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Home My WebLink AboutS01-City Attorney --- ..- > Il.LAN k'. MARKS . County Counsel o -~ '<::-, , r .----- ,'----"' ,',\Jo\,IO.~ IO.'l B[ll~AIlOI'lO County ~rnardino :~> '--./~ o DEPUTIES Cha,le. A. Due,beck Dawn Stafford Cha,les J. L.,kin P.ul F. Mordy Rex A. Hinesley Jo.nne Fenton Susan A. Hopkins Paul St. John SUNn Linds.y N.sh L. Thomas K,.helski Ch.rle. S. Scol.atico W. Andrew Hartzell Send,a D. Baxte, Harry E. Hicks Nell H. Stem Linda C. Stem Jean-Rene Ba,I. Alan L. G,een Michelle D. Blakemore Robert L. Jocks Patricia Campbell K.ren K. Nowak CRAIG S. JORDAN Assistant County Counsel CHiEf DEPUTIES Ronald D. Reitz Ruth E. Stringer DanMtI B. Haueter COUNTY COUNSEL 385 NORTH ARROWHEAD AVENUE SAN 8ERNARDINO. CA 92415-0140 September 16, 1991 Mayor Bob Holcolm Common Council of the city of San Bernardino 300 N. "0" Street San Bernardino, CA 92401 Re: Proposed Ordinance Regulating Ambulance Dispatch TELEPHONE 17141 387-5455 TELECOPtER 17141 387-5482 Dear Mayor Holcolm and Council members: The City of San Bernardino is considering enacting an ordinance regulating the dispatch of ambulances on emergency medical calls. The Public Health Department of the County of Bernardino and the Inland Counties Emergency Medical Agency ("ICEMA") oppose the City'S enactment of such ordinances on the following grounds: 1. A charter city cannot enact ordinances which conflict with the general laws of the ~tates [Hall v. Ta~t (1956) 47 C2d 177, 187, 302 P. 2d 574.] In this case, the State has enacted a comprehensive plan for the regulation of emergency medical services ("EMS"). [Health & Safety Code section 1797, et seq.] That plan vests all local control for administration of emergency medical services with the County and its local EMS agency (i.e., ICEMA). In this regard, ICEMA has sole control over the regulations pertaining to emergency medical dispatch [Health & Safety Code section 1797.220.] Therefore, as the State has preempted the regulatory field for emergency medical services, the City cannot exercise jurisdiction over ambulance dispatch. 2. In addition to the City'S lack of regulatory jurisdiction, a number of practical defects exist with respect to the proposed ordinance. Although it is understood that the language of the City'S ordinances not final, the proposed restrictions on Code 3 usage and the requirement to obtain consent from the emergency dispatch center on private originated calls run contrary to established procedure and only serve to slow emergency response time. ~t.~ ~(,Ifl s- I '1:J.Jti'" ^ # ,-,) Letter to Mayor and o Council o Page 2 september 16, 1991 The objections of the County PUblic Health Department and ICEMA are further dealth with in the letter dated September 12, 1991 which was submitted to the city Attorney's office. A copy of that letter is attached for your convenience. In summary, the City is overstepping its jurisdiction by attempting to regulate EMS services - in this case, ambulance dispatch. While it is understood that the city has significant concerns over the operation of both public and private ambulances within its territory, such concerns are best dealt with through the agencies charged with administering EMS activities with the County, the County Public Health Department and ICEMA. Very truly yours, Deputy c~unty Counsel AlG:.1 ltrCltyCn/AMl ee: J... PenMn/B.rIOll o o September 12, 1991 COP Y Dennis Barlow Deputy City Attorney city Hall 300 N. "D" street San Bernardino, CA 92401 Re: Proposed city Regulation of Ambulance Dispatch Procedures Dear Dennis: As a follow-up to our telephone conversations of September lOth and 11th, I am submitting the concerns of the County's Public Health Department and Inland Counties Emergency Medical Agency ("ICEMA") with regard to the City of San Bernardino's proposed addition of Section 5.76.505 (relating to ambulance dispatch procedures) to the San Bernardino Municipal Code. To begin, the County and ICEMA maintain that 'the city's ambulance dispatch ordinance is preempted by the State Emergency Medical Services ("EMS") Act. [Health & Safety Code section 1797, et seq.] More particularly, under the EMS Act, counties are permitted to develop EMS programs, and in developing such programs, counties are required to designate a local EMS agency (e.g., ICEMA) to administer the program. [Health & Safety Code section 1797.200.] The local EMS agency has primary responsibility for administration of emergency medical services within the County. [Health & Safety Code section 1797.94.] In addition, the local EMS agency is charged with the responsibility for planning, implementing and evaluating the EMS system and the implementation of its advanced life support systems. [Health & safety Code sections 1797.204 and 1797.206.] This includes transportation as a component of the system [Health & safety Code section 1797.103], and control over medical dispatch [Health & Safety Code section 1797.220]. In view of the pervasive nature of the EMS Act, the County and ICEMA maintain that the field of EMS regulation has been occupied to the exclusion of city regulation of EMS-related services such as ambulance dispatch procedures. In addition to the legal grounds for the County and ICEMA's objections as noted above, there are also practical objections to the city's ambulance dispatch ordinance. These objections are outlined as follows: - . Letter to D. Barlow o Page 2 o September 12, 1991 1. It is the position of the County and ICEMA that Sections 5.76.505(a) and 5.76.505(b) (2) are duplicative of current State law and are therefore redundant and unnecessary; 2. The requirement of Section 5.76.505(b) (1) that am ambulance service receive formal authorization to respond to a call from a private source will serve only to delay emergency response time with possible adverse affects to the patient; and 3. Finally, with respect to the impact of Section 5.76.505(b) (2) on Code 3 operations, the County and ICEMA believe that discretion should always favor a Code 3 response. Thus, only where it appears that no danger of death or further disability exists should an ambulance operate at any status less than Code 3. The issue of Code 3 operation raises an additional area of concern since it is felt some danger exists that City dispatchers may not be sufficiently trained to identify when less-than-Code 3 responses are appropriate. While it is understood that the city is seeking to implement the proposed ambulance dispatch ordinance to remedy problems it perceives with the business practices of the private ambulance operator within the City, it is felt that these problems may be better addressed through the City's power to regulate ambulance rates and in coopera- tion with ICEMA and the Public Health Department. Therefore, both the County and ICEMA request that before taking any further action with regard to the proposed ambulance dispatch ordinance, representatives of the City, ICEMA and County Public Health Department meet and explore alternative methods of aChieving the City'S goals. Should you care to discuss the matter in further detail, please feel free to contact me at your convenience. Very truly yours, ALAN K. MARKS County Counsel ALAN L. GREEN Deputy County Counsel ALG:Il air l owL/ANL cc: Dr. Pettersen Dil..... Ftlher