Ambulance war: State agency rules in favor of Gold Cross

Dixie Ambulance trucks stations at the St. George Municipal Airport, St. George, Utah, March 27, 2013 | Photo by Mori Kessler, St. George News, alteration by St. George News graphics

ST. GEORGE – The Utah Bureau of Emergency Medical Services ruled in favor of Gold Cross Ambulance Wednesday over long-time provider Dixie Ambulance Service as St. George’s exclusive 911-emergency medical services provider.

BEMS Executive Director Dr. David Patton issued the ruling in a 66-page document released Wednesday afternoon based on the recommendations made by Maxwell Miller. Miller was the state-appointed hearing officer who oversaw a four-day hearing in December between the two ambulance providers and concluded Dixie Ambulance should no longer provide EMS service for St. George and have its existing licenses for the city be granted to Gold Cross.

In the ruling, Patton said “the (Utah Department of Health) cannot reasonably conclude that continuance of the Dixie Ambulance licenses … is in the public interest. Rather, considered in total, the Department concludes that the evidence adduced at the hearing clearly shows that public convenience and necessity require that the Department issue Gold Cross the paramedic rescue and paramedic ambulance licenses for which it applied.”

Following the release of Hearing Officer Miller’s recommendation to the state, the City of St. George issued a letter to BEMS asking the agency to allow Dixie Ambulance a measure of time to rectify the inadequacies listed.

Among the inadequacies put forth by Hearing Officer Miller include: poor response times, inadequate use of available medical technologies, no clear goals, poor vehicle maintenance, little ability to reach the demands of a growing population, and a number of other issues.

Should Dixie Ambulance lose its EMS licenses for St. George, it will still be able to operate in the surrounding area where it retains licensure, such as Santa Clara and Washington. This will leave the ambulance service with about a third of its original service area.

Marc Mortensen, assistant to the city manager of St. George, said the mayor and city council are currently reviewing the ruling and will issue a unified statement when ready.

Mac Miller, public information officer for Dixie Ambulance, said the ruling mirrors the hearing officer’s recommendation and that Dixie Ambulance will appeal the ruling and go to court if necessary.

Patton’s ruling grants the EMS licenses for St. George to Gold Cross as of May 1, 2013.

Calls to Gold Cross were not returned by publication of this article.

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

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  • Troll March 27, 2013 at 6:21 pm

    Huh, I never knew there were 2 ambulance services here in St. George. Is it that bad having 2 ambulance services? What happens if there’s a major disaster, and one ambulance service isn’t enough to cover the disaster?

  • thankgoodnees March 27, 2013 at 8:08 pm

    You Dixie Ambulance lovers are probably raging mad right now… won’t be when its you on the stretcher and the equipment and paramedics are up to par.

  • not a troll March 27, 2013 at 8:15 pm

    There is only one contract. Bureaucracy at its finest.

  • Dover Ben March 27, 2013 at 9:51 pm

    This is great news, so happy to have Gold Cross coming. Providing the citizens of St. George with state of the art equipment. Having 4 ambulances, with 2 Paramedics 24 hrs a day. Offering health and dental benefits, and higher pay. Maybe now we can retain the great Paramedics who have been leaving, due to the fact they cannot provide for there families working here for another company. I welcome Gold Cross.

    • kevin March 28, 2013 at 7:17 am

      Yeah Ben I’m sure if they have already left that they are coming back to for peanuts! Do inform us all the going rate for a paramedic!! You sure are a good company man, are you able to think on your own?

  • Gunther March 28, 2013 at 7:31 am

    The way this was initiated and forced through the system was an event to behold. The lawyers (sharks) circled their victims and attacked with relentless vigor. A state Rep was even involved. But like they always say ” Hey, it’s just business” My respect for Gold Cross is nonexistent right now

  • elliemae100 March 28, 2013 at 7:51 am

    Dixie Ambulance has fought hard against this recommendation – and asked for time to rectify the problems that were identified during Gold Cross’ application process as well as in the initial report. Yet, they haven’t done anything to address the problems. Instead, on this site, they participated in personal attacks against their detractors.

    If Dixie Ambulance had wanted to be taken seriously, they would have addressed each & every one of the allegations and implemented a plan of corrections. From what I understand, Gold Cross pays living wages and their staff members work full-time (with benefits), versus Dixie Ambulance staff members who work several jobs to make ends meet. If I’m having a life-threatening crisis, I would prefer to be treated by someone who slept the night before and was focused on the job.

    Again, Dixie had plenty of time to rectify the issues that were identified in the reports. I don’t wish them ill will – if they continue to serve the surrounding areas, I hope that they work on the issues that were identified. This isn’t a “good ol’ boys” issue, and the local provider simply wasn’t the best in this case.

  • SunnyInUtah March 28, 2013 at 11:00 am

    I would have to agree with your ellie, just because you were here first doesnt mean that you can slack on your responsibilities as a first responder. There should be no entitlments here and the award of contract should go to the company that is compliant and has demonstrated excellent performance. If this means that Gold Cross is awarded the license then they have demonstrated this. If Dixie Ambulance knew what was expected of them and they did nothing to rectify the situation then that is their own fault. You can not rest on your laurels you have to be proactive NOT reactive.

  • Truth Seeker March 28, 2013 at 12:18 pm

    Elliemate100 and SunnyInUtah

    I have a very fair question to ask you both, how do you have the ability to know whether Dixie Ambulance has put forth efforts to change for the better or not? Have you sat in on executive management meetings? Have you worked alongside their employees to see if changes were made? Did you have direct contact with the organization?

    There were a lot of points brought up in the discovery of evidence in this care. However some things take time to change and do not occur overnight. How are any of us certain what really needs to change or what has or hasn’t already been done?

    I ask that you defend your opinion in this matter if strong statements like, “they haven’t done anything to address these problems” are made. In as heated of an issue as this is, it probably is best to use some discretion on matters that you are not fully aware of.

    • elliemae100 March 28, 2013 at 10:44 pm

      You asked me how I know whether or not Dixie Ambulance has put forth any effort to address the issues that were identified. According to every news story that’s been written, Dixie Ambulance has been well aware of the problems for at least 1-1/2 years. As the only game in town, they appeared to have continued to operate in the same manner as always.

      As was stated on this site 6/24/11, there have been questions about Dixie’s response times (which Dixie blamed on the dispatch system’s reporting); 11/28/12 Dixie received a negative audit from the agency that provides oversight; 12/4/12 Dixie’s solvency was called into question (and this site defended Dixie’s business model); and finally 12/30/12 this very site posted an love note that asked – among other things – why Dixie’s workers don’t strike if they believe that they’re getting the short end of the stick regarding their employment at Dixie Ambulance.
      To answer the question of striking, Utah is a right-to-work state. The employees of D.A.S. don’t strike because they would be fired and replaced immediately by other people who are as badly in need of a job as the current workers. It’s been widely reported that Dixie’s workers have no benefits – such as healthcare – and certainly have no job security. In an area hard-hit by the recession, those of us who are fortunate enough to be employed are beholden to the companies who choose profit over their greatest asset – their employees.
      With all of the issues that have been bantered back & forth (which reach back to June 2011), Dixie Ambulance Service has had plenty of time to implement a plan of corrections that surely would have been taken into consideration during this difficult process. I haven’t read one article that discussed Dixie’s desire to improve services, only their continued defense of their practices. So forgive me if I don’t appear to support Dixie Ambulance in their quest to continue the status quo.
      It’s not enough to award them the ongoing contract simply because they are the company that has been providing ambulance services in the past. I do admit that I haven’t sat in on executive meetings – but that doesn’t mean that I’m uninformed. Unless every news story that’s been written, from this site to the Spectrum to the SL Tribune, has been negligent with their reporting, Dixie has attempted to defend its practices but hasn’t submitted anything that leads one to believe that they accept their need to change. Had that occurred, they might not be in the position that they are today.
      Dixie has stated that Gold Cross is attempting to “take” what’s rightfully theirs, rather than to offer to buy Dixie out. While it’s true that GC is using the system to gain an exclusive contract, but from all of the stories I’ve read, Dixie’s greatest asset is the contract itself. Gold Cross can’t buy what Dixie doesn’t own. They appear to have placed themselves in a position where they have little operating capital, rendering them nearly insolvent (refer to the stories referenced above).
      I’m all for supporting the local company, but not at the expense of the community. Dixie Ambulance has been well aware of the potential for another company to apply for their license. Either they believed that no one would ever do so, or they believed that they would be the best candidate for the contract – but according to the commission findings, they were wrong.
      Again, one only has to look as far as the many articles that have been written by multiple news sites to weed through the information and formulate an opinion. My opinion was further solidified by the personal attacks that were posted on this site by the owners of Dixie Ambulance (since redacted). I do believe that it’s best to use some discretion when posting my opinion on this, an open internet forum – and I believe that I have done so. I would like to point out that Dixie was satisfied with the process when they were the only game in town. They have had 1-1/2 years to prove that they’re the better ems provider, and from all appearances they have failed. If the audit was correct, the owners won’t be hurting at all. The employees can apply with Gold Cross and the community will benefit.
      I’m a lifelong resident of this area and I know that change is difficult – but the community itself will benefit from this decision.

  • Hatalii March 28, 2013 at 12:23 pm

    I don’t know which is the better service. Having no experience with either one, all I can do is go by what it looks like, in reading the news articles. But from where I am standing, it looks to me like something is not quite kosher here with the way this was handled.
    I’m neither defending Dixie Ambulance, or saying Gold Cross is bad. But I am saying that it seems like having a law maker, who just happens to be an attorney working for Gold Cross, being actively involved in the whole thing, seems like a conflict of interest.

  • Dover Ben March 28, 2013 at 2:31 pm

    Wow Kevin, you seem a little upset. maybe your losing your job, so I wont take it personal. Anyway, i put in my statement that maybe we could RETAIN the Paramedics- definition of retain is to continue to have something/ or keep possession of. So I’m not sure what your tirant about bringing Paramedics back for peanuts is all about. And this is an opinion page, so everyone has the right to say how they feel. So calm yourself down, and grow up a little.

  • SunnyInUtah March 28, 2013 at 3:51 pm

    If they have taken steps to address the problems then this would not be an issue, correct? I am sure these issues in question did not just spring up over night. This has been going on for sometime. I am not saying that Dixie Ambulance should not keep their license what I am saying is if you have standards to meet why are you not meeting them the entire time?

  • SunnyInUtah March 28, 2013 at 3:54 pm

    I in all fairness believed this happended because of politics. I think that someone that knows someone that knows someone was able to get this passed. I was confused on why there was another ambulance service coming in to St George from Salt Lake to begin with. I found it rather strange. But it seems that the door has been left open for a “take over” and that door should have been closed and bolted shut long before now. Like I said PRO ACTIVE NOT REACTIVE.

    • elliemae100 March 28, 2013 at 11:19 pm

      Any company is able to apply for a license to do business in another company’s territory – and Dixie got too comfortable. The city of St. George, from the Mayor to the City Councilmen, stand firmly behind Dixie Ambulance. However, Gold Cross was awarded the contract. There’s no door that should have been shut & bolted; both companies defended their stance that they were the best company to serve the City and Gold Cross was awarded the contract on its merits while Dixie was found to be lacking.
      As difficult as this might be for the owners of Dixie Ambulance, they don’t have the right to limit another company’s right to apply to operate in their territory simply because they’ve been the only game in town for many years. It’s surprising that no other company has applied for the contract sooner – and if Dixie Ambulance believes that they deserve the contract, they can address their problems, then apply for the contract in the same manner as Gold Cross.
      Their video on Youtube mentions that their best reason for being awarded the contract is their satisfied customers – however, they need to present quantifiable evidence that they meet or exceed the requirements for the job. Perhaps their problem has never been what they’re doing – but how they report what they’re doing. Unfortunately, they fell short in this area.
      If you take out the emotions (which are running very high),it’s a simple issue: the community deserves to be served by a company that is able to meet or exceed all of the standards set forth by the commission that provides oversight.

  • Truth Seeker March 28, 2013 at 6:16 pm

    Thank you for your reply SunnyInUtah. I can’t agree with you more that this whole situation is politically driven. The door for a take-over may have been open, but that probably was not noticed to anybody from the State of Utah down to Dixie Ambulance and St. George city. It was never noticed because the Utah State Bureau of EMS has always had a positive working relationship with Dixie Ambulance and has continued to issue them their license to provide service. There are also no complaints against Dixie Ambulance at a state level, so no concerns were ever made.

    Responding to your comments about problems, standards violations, and why they haven’t been addressed is an interesting topic. There has to be some education on what exactly these “issues” are that we are talking about. A lot of the issues, which are public knowledge, have to be considered in context. For example, the issue of documenting response times on a piece of paper as opposed to a computer, is this really an ISSUE? Hurricane Fire/Rescue states they do the same thing, should they loose their ability to provide service? Another issue to illustrate my point is that of response times. NFPA, a national fire association who sets standards, states that an ambulance needs to arrive on scene in 14.9 minutes. Dixie Ambulance was found to provide at their longest response time 8.0 minutes within St. George (that does not include emergent calls). This demonstrates that national standards are not just met, but exceeded. So when these “issues” were brought up by Gold Cross, were they really “issues”, or just simply “pulling at straws” if you will.

    All information that is mentioned above can be verified in the legal audio recordings provided to the public on Dixie Ambulance’s Youtube page. Thank you for sharing your opinion.

  • Truth Seeker March 28, 2013 at 6:23 pm

    Here is a new item of consideration. Gold Cross has provided service to the community of St. George for the past few years by doing interfacility transfers and has done a great job. During their presence here, they looked at the services provided by Dixie Ambulance Service, who before that time nobody questioned their abilities. Gold Cross decided to apply for the exclusive 911 license for St. George. For them to legally obtain those privileges, a burden was placed on their shoulders to prove that Dixie Ambulance Service was not doing an adequate job. This required an investigation into every aspect of Dixie Ambulance Services business practices.

    Who did that study? Gold Cross representatives conducted several studies of Dixie Ambulance Service, Washington County Communications center, and other surrounding agencies relationships to stakeholders. The discovery of their findings were then given in the state’s “formal hearing”.

    Who here thinks that is poor practice? Shouldn’t have a third party with no ties or relationship to either company or the state been involved in the investigation of DAS? In all other domains of professionalism, a third party is asked to investigate. Why did that not occur here? Does that not make you think that some of the information communicated to the public might have fault?

    • elliemae100 March 28, 2013 at 10:58 pm

      Didn’t Dixie Ambulance have the same responsibility in this process – to defend every facet of the business practices that Gold Cross was questioning? Why hasn’t Dixie proven that the investigation was flawed (if that’s what their assertion is)?
      Both companies had the burden of proof in this matter, and Gold Cross presented information during the formal hearing. If Dixie believes that the process is flawed, they have every right to hire a third party and present any information supporting that they are the better option in this matter.
      This process has dragged on for 1-1/2 years; both companies have had adequate time to present their reasoning as to why they are the better choice for ambulance service in the City of St. George.

  • optimismalways March 29, 2013 at 10:49 am

    elliemae100: YOU ARE AMAZING! Kuddos to you for taking the time to find the information to dispute what DAS and their owners are saying. I, along with so many others, wholeheartedly agree with your statements and appreciate the respect of your comments in coming with fact.

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