Globe pursues agreement with Tri-City Fire over emergency response

It is not unusual, and in fact is common practice in Arizona, for a city fire department that provides medical services within its own jurisdiction to have a written agreement with the CON transport agency that responds within the same city limits.”

Globe Mayor Al Gameros

When medical emergencies occur within Globe city limits, two local agencies arrive at the scene — Globe Fire Department and Tri-City Fire District. This overlap has recently come under scrutiny. 

On May 13, Copper Country News published an article describing the City of Globe’s plans for its fire department and its hiring of an attorney to negotiate an agreement between Globe Fire Department and neighboring Tri-City Fire District. The article prompted a public statement from Tri-City Fire later that day and sparked criticism of the city on social media.  

In addition to mentioning the attorney hire, the article paraphrased Globe City Manager Paul Jepson as saying that “the transition to a new station is about more than just a building; it is about clarifying the city’s role in regional safety.”

In the public statement addressed to its taxpayers, Tri-City Fire District said the district had “no knowledge of the regional plan” involving fire services. Jepson later told Globe Miami Times that the city was in the process of reaching out to Tri-City Fire on the same day that the district released the statement.

In an interview with Globe Miami Times, Globe Mayor Al Gameros said the city’s focus is on the agreement; the decision to hire an attorney was in response to a letter from Tri-City Fire describing its statutory authority, ultimately dictating how emergency incidents would be managed.

According to Gameros, the city’s goal is to negotiate a formal agreement between the two agencies that would solidify operational expectations for each and clearly define authority and responsibilities on emergency scenes within Globe’s city limits.

“We're just trying to establish some guidelines or some procedures that we all abide by and we understand before we even get to the patient,” he said. “That's why we hired that attorney, to help us understand what the authority is and what the legal parameters are in the field if we don't have the transport.”

Currently, both Globe Fire and Tri-City Fire respond to medical emergencies within the city. However, only Tri-City Fire holds a state-issued Certificate of Necessity, which regulates ground ambulance service in Arizona and is what allows Tri-City to transport patients from a scene to the nearest available hospital.  

 Even so, whichever agency arrives first must begin providing care to the patient. That care is provided based on the direction responders receive from a medical director. When first responders arrive at a scene, they assess the patient and contact their designated medical director for further treatment as needed. 

According to Gameros, Tri-City Fire no longer uses Cobre Valley Regional Medical Center for medical oversight and has entered into a contract with an out-of-area agency instead, while Globe Fire continues to receive medical direction through CVRMC. 

“They may get different medical directions than what we get,” he said, which could potentially cause challenges involving patient care and communication between responding agencies. 

One example of potentially differing directions would be medical direction to fly a patient to an out-of-area hospital versus direction to keep the patient's treatment local. In some instances, the patient’s conditions could be handled locally, Gameros said, and a flight could cause financial hardship on the patient. 

“It's nice to have a common ground in order to understand each other's responsibility, and that's really what we're hoping to establish in a formal agreement,” he said.

“It is not unusual, and in fact is common practice in Arizona, for a city fire department that provides medical services within its own jurisdiction to have a written agreement with the CON transport agency that responds within the same city limits,” he said. “A formal written agreement is essential to ensure continuity of care, establish operational expectations, define authority and responsibilities on emergency scenes, and protect both the agencies and personnel from liability concerns.” 

In response to questions from Globe Miami Times, Tri-City Fire District Chief Tony Grainger said the two fire agencies are in the process of scheduling a meeting and Tri-City Fire is waiting to learn about the city’s official intent. Because of that, he said the district would wait until it had a more complete understanding of the situation before participating in an interview with GMT. 

Grainger did provide a written statement, saying, “While we are aware of recent public discussions regarding emergency medical protocols and local fire service plans, these are highly technical matters governed strictly by state administrative code, medical direction liability, and statutory transport boundaries.” 

“To modify or compromise these frameworks locally introduces severe operational risks and liability concerns that directly impact patient care on active 911 scenes,” he said. 

Grainger said in the statement that the district is currently engaging directly through state regulatory channels and has requested independent third-party mediation involving regional stakeholders.