Ambulance Service Expansion

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Picture of red ambulance with words Gilbert Fire & Rescue Ambulance Services

Gilbert's Ambulance Transportation Division is now in service, with six ambulances providing the best possible care and coverage for Gilbert residents. The Gilbert Fire & Rescue Department (GFRD) recently expanded to secure this critical line of service to uphold Gilbert's mission to anticipate, create and help people.

The goals of a GFRD-run ambulance service include:

Enhanced patient and employee safety
Cost effective service model with lower rates for users
Deployment model that prioritizes service to Gilbert citizens
Hiring of employees who match Gilbert's culture and values
Proficiently trained employees
Long-term sustainability of a critical line of service
Ability to innovate and adapt to Gilbert's needs

Expansion Process

In the Fiscal Year 2020/21 budget approved by the Gilbert Town Council on June 16, placeholder money was included to expand GFRD's ambulance service across town. View Chief Jobusch's presentation to Town Council here. On August 25, Town Council approved the purchase of six ambulances and six ambulance stretchers and power cots. GFRD's ambulance service began official operations in summer 2021.

Thank you to everyone who joined us for our Virtual Open House on August 13, 2020. If you missed watching it live, view it below.

History of Ambulance Service in Gilbert

The private ambulance service has been volatile the past several years. After Rural Metro, the sole private ambulance provider in town, filed for bankruptcy in 2013, Gilbert was faced with a major vulnerability that required action to protect a critical line of service. Gilbert took a two-pronged approach to protect the interests of the community by negotiating a contract with AMR for services in town and applying for its own Certificate of Necessity (CON), in which AZDHS acknowledges the need exists for Gilbert to operate ambulances. In 2015, Town Council approved GFRD's pursuit of a CON to protect Gilbert residents. Since then, the uncertainty in the ambulance industry continues to put Gilbert in a tenuous position. In fall of 2019, Gilbert launched its first ambulance service with the addition of Medic 253.

Frequently Asked Questions

Why is Gilbert Fire & Rescue Department proposing to expand its ambulance service?

The safety of Gilbert residents and those in need of ambulance services is our highest priority. In the past, unstable market conditions in the private ambulance industry have put Gilbert residents at risk. We are expanding our transportation division to secure this critical line of service to our residents. This line of service will be focused on providing the best possible care and equitable response coverage to Gilbert residents.

How much will it cost?

Will Gilbert’s liability go up?

The additional insurance costs, primarily for vehicles, were included in the financial model developed for full ambulance service. Additionally, the Town of Gilbert already addresses many of the liabilities associated with the expansion of the transportation model. While risks may be affected by the scale of the service, these are not new liabilities and they have effectively been managed in consultation with internal stakeholders and vendors. Put simply, Gilbert already provides patient care to its citizens, so much of the risk and liability exists regardless of who provides the ambulance service

Does the Town earn revenue on transports?

Yes. The Town will receive reimbursement for services rendered based on rates set by the Arizona Department of Health Services. The revenue collected through the medical billing reimbursement process will be utilized to cover the costs to operate the ambulance transportation division. Based on conservative estimates, we anticipate that the revenue will fully offset expenditures, thereby mitigating any negative impact to taxpayers.

Will this cause my taxes to go up?

Will the EMTs/Paramedics for the transportation division be sworn personnel and in the Public Safety Personnel Retirement System (PSPRS)?

How many full-time employees will be added?

Have agencies gone from civilian to sworn?

Will patients receive better care if Gilbert operates the ambulance service?

Who pays for the service?

How do Gilbert’s rates compare?

Why are AMR billing rates higher than Gilbert’s?

Ambulance operators may request rate adjustments from the Department of Health Services who will determine if a change is warranted. AMR has requested and instituted regular rate increases. These increases are not based only on their operations in Gilbert, but rather their entire Maricopa County operations. Gilbert’s rates are determined only on Gilbert conditions. Gilbert does not receive automatic increases and any rate change would require the approval of town council.

Can Gilbert arbitrarily raise the cost of transporting citizens?

Will providing this service inhibit innovation for the ambulance industry moving forward?

Agencies from across the country regularly outreach to Gilbert regarding its many innovative practices. Specific to the Gilbert Fire & Rescue Department, one example of innovation is Gilbert’s creation of the ability to conduct quality assurance audits to ensure better patient outcomes. This directly contributes to Gilbert’s recognition as an AZDHS Premier Agency. This is a recognition that the way we conduct our business and provide critical life-saving services to our residents is at the highest rated level granted by AZDHS

Another example of innovation is the medication restocking process implemented by Gilbert Fire and Rescue. Implemented in 2018, this process significantly optimized how medications necessary to emergency care were stocked and distributed. This is important because it enables our team to respond even more quickly during times of need.

Why does Gilbert’s Ambulance Revenue and Cost Report (ARCR) filed with the Department of Health Services show Gilbert is already operating at a loss?

DHS requires all CON holders to submit an ARCR regardless of whether the CON holder actually operated ambulances during the respective fiscal year. The report does not distinguish between municipal or private providers which can lead to an inaccurate accounting of the true values. The model works for organizations with a singular focus of providing ambulance services, however as applied to municipalities does not differentiate costs that would exist regardless of whether the municipality or a private company provided the service. For instance, the ARCR considers management salaries and space utilization in town facilities as part of the overhead. Gilbert’s 2019 ARCR shows a loss of $173K for operations during that reporting period. However, AMR provided all ambulance service and Gilbert didn’t operate any ambulances during the reporting period. ARCR’s are an accounting and reporting mechanism for DHS, not a way to accurately and appropriately identify cost of service.

When did Gilbert begin looking into starting its own ambulance service?

The private ambulance service industry has been volatile the past several years. It has been documented in other cities across the country that private ambulance companies have gone on strike or suddenly closed their operations overnight and stopped providing ambulance transport. After the Town of Gilbert learned through media reports that Rural Metro, the sole private ambulance provider in town, filed for bankruptcy in 2013, Gilbert was faced with a major vulnerability that required action to protect a critical line of service. Gilbert took a two-pronged approach to protect the interests of the community by negotiating a contract with AMR for services in town and applying for its own Certificate of Necessity (CON), in which AZDHS acknowledges the need exists for the Town of Gilbert to operate ambulances. In 2015, the Town Council approved GFRD's pursuit of a CON to protect Gilbert residents. Since then, the uncertainty in the ambulance industry continues to put Gilbert in a tenuous position. In fall of 2019, Gilbert launched its first ambulance service with the addition of Medic 253.

Gilbert, Arizona

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Ambulance Service Expansion

Expansion Process

History of Ambulance Service in Gilbert

Frequently Asked Questions