# Stockton back to BLS



## jgmedic (Sep 3, 2010)

http://www.emsresponder.com/article/article.jsp?id=14564&siteSection=1


I had heard something about this awhile ago, looks like it's official.


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## JPINFV (Sep 3, 2010)

Oh, this thread should be fun. I do find it fun watching the fire fighters cry when they're holding the wrong end of the stick for a change. 'Oh, it's for the people.' Bull. Plenty of studies show that an oversaturation is a bad thing, and having a paramedic on every response vehicle is definitely an oversaturation.


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## NorCal (Sep 3, 2010)

I have a feeling that budgets are part of this situation that wasn't addressed in the article. I wonder if the city fire dept. bills the county for CFS out of beat when the private vendor is not available or delayed getting to the call.


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## Markhk (Sep 3, 2010)

One of my paramedic instructors was from Stockton Fire, and all I can say is that he is one kick-a$$ medic. It's really regrettable that his ALS talents and expertise can't be utilized until this issue is resolved. Frustrating for everyone involved, I'm sure.


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## Akulahawk (Sep 3, 2010)

This issue (IMHO) has nothing to do with whether or not Stockton Fire Paramedics are good or not. It has to do with whether or not they can legally provide ALS services without the "blessing" of the San Joaquin County EMS agency. Stockton Fire contracted out their transport. I really don't see any reason why Stockton Fire couldn't provide ALS First-Response. They just can't do transport by themselves or via their own contracted providers. The County gave _most_ of the County to AMR for transport through the RFP process. There are a few places that AMR is not the primary provider.

Tracy Fire is an ALS first response agency. AMR handles transport. Tracy Fire doesn't seem to have the same problem that Stockton Fire did/does... 

Again, this isn't a comment on the ability/competency of Fire or Private medics. It's just about whether or not Stockton Fire can legally do transport. It appears that they can't.


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## JPINFV (Sep 3, 2010)

Akulahawk said:


> It has to do with whether or not they can legally provide ALS services without the "blessing" of the San Joaquin County EMS
> agency.



Here's your answer. 



> *Article 2. General Provisions
> 100144. Application of Chapter.*
> (b) No person or organization shall offer a paramedic training program, or hold themselves out as offering a paramedic training program,* or hold themselves out as providing advanced life support services utilizing paramedics for the delivery of emergency medical care unless that person or organization is authorized by the local EMS agency.*



Emphasis in section (b) added. 
http://www.emsa.ca.gov/laws/files/ch4_emtp.pdf


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## Akulahawk (Sep 3, 2010)

JPINFV said:


> Here's your answer.
> 
> 
> 
> ...


Yes, great link. The underlying Health and Safety Code also says: 



> 1797.201.  Upon the request of a city or fire district that
> contracted for or provided, as of June 1, 1980, prehospital emergency
> medical services, a county shall enter into a written agreement with
> the city or fire district regarding the provision of prehospital
> ...


The regulation you cited may NOT override the above code. That is what the squabble was about. Apparently Stockton Fire didn't provide services prior to that date.
Oh, and there's some case law on this too. _County of San Bernadino v. City of San Bernadino_,  15 Cal. 4th 909, 938 P2d 876, (1997)



> The judgment of the Court of Appeal is
> affirmed in part, insofar as it ruled that the City has the
> right to continue to administer its own prehospital emergency
> medical services. The judgment of the Court of
> ...


Basically, the city can not do expand upon services from what it had in 1980, nor can they exclude the county provider. If they did NOT provide services prior to June 1, 1980, they may NOT do so on their own.

Had Stockton been providing ALS services on June 1, 1980, they could tell the County to stick it in their ear... we're retaining the administration of ALS services. In other words, Stockton could have performed ALS services without the authorization from the County had the City been providing ALS transport prior to that date. That would have been against the regulations above, but that regulation would not have applied. Since the City did NOT provide such services prior to that date, the regulation does apply to the City of Stockton. The County still does medical control and patient destination stuff. Your answer was correct, but incomplete.


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## JPINFV (Sep 3, 2010)

Ahh... Thanks!


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## Akulahawk (Sep 3, 2010)

You're welcome!


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