Suit Over California Ambulance Services Filed

Enloe Medical Center and Oroville Hospital filed suit Monday to try to keep new ambulance services from operating in the county.

A company called Priority One Medical Transport has applied to do business in Butte County.

If it and other new ambulance services are let into the county, emergency medical services could decline in quality, Enloe CEO Dan Neumeister said in a phone interview Monday. 

But a Chico State University professor with expertise in this area said he thought competition could improve local emergency medical services.

The suit, filed in Butte County Superior Court, names a nonprofit corporation, Northern California Emergency Medical Services (NorCal EMS), and Butte County as defendants.

At issue is whether NorCal EMS has the authority to grant additional ambulance services the right to operate in the county.

According to the suit, in 1980, a state law was passed to better coordinate the delivery of emergency medical services. It gave counties the choice of either operating as their own local emergency medical service agencies or contracting that function out.

Butte County chose to perform the coordinating function itself until 1991, when it decided to join other north-state counties that were having the function performed by NorCal EMS, the suit stated.

For many years, two ambulance services have transported patients to Enloe Medical Center: Enloe's own ambulance service and a private company, First Responder Emergency Medical Services. First Responder also serves Oroville Hospital and Feather River Hospital.  

The suit claims NorCal EMS is now acting beyond its authority by accepting an application from Priority One, granting it "operating authority," and proposing to allow other providers to come into the county until competitive bids are taken.

The suit says the law allows emergency medical service agencies to set up what are called "exclusive operating areas," where just one ambulance service can operate, if the exclusive operator is selected through competitive bids. However, the suit says, bids are not required if an agency is using operators that were "grandfathered in" on Jan. 1, 1981.

The lawsuit contends that when Butte County delegated certain of its powers concerning emergency medical services to NorCal EMS in 1991, it did not delegate the power to set up exclusive operating areas.

Neumeister said his hospital and First Responder have invested millions of dollars in ambulances, expecting they would have exclusive operating rights.

If new companies are allowed in, Enloe and First Responder would see their income cut, and paramedics would handle fewer cases and not get as much experience, Neumeister said. In medicine, the quantity of cases handled typically translates into higher quality care.

Professor Richard Narad, of Chico State's department of health and community services, said competition often improves emergency medical services.

Narad, who works as a consultant on emergency medical services, said he thought NorCal EMS is required by state law to authorize Priority One to come into Butte County.

"As things stand now, NorCal EMS has no authority not to allow Priority One in," he said.

Narad said he was involved in writing the 1980 state law on coordinating emergency medical services. The legislation "grandfathers in" only those companies that were operating on Jan. 1, 1981, and that have continued operating in "the same scope and manner."

Narad said he understood the issues currently in dispute came up in the early 1990s, and it was ruled then that First Responder had gone through changes so that it didn't meet the "same scope and manner requirement."

Officials representing Enloe, Oroville Hospital and First Responder talked about the lawsuit at a press conference Monday.

Priority One Medical Transport is based in Ontario. The company operates in six counties in Southern California and nine counties in Northern California.