For decades, the Arizona Department of Health Services (ADHS) has done a good job of making sure ambulance service in Arizona is safe, affordable, and available to everyone.
HB2823 threatens to upend this system, which balances the needs and costs of the 911 system and interfacility transfers. The measure would also divert funds from first responders and private ambulance companies who provide ambulance service under a strict set of rules. As a representative of the Professional Firefighters of Arizona, I see this bill as a threat to fire departments and fire districts in Maricopa County and the rest of the state.
HB2823 is the brainchild of Dignity Health, which owns a majority share of an ambulance company called Community Ambulance. An administrative law judge recently rejected an application from Community Ambulance to do business here. The judge found the company was not fit and proper to operate in Arizona and did not prove that there was a need in the highly regulated marketplace that ensures timely service. The director of the Department of Health Services affirmed this decision.
Now Dignity, which has some pretty deep pockets when it comes to political spending, has decided to advance this special interest legislation and effectively write their own license to get into the ambulance business in the most self-dealing way.
Currently, if an ambulance provider wants to operate in this state, it must prove it can properly serve patients. It must show proof it has the financial resources to maintain its equipment and pay its staff. The vast majority of providers doing 911 service and interfacility transports must follow a rate structure designed to balance costs of both services.
If this bill becomes law, the three fire districts in Maricopa County (which by law cannot raise revenue) will have face budget cuts: Daisy Mountain ($1 million), Buckeye Valley ($3 million), and Arizona Fire & Medical Authority ($600,055). These massive cuts will force layoffs of advanced life support fire engine crews, in turn causing emergency response times to rise to dangerous levels. One way to look at the danger is that for every minute your heart is stopped during a cardiac event, a patient loses 10% of their chances of survival.
HB2823 would prevent the current providers from doing interfacility transports in Maricopa County. The hospitals would be able to skim profits from the high-paying portions of the market. This practice would divert needed revenues from fire departments, fire districts, and other regulated ambulance companies in the private sector who are obliged to serve everyone in their service area.
Even worse, the bill would bring a provider to Arizona who was denied a Certificate of Necessity in a court hearing and who was sued by emergency physicians.
This is not about competition. There is no shortage of ambulance service providers in Arizona. The current system that requires a Certificate of Necessity (CON) from the Arizona Department of Health Services is working. There are 96 CON’s in the state of Arizona, with 33 of them having been issued since 2000. If HB2823 becomes law, the private sector will suffer and the public sector will suffer. But most importantly, patient care will suffer.
HB2823 is a bad idea that purports to fix a system that is not broken. Your firefighters hope you will join us in opposing this bill.