ST. GEORGE – Matters involving company solvency and adequate staffing were addressed and revisited during the second day of hearings between Dixie Ambulance and Gold Cross Ambulance Tuesday.
Lawyers interviewed Dixie Ambulance president Tony Randall and others for several hours in a public hearing held at the Southwest Utah Public Health Department. Alan Sullivan, lead attorney for Gold Cross, began questioning Randall concerning the financial solvency of his company. Sullivan had Randall identify himself as the president of Dixie Ambulance, and also as one of the principals of Rand Properties.
Rand Properties is the entity which owns the ambulances and facilities used by Dixie Ambulance, while employees of the company are hired and work under the Dixie Ambulance banner.
Sullivan said the biggest asset of Dixie Ambulance is its “accounts receivable,” and asked Randall if he agreed. In contrast, Randall said the company’s biggest assets are the emergency medical service licenses it holds.
Balance sheets for 2010 and 2011 for Dixie Ambulance were then produced and Sullivan pointed out alleged liabilities that exceeded company assets for both years. Sullivan also said Rand Properties, which holds assets estimated at over $900,000, had liabilities equaling around $1,500,000.
Randall, however, said he does not believe the company is insolvent.
Later, Adam Dunn, attorney for Dixie Ambulance, recalled Randall saying the company’s primary assets are its medical transport licenses, and asked if that was still true. “You bet,” Randall said.
Dunn said if the licenses weren’t valuable, Gold Cross wouldn’t spend so much money on lawyers to try and obtain them through litigation.
“(Gold Cross wouldn’t) if they think we’re insolvent – why would they?” Randall said.
Mike Moffitt, the president of Gold Cross Ambulance, said his company would have four ambulances staffed with two paramedics each that would be on standby 24 hours a day if his company’s application is granted. Since November 2010, Dixie Ambulance has had three ambulances on duty during the day, staffed by one paramedic and one intermediate EMT.
Utah code requires two paramedics be on scene of an emergency. Gold Cross attorneys said Dixie Ambulance is not in compliance with the state code because only one paramedic is assigned to an ambulance. However, Randall said Paul Patrick, director of the Bureau of Emergency Medical Services and Preparedness, had told Dixie Ambulance and other EMS services that two paramedics simply had to be at the scene, and “not in the truck.”
“It doesn’t matter how they get there,” Randall said. He added Dixie Ambulance had applied for a paramedic-EMT waiver in 2003. Randall said that rules governing the staffing of paramedics on ambulances had changed since that time, and according to his understanding, a single EMT and paramedic per vehicle was acceptable by the state.
Patrick, who is currently attending the hearing, said there were exceptions to the two paramedic rule, and that a “scene” could stretch from the original site of the accident to the doors of a hospital, depending on the situation. However, certain criteria have to be met to allow the exemption.
Randall said only a third of the calls Dixie Ambulance receives in a 24-hour period require an extra paramedic. In the St. George area, he said the company receives an estimated 13.9 calls, with only 8.7 actually requiring a medical transport. Less than three calls made to Dixie Ambulance require the presence of a second paramedic.
However, when a second paramedic is needed, Randall said a second ambulance can either meet the first paramedic at the scene, or at the hospital. A second paramedic is called in between two and three times a month at the most, he said.
Randall said he also stages three ambulances in the St. George area in order to reply to emergency calls in a timely manner. He said he believes the staging allows the ambulances to respond to calls within 8 minutes, 59 seconds, which he said is a recognized industry standard.
Max Miller, the presiding officer over the hearing, asked Randall what percentage of transports occur within the St. George area. Randall said it is approximately 76 percent – the bulk of Dixie Ambulance’s business.
Gold Cross itself maintains a contracted time with Salt Lake City, said Darren Judd, CAD system deployment coordinator for Gold Cross. For calls that require lights and sirens, a time of no more than 9 minutes 59 seconds is recommended, though Judd said Gold Cross holds itself to a standard of 8 minutes 59 seconds. For calls that do not require lights and sirens, the time limit is higher.
Judd said the CAD (computer-aided dispatch) system used by Gold Cross tracks calls and response times, as well as helps coordinate the placement of ambulances throughout Salt Lake City. The system also recommends to dispatch the nearest available ambulance, and moves on the next available unit should the original choice already be in use.
Judd said he had used the system to analyze response times for Dixie Ambulance supplied by St. George Dispatch, though said a part of the data, an estimated 2 minutes 40 seconds, was missing in some cases. The 2 minutes 40 seconds is the estimated average time elapsed from when dispatch first receives a call to when Dixie Ambulance is contacted. Judd’s data indicated Dixie Ambulance’s response times over the last three years were not the best.
Dunn proceeded to question Judd’s findings, and said the data was not formulated properly. Judd said he used “a random sampling” of calls.
Gold Cross Ambulance currently holds an inter-facility transport license for Salt Lake City. The only region it has a license for intermediate (emergency) transport is Vernal and the surrounding area. Dixie Ambulance currently holds a paramedic rescue license and intermediate transport license for St. George and the surrounding communities.
The hearing will continue through Friday. The final recommendation to the state will not be made at that time, though. Miller said the decision could take a week, a month, or longer to finalize.
Update: The hearing continued on Wednesday at 8 a.m. and recessed at 1:40 p.m. Additional witness testimony was given concerning the state of Dixie Ambulance’s solvency and compliance with the two-paramedic rule. The remainder of the witnesses will appear Thursday morning, with closing arguments possible being given around 1 p.m. Elements of Wednesday’s testimony will be featured in the article covering Thursday’s proceedings.
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