UPDATE 7/4/2025
AZ DHS has notified the hospital that there is an exception in the law as follows:
Under Arizona law, A.R.S. 36-2217 there are exemptions from regulation related to certificate of necessity (CON). Specifically, ARS 36-2217(A)(5) notes that ambulances from other states are exempt under the following conditions:
- Responding to a major catastrophe or emergency in this state because there are insufficient registered ambulances in this state to respond in that situation
- Operating either from a location outside of this state to transport a patient to a location within this state or operating from a location outside of this state and crossing through this state to transport a patient to a location outside of this state
Under the above conditions, any out of state ambulance service, including Kane County EMS, is permitted to respond. Please note that tribal lands are not covered under Arizona Statute and Rule and therefore would be considered a location outside of this state.
In addition, Fredonia Mayor Don Johnson signed a Declaration of Local Emergency this morning that enables Kane County Hospital EMS to respond to Town of Fredonia, Arizona while the declaration is in effect.
Due to these exemptions listed above, we are going to resume Arizona ambulance operations for 911 calls.
7/2/2025
At the request of Arizona DPS, Sherriff’s department, and the North Rim National Park Service, Kane County has provided ambulance services for over 40 years. In 1989 when the hospital was formed as a Special Service District, they assumed responsibility for the ambulance operations. In 2022, in an attempt to get paid the full Arizona payment rate, the hospital filed for what is called a Certificate of Need (CON). The CON is what the State of Arizona issues to recognize an ambulance service operating in the State of Arizona. The hospital has been working with Noreen Adlin, Deputy Bureau Chief, since she took this position. After multiple applications, changes to those applications at her request, and filing numerous documents, we received electronic notice that they considered our application withdrawn due to missing information. Shortly after the electronic notice that our application had been withdrawn, we received a “Notice of Investigation”. In this notice it states that the Page Fire Department filed a complaint against Kane County Ambulance for transferring a patient from Banner Health, Page without a CON. Additionally, our application received a letter of opposition from the Page City Manager.
In the Notice of Investigation, it states that Kane County Ambulance was reported for concerns related to “alleged illegal transport of patients from Banner Page Hospital”. Additionally, this same notice states that operating in the State of Arizona without a CON is in violation of Arizona State Law.
For 40 years no agency from Arizona has tried to serve Fredonia or surrounding areas. The Page Fire Department has a strict rule that they will not travel outside of the City of Page. The only other Northern Arizona ambulance service is in Colorado City, and they have been as responsive as they can with the personnel they have. No one has been willing to cover this particular part of Arizona, yet we have been denied the CON and now are being investigated for helping Arizona with ambulance transports.
What does this mean for Fredonia, Jacob Lake, Lees Ferry, North Rim of the Grand Canyon and all the areas in between? No ground service can be provided from Kane County Ambulance. Ben Armstrong, Kane County Ambulance Director, and I made phone calls to the investigator Lance Bevins, who seemed shocked that we have been providing services for over 40 years. When we asked what this meant, he said that if you don’t have a CON, it is against the Arizona State law for you to operate in Arizona and you need to stop service until you get the CON. He suggested that we call Noreen Adlin, and we did. Noreen has been the one directing the CON application process for us and is also the individual who denied the CON application. When we spoke to Noreen, we asked if she realized the impact this would have on the citizens of Fredonia and the surrounding areas. She said, “I’m aware”.
In our regularly scheduled board meeting July 1, 2025, it was determined that because of the actions from the State of Arizona officials and the “Notice of Investigation”, that Kane County Ambulance can no longer come into Arizona to provide ambulance services. The ambulance can still respond to 911 calls within the State of Utah and the hospital will continue to transport any patients who come to the hospital. The hospital will continue to treat any patients who come to the hospital, but we will not be able to provide ambulance services to Arizona.
If you want your voice to be heard, reach out to Noreen Adlin, Deputy Bureau Chief. Her phone number is (602) 463-8076. Her email address is Noreen.Adlin@azdhs.gov. You can also call your State legislators and let them know what is happening.
As soon as we are allowed to operate in the State of Arizona, we will resume our ambulance services to our Friends and Neighbors to the South.
Sincerely,
Kurt R. Loveless Jeff Mosdell Marybeth Kuntz
Chief Executive Officer Board Chair Board Vice-Chair
Kane County Hospital Kane County Hospital Kane County Hospital