Forum Probie
To anyone working in Arizona, how exactly does the certificate of necessity work when there are multiple companies and agencies overlapping one area? Is there a primary agency, and the rest are backup? Or does one fire and one private ambulance show up, and fire only takes high acuity patients, leaving the private companies to pick up mostly BLS patients? Really curious about the Tucson and Phoenix metros.

Here's the map I'm referencing: ADHS Certificates of Necessity


Forum Crew Member
Phoenix is run by Phoenix Fire & they do all their own transports. Maricopa Ambulance covers Glendale & responds with 1 medic & 1 EMT. They also respond with Scottsdale Fire but they send a BLS unit & Scottsdale Fire rides in on everything. Maricopa also covers city of Surprise but I’m not familiar with their set up out there. Mesa Fire has a few of their own ambulances but they only respond within a certain radius of their station, otherwise you have AMR responding. In Gilbert, you have AMR. In unincorporated Gilbert (the County islands & into San Tan Valley you have Rural Metro Fire Department & Rural Metro Fire Department Ambulance responding. In Chandler, you have Chandler Fire responding with Lifeline (aka AMR) but the side of the ambulance says Chandler Fire with lifeline ambulance on the back doors & is staffed with a Chandler Fire paramedic & an AMR/Lifeline EMT.

The certificate of necessity basically is a pretty piece of paper that goes to DHS &’goes through a bunch of legal establishing a need for EMS services in an area. Maricopa Ambulance came in and got letters of support from some of the hospital systems saying AMR was unable to meet the demand of calls for IFT’s, then Scottsdale Fire jumped on board & AMR is slowly being run out of town. I’m not sure how things are run down in Tucson, but if memory serves me correctly, AMR is the sole transportation company in the area.

If you have any more questions, let me know & I’ll do my best to answer them!