ST. GEORGE — Concerns over ambulance service compliance in St. George appears to be on the way to resolving following a Thursday work meeting of the St. George City Council.
Issues of compliance between Gold Cross Ambulance and the city came to light last month when Councilwoman Michelle Tanner mentioned it as a part of a list of items she wanted to see on future council meeting agendas.
Gold Cross Ambulance, which has served as the city’s emergency services provider for a decade, was determined to be in violation of the city’s ambulance staffing requirements. The company was also found to be taking too long to respond to certain emergency calls.
In addition to the ordinance, these issues also violated the terms of the service contract Gold Cross has with the city.
Mike Moffitt, president of Salt Lake City-based Gold Cross Ambulance, presented the council a proposed solution during its Thursday meeting.
Problems and proposed solutions: Staffing
Under the city’s ordinance, Gold Cross is required to have two paramedics on an ambulance that responds to 911 calls. This was also a state rule at 2013 when Gold Cross began service in St. George. The state rule has since changed to allow for one paramedic and one emergency medical technician, or EMT, per ambulance.
Moffitt asked the City Council to change the current ordinance to reflect the state rule, adding that doing so will make it easier for Gold Cross the staff more ambulances in the city.
“We could go to six (ambulances) almost immediately,” Moffitt said.
Specifically, Gold Cross would have one paramedic and one advanced EMT per ambulance. The latter was a point stressed by Mayor Michele Randall. A regular EMT wasn’t considered to have enough experience while an advanced EMT was. This was a point Moffitt agreed with and noted his company trains their advanced EMTs to be “paramedic assistants.”
Additionally, Moffitt proposed that two “quick response units,” or QRUs, be brought into service. These would be pickup trucks driven by a paramedic that also carried medical equipment needed for an emergency response. One unit would set up on the north side of the city while the other would be on the south side, he said.
Depending on how a 911 call unfolds, the paramedic in the QRU would probably make it to the scene before the ambulance and determine if additional aid was needed or not. If so, then two paramedics would be on the scene once the ambulance arrives.
Changing the two-paramedic rule will also help with general staffing issues created by a nationwide paramedic shortage that worsened during the pandemic, Moffitt said.
Response times and additional coverage
Emergency response times can vary depending on the type of call received by the dispatch center. Calls marked as Alpha and Bravo are not considered as serious and have a 12-minute response requirement under city code. More serious calls, marked as Charlie, Delta and Echo, are given an 8-minute response time.
An ambulance service must achieve a 90% or more response rate during a calendar month to remain in compliance with the city’s ambulance ordinance.
Two issues that had hampered Gold Cross’ response times have been COVID-19 and the sheer volume of calls that come in at times, Moffitt said.
During the height of the pandemic, a COVID-19 call could double the time an ambulance was unavailable for use because the ambulance and staff would need to be cleaned and decontaminated before being allowed back in service.
At other times, the number of calls would skyrocket beyond Gold Cross’ ability to answer with its four dedicated 911 ambulances. In such cases, they have been able to call for mutual aid from neighboring agencies.
Moffitt proposes to add two or three new ambulances on top of the four covering St. George. These additional ambulances and personnel would be in service during the days Gold Cross determined to be its busiest, which is Thursday through Saturday. In additional to that, the two new quick response units will be added.
The additional units and flexibility in staffing will help Gold Cross reach compliance while also providing additional coverage for the city which has seen tremendous growth over the last decade.
“Response time is the ultimate goal,” Councilman Jimmie Hughes said. That sentiment appeared to be the general attitude of the City Council and staff, which was as long as the response times were met there wasn’t an issue.
Meeting growing demand
Other concerns raised during the council meeting related to the number of ambulances serving the St. George Area. Overall, Gold Cross Ambulance covers St. George down to the Arizona border and into the middle of Washington City and up a part of state Route 18 toward the Ledges.
Gold Cross has served that entire area with its four dedicated 911 ambulances and back up units as needed for the last 10 years, and while the number of ambulances hasn’t gone up, the area’s population and emergency call volume have.
“What’s the right number (of ambulances) based on population density?” City Manager John Willis asked.
Recommendations were made to put language either in the city’s ambulance ordinance or Gold Cross’ contract that called more more staff and ambulance units when the area reached certain population benchmarks.
“As the population goes, I think there should be an automatic trigger,” Hughes said.
Moffitt agreed, and thanked the council and staff for working with his company on ways to address the issues they faced.
Moving forward
“We feel this is a good solution staffing-wise,” St. George Fire Battalion Chief Robert Hooper said when asked by council members for his opinion as he oversees EMS operations in St. George.
The St. George Fire Department and Gold Cross Ambulance often work hand-in-hand at emergency medical scenes.
“There’s a lot we can do with Gold Cross on, and we’ve had a good relationship with them,” St. George Fire Chief Robert Stoker said. “This will provide use with more (medical) units in the city and we feel what they presented is good.”
From there the City Council instructed staff to revise the city’s ambulance ordinance to allow the one paramedic and one advanced EMT per ambulance while also clarifying parts of the ordinance regarding population growth and other items.
Once drafted and reviewed, the revised ordinance will be voted upon in a future council meeting.
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