By Tom Scanlon
East Valley Tribune
SCOTTSDALE, Ariz. — Fortunately, getting an ambulance in Scottsdale does not take nearly as long as getting an ambulance service.
While few things can get adrenaline surging like ambulances racing through city streets with sirens wailing, the process of operating them is slow and dreary.
As Councilwoman Kathy Littlefield pointed out during a marathon March 5 meeting, Scottsdale has been trying to have its own ambulance service since it launched its own fire department 20 years ago.
Littlefield and her colleagues listened with interest and provided encouragement for the long-discussed ambulance program to be birthed.
The baby is still not ready, though the end of a long process may be nearing.
Scottsdale Fire Chief Tom Shannon says the program is crucial for “door-to-door” service — last year, he noted, a third-party ambulance service took 18,000 Scottsdale residents and visitors to hospitals.
Near the end of a four-hour City Council meeting that also included debate on how to proceed with a potential sales tax extension and likely increases of water and other rates, Shannon gave a PowerPoint titled “Scottsdale Ambulance Transportation Program.”
In what might be called putting the horsepower before the certificate, the city shelled out $1.6 million for four ambulances last year — though the city still awaits a state permit to operate an ambulance service, plus official approval for the program from City Council.
Still in the works is a crucial “Certificate of Necessity” from the Arizona Department of Health Services, which City Council asked Shannon to pursue three years ago.
According to the agenda report, Shannon put together a team including outside experts and “followed the very strict process of application, administrative review, substantive review, rates and fees and hearing process to place the city in the best position possible to successfully acquire the capacity to care for our citizens and visitors from door to door.”
In January, an administrative judge recommended the state issue the certification to Scottsdale. “The city should expect a confirmation of approval in April,” Shannon said.
The chief said the department is on pace for “a January 2025 first transported patient” by the still-theoretical Scottsdale Fire ambulance service.
Meanwhile, as Shannon explained, Scottsdale continues to use a third-party ambulance service.
Firefighters answer all of the department’s 911 calls in firetrucks. When they assess a patient must go to a hospital, they call Maricopa Ambulance.
According to the ambulance company’s website, “We proudly serve the Valley with an experienced team who are dedicated to exceptional care for our patients and customers.
“At Maricopa Ambulance, our EMS professionals are trained in the latest technology and pre-hospital medical protocols to always support the comfort and safety of our patients.”
The service doesn’t cost anything to the city, as Maricopa Ambulance bills patients it transports to hospitals.
Maricopa Ambulance, which also operates in Glendale, Goodyear, Surprise and Chandler, has been working with the Scottsdale Fire Department since 2018.
“Maricopa Ambulance has met our expectations and together, we have built a true partnership,” Shannon said, when the Scottsdale-Maricopa Ambulance contract was renewed in 2020. “The Scottsdale EMS system delivers consistently excellent and responsive care and we look forward to continuing that relationship in the future.”
But, Shannon insisted, a better model is for Scottsdale to have its own fleet of ambulances, which city firefighter/paramedics would use for “door to door” home-to-hospital service.
According to the presentation, “the citizens of Scottsdale need more emergency ground ambulance service. The citizens of Scottsdale will also benefit from an increased level of care through SFD’s ability to provide EMS service from its first response to hospital delivery.”
Shannon told the council the best way to do this is by slowly building the ambulance program over three years.
The first year of running its own ambulance service would cost the city about $900,000, Shannon said.
After initial start-up costs, the program could be “revenue neutral” — or even make a small profit — by year four.
Moving forward
Some discussion focused on the plan for nine ambulances — three more than Tempe and Gilbert , which have six each.
The ambulances will be housed at fire stations throughout the city, Shannon said.
Scottsdale would hire an extra 20 firefighter/medics the first year of the ambulance program. Shannon said the department will bill insurance companies a projected $5 million the first year, tripling to $15 million in year three.
Shannon said the department will bill insurance companies a projected $5 million the first year, again tripling to $15 million in year three.
Training for the new crews in the new ambulances will take place at the under-construction training center — which was pitched to voters in 2019 as costing $4.2 million, but ended up costing well over $20 million. Last year, Shannon cited a “clerical error” for the cost increase.
“Our current estimate is an August 2024 academy start date for 24 new firefighter positions tied to the ambulance operations,” Shannon said.
In addition to “10 firefighter/EMTs (and) 10 firefighters/paramedics,” Shannon calls for SFD to hire seven employees to support the program, including a medical director.
Last year, Shannon warned of a dire need to recruit replacements for a wave of firefighters who will reach retirement service dates in 2025.
Just about a year later, Deputy Fire Chief Danny Ables, Battalion Chief Brian Joseph, and Medical Director Casey Solem took on sections of the March 5 presentation to Council.
There were some questions, particularly by Councilman Barry Graham, on financing specifics.
As the minutes from the meeting note, “There was Council consensus on the following items: Continue the process towards creating the Scottsdale Ambulance Transportation Program; this program would be an enhanced service to provide better care.”
As Councilwoman Tammy Caputi put it, the city having an ambulance service “will allow us to provide world-class care.”
According to the presentation, Shannon will be back at the 5 p.m. Tuesday, March 19.
Shannon said he will ask Council to approve “one-time expenses for Phase I — to establish logistical capacity moving into the summer and fall where we are building the business model.”
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