on the interstate and roads within the Virgin River Gorge.

“This type of agreement works well for both fire departments and has for years,” Hunt said, “which is critical when disaster strikes along the 28-mile stretch through the Virgin River Gorge.”

The mutual arrangement between the two fire departments assures coverage because each comes from opposite ends of Interstate 15 through the Gorge. This can reduce response time and whichever agency arrives first initiates containment and care while the other agency is en route.

However, there is no such agreement with Gold Cross Ambulance, Hunt said, despite his several attempts to implement one.

The mutual aid agreement Beaver Dam/Littlefield proposed to Gold Cross was not automatic, but by invitation only, Hunt said, and would have allowed Gold Cross to operate legally under Beaver Dam’s licensing or by Certificate of Necessity, as long as Gold Cross services were requested on a case-by-case basis.

Instead of entering into the agreement, Gold Cross consistently responds to incidents in the Gorge, Hunt said, and operates without a mutual aid agreement in place or the appropriate licensing and certification that is required under Arizona law.

Gold Cross Ambulance was founded in 1968 by Chairman of the Board and CEO Gene Moffitt, and responds to calls in Salt Lake, Uintah, Utah, Washington and Juab Counties. The company employs 350 individuals and runs a fleet of 65 ambulances, according to information obtained from the company’ website.

Beaver Dam/Littlefield is a nonprofit agency that operates using Mill Creek funds from Mohave County, funding which is limited. Any revenue generated from patient transports or EMT care through Beaver Dam/Littlefield’s fire and rescue ambulance goes directly into the station’s operations, Hunt said, and it’s revenue that they can’t afford to lose.

Every time Gold Cross comes across the state line into Beaver Dam’s jurisdiction, they take that revenue with them, he said.

Hunt also said the problem has persisted because of the nature of the job – the need to place patient care above everything else.

“I haven’t really pursued this issue because lives are on the line here, but that doesn’t take away from what they are doing.”

Yanofsky said Beaver Dam/Littlefield Fire District has had a Certificate of Necessity on file for more than 10 years. There is “the expectation that the system is working as it should,” he said. If not, then Arizona’s Bureau of Emergency Medical Services and Trauma Division “has an enforcement department that deals with these issues.”

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