Revisions to AMR Agreement

Control No. 00799-22 
Political Subdivision Contract Review  
Page 2 of 3 
 
 
Douglas A. Ducey  |  Governor      Don Herrington  |  Interim Director 
150 North 18th Avenue, Suite 540, Phoenix, AZ 85007-3248      P | 602-364-3150      F | 602-364-3567       
W | azhealth.gov 
Health and Wellness for all Arizonans 
Remark #1, Page 1, Section 1, c: The term “Automatic Aid Contract Area” 
Please edit this section by adding the following bolded language:  
 
The term “Automatic Aid Contract Areas” as used in this agreement shall mean all areas within and 
surrounding the City and included in the service area of CON 136, in which the City has agreed to, 
provide Emergency Medical Service pursuant to automatic aid agreements. 
 
Remark #2, Page 2, Section 2, a, “Term, Extension, and Agreement Modification”: 
The language in this section appears to allow the contract to begin before BEMSTS approval.  Please 
modify to indicate that BEMSTS approval is required before the contact can begin. 
 
Remark #3, Page 3, Section 3, “Ambulance Service Requests”: 
The City of El Mirage does not hold a Certificate of Necessity to operate an ambulance service in Arizona 
as the Contractor or other ambulance referenced in this section does. Arizona Revised Statute 36-2208(B) 
does not allow for the provision of ambulance service but rather the transportation of an emergency 
medical patient if in terms of the existing medical situation it is deemed not advisable to await the arrival 
of an ambulance.  The distinction between “Ambulance Service,” a statutorily defined term, and 
transporting an EMS patient must be made clearer or remove the section “to provide such service itself as 
prescribed in ARS 36-2208(B)”. 
 
Remark #4, Page 7, Section 8, “Liquidated Damages for Failure to Meet Requirements”: 
This part of the contract should state that any non-performance penalties, fines, or liquidated damages 
will not be included in establishing rates and charges as prescribed in A.A.C. R9-25-1106. All penalties 
or fines should be reported separately on the Ambulance Revenue and Cost Report.  
 
Remark #5, Page 8, Section 10(b), “Ambulance and Locations”: 
Please provide the historic and projected call volume that supports the number of dedicated ambulances 
being proposed in this contract.  
 
In the future, if there is a significant increase in the number of dedicated ambulances, the CON holder 
should provide a written justification so that the Department has sufficient information to make an 
informed decision. 
 
Remark #6, Page 10, Section 13 “Equipment and Supplies”: 
“As mutually upon by the Parties, City may under separate agreement purchase equipment for use in 
Designated Ambulances and lease to Contactor”. 
 
Without additional information on the purpose, cost and frequency of the section above, BEMSTS is 
unable to assess the potential financial impact to the CON holder. 
 
Remark #7, Page 11, Section 16, b, “Dispatch and Communication Fees” 
“Contractor shall reimburse on a monthly basis the City’s actual cost of dispatch services as described in 
Section 17a.”  
 
The contract does not include a section 17a.  Without further information BEMSTS is not able assess the 
potential financial impact to the CON holder.  Please include in any additional information on this section

Control No. 00799-22 
Political Subdivision Contract Review  
Page 3 of 3 
 
 
Douglas A. Ducey  |  Governor      Don Herrington  |  Interim Director 
150 North 18th Avenue, Suite 540, Phoenix, AZ 85007-3248      P | 602-364-3150      F | 602-364-3567       
W | azhealth.gov 
Health and Wellness for all Arizonans 
whether the CON holder is proposing to reimburse only for ambulance service requests for dispatch or for 
dispatches that do not result in an ambulance service request. 
   
Remark #8 Page 13, Section 24, c, “Cost of Service”: 
“Contractor may bill patient for meaningful ALS services that are rendered by Contractor in accordance 
with DHS regulation when transport is not provided by ground ambulance. 
 
Please remove the word “meaningful” from this section.  
 
Or  
 
Please edit to “Contractor shall charge patients according to Arizona Revised Statute 36-2239 and 
Arizona Administrative Code R9-25-1107.”  
 
Remark #9, Page 13, Section 25, c, “Provision of ALS Services”: 
This section is unclear.  Please describe what defines an “offer of transition of care”? 
 Does this section only apply to ALS ambulances? 
 
The third paragraph of this section refers to a ride in algorithm that has not been provided as part of this 
contract. It will be required for approval of the contract pursuant to Guidance Document GD-102-PHS-
EMS Section 4 and must be signed by the CON holder’s Medical Director.  
 
Remark 10, Page 24, Section 58, “Pilot Program”: 
The Pilot Program referenced may require submission to the Department and Director approval pursuant 
to Arizona Administrative Code R9-25-503.