Late last week, Cara Christ Arizona Health Services Director, overturned Administrative Law Judge Thomas Shedden’s May 21 decision which denied Timber Mesa Fire & Medical District’s application for an overlapping Certificate of Necessity (CON), to provide ambulance services in Show Low and Linden. The decision is considered virtually unprecedented since only two out of 26 Certificate of Necessity case rulings in Arizona have been overturned by a Department of Health Services director over the last five years. The Show Low EMS/Timber Mesa Fire & Medical District case is one of those two exceptions. A Certificate of Necessity (CON) is essentially a system used to regulate ground ambulance service in Arizona.