The organization that regulates emergency medical services throughout Utah needs better monitoring procedures for ambulance providers and clearer service standards, a legislative audit says.
In addition, the Bureau of Emergency Medical Services and Preparedness (BEMSP) — an organization within the Utah Department of Health — needs to clarify provider responsibilities, a performance audit by the Office of the Legislative Auditor General says.
The BEMSP had been slow to alleviate overlapping rights and responsibilities that have resulted in two ambulance companies responding to the same call, according to the audit, which was presented Tuesday to the audit subcommittee of the Legislative Management Committee.
David Patton, Utah Health Department executive director, told the subcommittee that his agency welcomes the audit results and already has implemented some of the recommendations in the report.
The subcommittee voted unanimously to refer the report to the Health and Human Services Interim Committee.
BEMSP issues two types of licenses, one that limits the holder to transporting patients between medical facilities and another that allows the company to provide all services.
The audit request included 13 letters from various EMS providers who are concerned about whether their exclusive geographical areas are being preserved, the audit says. It says BEMSP was slow to eliminate overlaps, pointing to Orem as an example.
The Orem Department of Public Safety provides both ambulance and inter-facility transportation, and Gold Cross Ambulance also has an inter-facility license, the audit say, resulting in "the potential for confusion and unnecessary duplication."
The audit also used as a case study St. George and two service providers. Dixie Ambulance Services had served the southern Utah city for years; Gold Cross Ambulance began using its Salt Lake County license in 2010 to provide services for Dixie Regional Medical Center in St. George. (Gold Cross had received statewide authority by BEMSP in 1984 to provide inter-facility transport services; that authority was removed about a year ago to resolve overlap problems).
The St. George situation created conflicts between the two ambulance companies and led to two BEMSP administrative hearings, which found in 2013 that Dixie Ambulance was not financially viable. The bureau removed the company’s licenses, the audit says.
The audit notes the bureau could have imposed less serious penalties, including suspension and probation, which would have given Dixie Ambulance a chance to correct deficiencies.
Other recommendations include that BEMSP require providers to submit data indicative of their financial solvency; review standards that support early detection of provider deficiencies; and post its complaint form on its website.
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