Ambulance war: Eyes on the St. George City Council

The notepad Dixie Ambulance uses to record patient information during transport to the hospital. St. George City Council member Jimmie Hughes said it wasn't what he expected after reading Maxwell Miller's report that criticized Dixie Ambulance for using a pen and notepad to record patient information instead of using more modern technologies like a laptop or tablet, St. George, Utah, Jan. 31, 2013 | Photo by Sarafina Amodt, St. George News

ST. GEORGE – While Dixie Ambulance Service continues to speak out against the 66-page recommendation given to the Bureau of Emergency Medical Services, which recommends that Gold Cross Ambulance be chosen to replace Dixie Ambulance as St. George’s exclusive 911 emergency transport provider,  the City of St. George has yet to issue an official, unified statement concerning the matter.

However, some individual members of city government have said they have questions.

Questions

Though the recommendation has been made, some in city government have questions about it and the process by which it came about.

City of St. George Mayor Daniel McArthur said he wondered why no questions were asked in the recommendation concerning patient care outcome. Has Dixie Ambulance ever not picked up anyone? Has anyone died because of inadequate care? Those are the questions he wants answers to, he said.

“I don’t think (the recommendation) really addressed that,” he said.

As to the process itself, and the hearing that accompanied it, he said, “I think it turned into something it wasn’t meant to be.”

Gail Bunker, a member of the City of St. George City Council, said in an email to St. George News: “I honestly thought the process was an audit of (Dixie Ambulance) and was a little surprised with the result.”

Concerning the recommendation, she said: “I feel nothing has been revealed to indicate inferior care to patients. (Dixie Ambulance’s) history of response, stabilization, professional care, and transport has not been questioned. That to me is the deciding factor.”

“I thought this was a review process,” Council Member Jimmie Hughes said. He said he also thought it was odd that the recommendation weighed so heavily in Gold Cross’s favor.

Jon Pike, who has background in health care administration with Intermountain Healthcare, said he has no concerns about the recommendation.

“I believe I have a good understanding now of the issues, the testimony, the process, and the recommendations,” he said.

The ride-along

In order to get a firsthand account of how Dixie Ambulance operates, Hughes did a ride-along with Dixie Ambulance on Jan. 28.

“It was a great experience for anyone who wants to know the truth about (Dixie Ambulance’s) quality of care,” Hughes said. He said he spent between five and six hours with Dixie Ambulance personnel. He said he recognized that didn’t qualify him as an expert; still, after the ride-along, Hughes has taken issue with aspects of the recommendation, going so far as to call parts of it “ludicrous.”

While travelling with Dixie Ambulance on emergency calls, he observed how the staff gathered patient information and gave it to the staff at Dixie Regional Medical Center. He said he watched as information was written on the notepad which the recommendation describes as an inadequate method of data collection. He said it is not a typical note pad, but one that has a detailed check list on it.

“That thing has been blown out of proportion like no other,” Hughes said. While at DRMC, he said he also watched a nurse make a quick note about an incoming emergency patient on a napkin.

Sometimes writing things down is faster, Hughes said.

While riding in the ambulance, Hughes said he asked the staff about the recommendation. He said they told him they “resent the fact they are portrayed as ill-equipped and understaffed.”

The notepad Dixie Ambulance uses to record patient information during transport to the hospital. St. George City Council member Jimmie Hughes said it wasn’t what he expected after reading Maxwell Miller’s report that criticized Dixie Ambulance for using a pen and notepad to record patient information instead of using more modern technologies like a laptop or tablet. St. George, Utah, Jan. 31, 2013 | Photo by Sarafina Amodt, St. George News

From his own observations, Hughes said the assertion that Dixie Ambulance “is understaffed and under-equipped is ludicrous.”

Mayor McArthur said he wouldn’t opt for a ride-along himself, because he didn’t feel it would be a “true comparison” between the companies.

While Dixie Ambulance currently holds the 911 emergency licenses for the area, Gold Cross Ambulance service in St. George only handles nonemergency, interfacility transport.

The two aren’t necessarily comparable, McArthur said.

Dispatch

Hughes said he also visited the St. George Communications Center. He said St. George has a great communications system, but that some issues could be worked out between the dispatch center and Dixie Ambulance, though he did not elaborate on what those particular issues were.

“There are some issues that could be worked through,” he said. “It takes two to tango.”

Pike also visited the dispatch center. “I think the issues that exist surround those of the radios and the dispatch system,” he said.

However, he added he felt Dixie Ambulance could improve its side of the issue by using the mobile Spillman CAD (computer-aided dispatch) system on its vehicles. Spillman is the CAD system employed by the St. George dispatch center. Its reliability was a subject of debate during the December hearing, and it responded to the debate in an interview which St. George News reported on Dec. 28, 2012.

Pike and Gold Cross

Some members of the community believe that Pike asked Gold Cross to review Dixie Ambulance’s services. St. George News asked the councilman about this and received the following response via email:

“…I did meet with Gold Cross Ambulance’s president, Mike Moffitt, several years ago at his attorney’s request. They talked with me about their experience, their quality, their staffing, and their response times. Later they decided to apply to the state to have the current ambulance licensee reviewed and potentially replaced by Gold Cross. The mayor and city council agreed to support this state process, but not necessarily either party.” (Emphasis added.)

Weighing in

According to state law, a municipality has the power to choose who it wants as its ambulance provider.

A book of protocols used by Dixie Ambulance. Mac Miller, Dixie Ambulance’s public information officer, said the EMTs and paramedics of Dixie Ambulance have to memorize the protocols. He said anyone who has to refer to the book to know what they are doing is not fit to work for Dixie Ambulance. St. George, Utah, Jan. 31, 2013 | Photo by Sarafina Amodt, St. George News

“The council will weigh in,” McArthur said.

“We deserve to weigh in,” Hughes said, “and it’s our responsibility to.”

Both Hughes and McArthur said they have no issue with Gold Cross.

“I have nothing against Gold Cross,” Hughes said.

McArthur also said doctors he knows have “spoken highly of both company’s personnel.”

Soon after the recommendation was released to the city on Jan. 23, McArthur asked the Bureau of Emergency Medical Services to delay its decision for a minimum of two weeks so the city council could evaluate the recommendation’s findings.

As of Feb. 2, an official statement has yet to be made by the city council

Tammie Goodwin, a spokeswoman for BEMS, said that if the city council supports Dixie Ambulance and the Bureau still rules in favor of Gold Cross, the city may have to issue an RFP, or Request For Proposal, which is an open bid for ambulance providers.

Maxwell Miller, the presiding officer who wrote the recommendation, referred to an RFP as “a more democratic process for selecting an EMS provider” that the public could pressure the city into issuing.

Should Gold Cross take over 911 ambulance service in St. George, Dixie Ambulance will lose approximately 75 percent of its coverage. Yet, it will be allowed to continue operating in the remaining 25 percent of its original service area which includes Santa Clara and Washington.

At this prospect, Hughes said, “(Dixie Ambulance) is good enough for Santa Clara and Washington, but inadequate for St. George?”

Related:

Email: mkessler@stgnews.com
Twitter: @MoriKessler

Copyright St. George News, SaintGeorgeUtah.com LLC, 2013, all rights reserved.

The notepad Dixie Ambulance uses to record patient information during transport to the hospital. St. George City Council member Jimmie Hughes said it wasn’t what he expected after reading Maxwell Miller’s report that criticized Dixie Ambulance for using a pen and notepad to record patient information instead of using more modern technologies like a laptop or tablet, St. George, Utah, Jan. 31, 2013 | Photo by Sarafina Amodt, St. George News

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16 Comments

  • Bill Workman February 3, 2013 at 1:36 pm

    So I would like to start by responding to this comment:

    At this prospect, Hughes said, “(Dixie Ambulance) is good enough for Santa Clara and Washington, but inadequate for St. George?”

    Who said DAS was good enough for Santa Clara and Washington? It’s bad enough you get the right to speak for the people of St.George… don’t try and speak for those that don’t want you to.
    .
    I think this needs to be said: If Dan and his Clan would like to push and decide who gets the contract for St.George. Dan and his good Ol’ boys as well as the City of St.George can and will be held liable for any lawsuits derived from DAS. WHat do you think tax payers, I would suggest you contact the city and tell them to keep their nose out of who gets the contract. Let the state do their job and keep out of it.
    .
    If anyone doesn’t agree on whether or not the City of SG can be held liable after a Mayor and City Council take it upon themselves to support one or the other please let me know… And yes defending one means you are helping them. Best thing to do is say nothing at all.

    • Pamala Englert February 3, 2013 at 8:15 pm

      The decision was already mandated by Utah state law to be in the hands of the political subdivision of the EMS Provider, which in this case was the City of St. George. They had the authority to make its own decision, and only turned it over to the state BEMS after meetings occurring by way of introduction of Gold Cross legal representation (also present at several “back door”) meetings, who happens to be our own State Senator, Steve Urquhart. Mr. Urquhart is the private attorney to Gold Cross.
      .
      Conflicts of interest aside, the fact remains that Gold Cross does have a history of filing lawsuits against cities in Utah which do not select them as their provider. Of course they have lost each case, and interestingly cited nearly identical damages as they cited in their own case filed against Salt Lake City. After losing in Salt Lake City, they did the same thing in West Valley City. Lost again. Now they create havoc in Provo and Orem. There is an extensive enough history and case law on record. If and likely when Gold Cross decides to sue the City of St. George, they may spend big dollars; however, the result will be another loss for Gold Cross. Perhaps you should suggest that they change their standard operating procedure.
      .
      Far too many hundreds of people have chosen to not be apathetic about this issue. Those same people will be seeking ethics reform and participating in official ethics complaints against certain elected officials. Perhaps Steve Urquhart can line his pockets even more when he may decide to also serve as legal counsel for Gold Cross, when they decide to sue the City of St. George, as has been the pattern.
      .
      Best of luck to Mr. Urquhart when he faces two different ethics committees and the very constituents who elected him. Truth will always prevail. Eventually, the floodgate had to open. Far too many holes to “plug” now exist. Truth and evidence is in the hands of many, for this issue is of concern and interest to, not just people in St. George. The information is now in the hands of very active and vocal people from other states and even other countries. That’s what happens when any politician decides to place self-interests and individual political ambitions above the responsibility to serve those who elect them. I for one would never “say nothing at all.” Far too much is at stake, for all of us. My comment is presented respectfully. I do not respond to anything unkind or disrespectful which may be said in return. Thank you.

  • Fast Fisher February 3, 2013 at 3:54 pm

    It is no secret that Councilman Jon Pike and Senator Steve Urquhart contrived a plan to kill Dixie Ambulance. Pike and Urquhart have been cozy for years. Just in 2012 public filings alone, Urquhart reported contributions from Pike’s employer. Urquhart also donated $300.00 of his campaign funds to Jon Pike’s son’s eagle scout project.

    It doesn’t take too much digging and reporting to realize that Urquhart, the attorney for Gold Cross, and Jon Pike have combined to oust Dixie Ambulance. Bringing in Gold Cross directly helps Urquhart’s best client. Pike needs all the support and money he can get in his upcoming bid for Mayor and he wants to help his ally.

    Both men deserve to have very strong opposition in the next election opportunity. I will vote for neither.

    • John Doe February 3, 2013 at 6:02 pm

      Not to mention the $2,000 paid from campaign funds to Pike’s daughter as an intern or the $1,000 Urquhart contributed to Pike’s last campaign for city council…

  • Sherri February 4, 2013 at 9:46 pm

    What about the minimum standard that is expected from an ambulance service? If DAS was doing a great job there would be no chance of this report. The state is slow to bring audits and changes and often work with agencies for years trying to help improve services. I would like to see the 66 page report and it sounds from the reports it sounds like the complaints are legitimate. How will DAS fix the problems in the services, how can they afford to increase coverage and have two paramedics in each ambulance ? They have always complained about the lack of funds for staff and equipment. Will Gold Cross provide better service? What is best for the community? Not what is best for DAS or Gold Cross. We deserve quality EMS

  • Bandit the monkey February 4, 2013 at 9:47 pm

    Pamela you have no idea what you are talking about in Provo/ Orem. Lets let the adults handle this. Your rhetoric is getting old. You do realize Gold Cross is the provider in SLC right? That southwest left in the middle of the night with rigs parked on the side of the road. It had nothing to do with the lawsuit. It is irrelevant. Just accept you will get a better service in GC and be grateful. Also realize that 90% of the GC employees in st george will be the same employees that work for DAS and support them. Your rantings are getting old and have little credibility. All you do is talk about 8 y/o lawsuits that mean anything.

    • Pamala Englert February 5, 2013 at 8:21 am

      “Bandit,”

      My reply to you is simply this: I choose only to speak to people. I love monkeys, but chose long ago not to have conversations with them.

      Since “you” seem as a “monkey” at least able to read, perhaps you should read facts and evidence on record before you attempt even a remotely intelligent response.

      Check again the true facts about what occurs in Salt Lake City regarding the provision of ambulance services. While you are at it, you should understand (if a “monkey” can), that people may easily research for themselves about Provo, Orem, Salt Lake City, West Valley City and several other cities in the state of Utah, which Gold Cross has either sued or been asked to leave for its sub-par standards of patient care.

      Please do not respond to me until you are at least willing enough to use a true identity. Hiding behind your computer screen and “bullying” others is not the least bit impressive. Thank you.

  • better late than never February 5, 2013 at 10:55 am

    Pamela it’s true you don’t know what you are talking about. I don’t know of all of Gold Cross dealings but I do know about Provo and Orem. Neither of them have asked Gold Cross to leave. They both have a great working relationship with Gold Cross and they value the work gold cross does that allows them to focus on 911. You may not talk to monkeys but im certain you’ve got a have a house full of cats. Remember you always promise not to respond to people so please don’t. I would also wonder if you have ever stopped by Gold Cross why you are in Salt Lake. I would challenge anybody (that includes city councilman and the mayor who stated he needs somebody to die before he is on board with upgrading ambulance service) to stop by Gold Cross in Salt Lake and see the big picture and meet the people there. You will be suprised at what you find. A modern company using modern techniques and equipment with happy well compensated employees delievering it to not tens of people everyday as Dixie does but literally hundreds of people each day.

    • Pamala Englert February 5, 2013 at 1:52 pm

      “Better Late than Never,”
      .
      I keep wondering when anybody may be brave enough to stop hiding behind their computer screens and intelligent enough to do their own “homework.”
      .
      http://www.heraldextra.com/news/local/central/orem/cities-looking-at-ambulance-license/article_21fef15a-aff4-5313-8ee6-353ac7d21afc.html

      .
      .

      • better late than never February 5, 2013 at 3:58 pm

        That was eye opening. Just so everybody knows what Pam is talking about let me put some exerts here to be read by all

        ” We currently have a great relationship with Gold Cross” – Scott Gurney Orem Fire Chief

        “We have no intention of pushing Gold Cross out, we want to create a good relationship with Gold Cross” – Scott Gurney Orem Fire Chief

        “All three enities are Superb providers and have no outstanding complaints” – Paul Patrick Director of the Bureau of EMS

        Thanks for the link so everybody in St George can see that Gold Cross is known for developing tight bonds with the cities they work with and ALWAYS provide excellent medical care …… Myself included

  • Bandit the monkey February 5, 2013 at 3:47 pm

    Pamela, where to start. GC has never sued Provo or Orem. That aricle is outdated already but with all your well placed sources I’m sure you know that. The Provo fire chief has admitted in the article that his dept can’t handle the aditional 15-20 calls per day and would have to contract it out, which is illegal. Orem is in the same boat, their resources are tied up on 911 calls and want GC to take more calls. So, back to Dixie, the community will he in good hands for years to come. If you all want your taxes to up by all means have the city take it over. Ask West Valley how that’s going. I see them going back to GC in a few years. They have outdated equipment, their guys have had no raises since they took over ambulance. Good move? Be grateful you will be in such capable hands, the same hands you are in now. Only a different company that can and will provide better care. More rescources is a good thibg. You will be safer. Thank Mike Moffit and the people wuth the foresight to take this challenge. You’re welcome.

  • Bandit February 5, 2013 at 7:11 pm

    @Sherri, very good post. Uou do deserve top quality EMS. I can’t speak for DAS higher ups but i have and do know some Paramedics. They are top notch and they deserve the best. Most will be absorbed by GC. Same faces different uniform.Dixie has had years to fix these problems and chose not to. I hope the community will support the hard workibg men and women of GC if and when they take over. Don’t take out the hate for ownership on the guys on the street. They are hust doing their job. They have no say in the politics going on. Give them a chance. Gold Cross will have three ambulances on at a time with two paramedics each.

    • paraminnick February 5, 2013 at 10:35 pm

      Actually 4 ambulance on with 2 paramedics each 24 hours a day. Currently Dixie has 3 ambulances during the day with 1 paramedic each and 2 ambulances at night with one paramedic each.

  • Professor Wernstrom February 5, 2013 at 11:15 pm

    I noticed in the comments in earlier articles about the Dixie/Gold Cross story claims that Dixie paid starvation wages and that Gold Cross’s wages were better. Can anyone comment on this? If it’s the case that the local owners of Dixie are milking a cash cow and not sharing the wealth with those who do the work I would be inclined to listen to the arguments of a new provider who would pay a breadwinner enough to raise a family on.

  • Anon February 7, 2013 at 7:17 pm

    There is a HUGE issue being overlooked. If Dixie Ambulance is deficient is some area, the city of St. George needs to put out a Request for Proposal so the best possible service can be brought into St. George for its citizen’s.

    Who says Gold Cross is any better??

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