WOMAN: Please hurry. Please hurry.
DISPATCH: What’s going on?
WOMAN: The baby fell into the bathtub. She drowned. She’s not breathing. Send help right away.
The 911 call came on Aug. 20, 2021.
While en route, Central Arizona Fire and Medical Authority firefighters made two calls.
The first was a radio call to the responding ambulance.
“How far are you guys out?”
The answer: “We’re about 12 minutes out.”
That’s when the firefighters made their second call — a judgment call. They decided to use the unofficial ambulance they brought as a backup.
The crew got the baby to a nearby helicopter, which flew the 8-month-old girl to Phoenix Children’s hospital.
The baby survived and was released days later.
“We really didn’t think much about it, other than we transported with (our own rescue vehicle) and this was a good thing. We saved somebody in the community,” said Scott Freitag, chief of the Central Arizona Fire and Medical Authority, or CAFMA. “That is until we got the notice of investigation from (the Arizona Department of Health Services).”
There are more than 150,000 residents in Prescott, Prescott Valley, and the surrounding area, but the state licenses one ambulance provider to operate there. It’s Life Line Ambulance, which is a for-profit company underneath a larger one called American Medical Response (AMR).
The fire department believes the private company’s response times are regularly too slow and that there aren’t enough ambulances in service.
So in defiance of the state health department, CAFMA uses a fleet of its own unofficial ambulances, which it calls “Rescues,” to respond to calls when firefighters feel Life Line’s units are too far away.
When asked if he regretted his crew using a “Rescue” in the baby’s near-drowning call, Freitag responded, “Not at all.”
In recent months, Life Line has started filing written complaints with the state health department against CAFMA for the unapproved “Rescue” transports, records show. (CAFMA has also filed more than 1,000 complaints against Life Line going back years.)
As a result, the state has issued CAFMA multiple notices of investigation for many incidents dating back into summer.
On one of the most recent notices, it states, “The complaint alleges that on the dates and locations listed below CAFMA inappropriately transported a patient when it was not medically necessary.”
What follows is a list of 15 different calls, including the near-drowning involving the baby.
In a written statement, a spokesperson for the Arizona Department of Health Services confirmed they have sent multiple notices to CAFMA and have an open investigation.
“ADHS also has an obligation to make sure that medical transport provided by entities that are not certificated ambulance providers, including CAFMA, meet standards of medical necessity developed in the interest of public health and safety,” wrote ADHS spokesperson Steve Elliott. “To date, ADHS has sent CAFMA three Notices of Investigation requesting additional information about the use of CAFMA rescue units to provide EMS patient transport. Nothing is implied in these requests, which will help ADHS determine whether the transports were proper.”
(The health department’s entire statement on the issues surrounding Life Line and CAFMA is at the bottom of this report.)
ABC15 interviewed Life Line/AMR regional director John Valentine about the issues.
He denied that they were filing “complaints” with the state.
“So we’re not filing complaints. What we do is if there’s an incident, and we’re responding to a call, and we show up on scene, and their rescue is there, and they’re loading the patient, we may file an information (request) with the Department of Health Services for them to look into why they didn’t utilize our (ambulance),” Valentine said.
Valentine added that Life Line wasn’t necessarily opposed to CAFMA using the “Rescues.”
“We’re not against the fire department using rescues,” he said. “If there are appropriate patients in dire need of transportation, and they’re there, utilize the rescue.”
Valentine told ABC15 that CAFMA’s public criticism of Life Line has been misleading.
He took issue with how the baby’s near-drowning call has been portrayed by the fire department as part of its social media campaign to put a spotlight on response times and ambulance service in the Prescott area.
“We were 12.7 miles from that incident. We were dispatched on that call immediately…. It’s probably, without Googling it, a 15-minute response time from our location. CAFMA also responded to that incident,” Valentine said. “And about 13 minutes into the incident, the battalion chief or captain, one of them, diverted our unit to go meet the helicopter. So we were roughly 3-ish minutes from going to the scene and moving that patient to the hospital.
“I think that’s the piece that’s misleading because it made it seem like there was no ambulance responding to that call,” he said. “There was an ambulance responding to that call.”
But Freitag said every minute saved is worth it.
“We can’t wait 12 minutes. We can’t wait three minutes additional at the scene if we have the ability to transport that child and get them to where they need to be,” he said.
In late October, CAFMA officially filed an application with the state to operate its own ambulances. The department is also backing another private company’s application to add ambulances to the area.
But the application process takes at least a year. And it’s not just CAFMA raising issues.
Other fire departments and a local hospital have also filed complaints with the state and written letters in support of new and additional ambulance providers.
“The department has investigated a number of these complaints and they found us compliant,” Valentine said. “We’re meeting our response times.”
The health department confirmed they found Life Line to be in compliance. However, the state said they are keeping an investigation into the matter open to gather more information.
On CAFMA’s side, Freitag is not hiding from the state about what his department is doing with its “Rescues.”
In fact, he is essentially forcing the issue.
CAFMA now sends the state health department a weekly list of the times it used “Rescues.”
“The state is looking really hard at us for what we’re doing with our 'Rescues,'” Freitag said. “It’s not something they want to see. So to be fully transparent with the state, we send them a list and say here’s what we transported, here’s when, here’s the incident report number, here’s why we transported that patient.”
Below is the full statement from the Arizona Department of Health Services:
“The state’s commitment to the health and safety of Arizona communities extends to its oversight of emergency medical services providers. We are aware of the community concerns and are following a process to ensure that residents have access to reliable EMS transport. ADHS has hosted stakeholder meetings and worked with the current certificated ambulance provider in the region (Life Line) to improve response times. This resulted in an amendment of Life Line’s Certificate of Necessity finalized in early 2021. An administrative hearing is currently underway to determine whether an additional CON can be granted to a second ambulance provider (Priority Ambulance) to operate in the area.
“Between late 2018 to mid-2021, the ADHS Bureau of Emergency Medical Services received and reviewed a log of EMS calls provided by CAFMA that included over 1,000 calls covering several years. ADHS has opened an investigation on the current ambulance provider (Life Line) to request additional information about any potential gaps in service or community need. The investigation has found Life Line to be in compliance with its improved ambulance response time requirements, which are measured over a 12-month period as required by Arizona Administrative Code. However, the investigation remains open at this time to gather more information.
“ADHS also has an obligation to make sure that medical transport provided by entities that are not certificated ambulance providers, including CAFMA, meet standards of medical necessity developed in the interest of public health and safety. To date, ADHS has sent CAFMA three Notices of Investigation requesting additional information about the use of CAFMA rescue units to provide EMS patient transport. Nothing is implied in these requests, which will help ADHS determine whether the transports were proper under ARS 36-2208(B). ADHS is currently reviewing additional information recently submitted by CAFMA, and the status of the investigation remains open.
“While we cannot disclose patient information, the Bureau is committed to working with EMS providers to ensure that patients are transported safely to get access to emergency medical care. All parties agree that patients should have access to the right resources in the right amount of time. We have deep respect for frontline workers, including those employed by Life Line, CAFMA and the area’s 911 system.”
Contact ABC15 Investigator Dave Biscobing at Dave@ABC15.com.