Ariz. Admin. Code § 9-25-906

Current through Register Vol. 30, No. 45, November 8, 2024

Section R9-25-906 - Determining Public Necessity (Authorized by A.R.S. Section 36-2233(F))

A. In determining public necessity for an initial or amended certificate of necessity, the Director shall consider the following to ensure quality patient care:

1. The following information, as proposed by the applicant for the service area:

a. Proposed response times or compliance percentage,

b. The priority that may be assigned by an applicant or a certificate holder to a response, and

c. The percentage of time the actual response time for a run is or is anticipated to be compliant with the proposed response times during a 12-month period;

2. Whether issuing the certificate of necessity is in the public's best interest:

a. Based on a possible gap in service or unmet needs in the service area; and

b. To ensure consistent service provision, efficiency, cost-effectiveness, and the health and safety of individuals in the service area;

3. The information in R9-25-902(A)(1) through (4), (6), (8), (12) through (14), and (19) through (22);

4. If applicable, the information in subsection (B); and

5. Other matters determined by the Director or the applicant to be relevant to the determination of public necessity.

B. In deciding whether issuing a certificate of necessity to more than one ground ambulance service for the same service area or overlapping service areas is in the public's best interest, the Director shall consider the following in addition to the information in subsections (A)(1) through (3):

1. The existence of another ground ambulance service providing ambulance response or transport to all or part of the service area, including the level of service and type of service being provided;

2. The current response times and compliance percentages achieved for requests made through 9-1-1 or a similar system in all or part of the service area;

3. If applicable, the current response times and compliance percentages achieved for interfacility transports for patients with a time-critical condition in all or part of the service area;

4. If applicable, the applicant's plans to provide interfacility transports for patients with no time-critical condition in all or part of the service area in compliance with R9-25-908(E)(3);

5. The applicant's plans for implementation, taking into consideration the stability and consistency of service provision;

6. If available, information or data that demonstrates the inability of the other certificate holder to provide services in all or part of the service area;

7. How the applicant plans to interact with the ground ambulance service currently providing services in all or part of the service area, including the information in R9-25-908(E)(1)(a), (b), and (c);

8. The availability of emergency medical services in all or part of the service area;

9. The financial impact on certificate holders whose service area includes all or part of the service area in the requested certificate of necessity;

10. The demonstrated need for additional 9-1-1 or similarly dispatched transport, convalescent transport, or interfacility transport, as applicable, including:

a. Whether a study or statistical analysis demonstrating need has been created for or adopted by the applicant, a political subdivision within the current or proposed service area, or a local emergency medical services coordinating system under A.R.S. § 36-2210 that:

i. Examines whether another ground ambulance service is necessary within the service area or proposed service area to provide ambulance response or transport; and

ii. Takes into account the current or proposed service area's medical, fire, and police services and the other ground ambulance service;

b. If a study or statistical analysis in subsection (B)(11)(a) exists, the content of the study or statistical analysis demonstrating need; and

c. Information received by the Department from a political subdivision, a health care institution, an elected official, or another interested party, as described in A.R.S. § 36-2233(D), indicating a need;

11. For an application for additional 9-1-1 or similarly dispatched transport, the difference between the current response times in the service area for 90% compliance and the response times for 90% compliance proposed by the applicant; and

12. Whether a certificate holder for the service area has demonstrated noncompliance with requirements in this Article, Articles 2, 10, or 11 of this Chapter, or A.R.S. Title 36, Chapter 21.1.

C. The Department may periodically assess whether there have been changes in public necessity associated with a certificate of necessity, to include ensuring quality patient care.

Ariz. Admin. Code § R9-25-906

New Section adopted by final rulemaking at 7 A.A.R. 1098, effective February 13, 2001 (Supp. 01-1). Renumbered and amended from R9-25-903 by final rulemaking at 30 A.A.R. 581, effective 3/7/2024.