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Receive a presentation on Emergency Medical Services (EMS) in Solano County, including the role and responsibilities of the Local Emergency Medical Services Agency (LEMSA); Adopt a resolution to withdraw from the Solano Emergency Medical Services Cooperative Joint Powers Authority; and Approve the establishment and composition of the LEMSA advisory committee
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Published Notice Required? Yes ___ No _X_
Public Hearing Required? Yes ___ No _X_
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS) recommends that the Board of Supervisors:
1. Receive a presentation on Emergency Medical Services (EMS) in Solano County, including the role and responsibilities of the Local Emergency Medical Services Agency (LEMSA);
2. Adopt a resolution to withdraw from the Solano Emergency Medical Services Cooperative Joint Powers Authority; and
3. Approve the establishment and composition of the LEMSA advisory committee.
SUMMARY:
Solano County’s Emergency Medical Services (EMS) system is a core component of the public health and public safety infrastructure, responsible for ensuring timely, coordinated emergency medical care from the moment a 9-1-1 call is received through hospital treatment. Under California law, each county must operate a Local Emergency Medical Services Agency (LEMSA), which is responsible for system oversight, ambulance regulation, medical control for paramedics, quality monitoring, and coordination of disaster medical response through its role as the Medical Health Operational Area Coordinator (MHOAC).
In December 2025, the Board introduced an ordinance amending Chapter 7.1 of the Solano County Code to return LEMSA authority to Solano County. The ordinance became effective 30 days after adoption.
This presentation provides the Board with an overview of Solano County’s EMS system, including governance, statutory requirements, operational responsibilities, and recent structural changes. The presentation outlines the core functions of the LEMSA, including system oversight, ambulance regulation, medical control, quality monitoring, and disaster coordination through its Medical Health Operational Area Coordinator (MHOAC) role. It also describes the components of the EMS system, including ambulance services, hospitals, dispatch, and public safety partners, as well as current system capacity and specialty care designations. Additionally, the presentation includes an overview of the County’s exclusive ambulance services’ ongoing system responsibilities such as compliance, performance monitoring, and emergency coordination.
Actions requested of the Board today are to approve a resolution to withdraw from the Solano Emergency Medical Services Cooperative (SEMSC) Joint Powers Authority and approve the establishment and composition of the LEMSA advisory committee to continue the progress in the transition of the LEMSA. A future item will be brought back for the Board to ratify the agreements and resolutions of the SEMSC now that the Board is designated as the LEMSA.
FINANCIAL IMPACT:
There is no cost to receive the presentation. The costs of administering the LEMSA are included in the Department’s FY2025/26 Working Budget and FY2026/27 Requested Budget.
DISCUSSION:
The EMS system includes multiple interconnected partners, including ambulance providers, fire agencies, hospitals, dispatch centers, public health, and law enforcement, all working together to deliver emergency care. The County is responsible for ensuring these components operate as a coordinated, patient-centered system, supported by data reporting, performance monitoring, and compliance with state requirements. This includes oversight of specialty care systems such as trauma, stroke, cardiac, and pediatric services, as well as ensuring system readiness for large-scale emergencies.
A key responsibility of the County as the LEMSA is the administration of the exclusive ambulance services contract within the designated Exclusive Operating Area (EOA). The County is currently in the final stages of a competitive procurement process to select a provider for 9-1-1 ambulance services, ensuring performance standards, accountability, and system reliability moving forward.
The Emergency Medical Services System and Prehospital Emergency Medical Care Personnel Act (Health and Safety Code §§1797-1799.207) establishes the framework for EMS systems in California. In June 1994, the Board established the Ambulance Service Facilitating Team to develop a countywide prehospital care system. On February 6, 1996, the Board authorized the creation of the Solano Emergency Medical Services Cooperative (SEMSC), a Joint Powers Authority (JPA), to serve as the County’s designated LEMSA pursuant to Health and Safety Code §1797.200. SEMSC was intended to promote regional coordination among the County, cities, and fire districts.
At its meeting on October 28, 2025, the Board directed staff to:
• Begin the process to revoke the LEMSA designation for the SEMSC;
• To provide a notice of termination from the SEMSC; and
• To explore the creation of a LEMSA advisory committee.
Accordingly, on November 18, 2025, the Board introduced an ordinance amending Chapter 7.1 of the Solano County Code to return LEMSA authority to Solano County. The ordinance was subsequently adopted in December 2025 and became effective 30 days thereafter, formally designating the Health and Social Services Department, Public Health Division, as the County’s LEMSA. This transition restores direct County oversight of EMS, including ambulance contracting, regulatory compliance, and system performance, and ensures these functions are carried out independently under the authority of the Board of Supervisors.
With the return of LEMSA authority to the County, the SEMSC Governing Board is no longer required as a governing entity. Pursuant to the Board’s direction on October 28, 2025, H&SS is recommending that the Board adopt a resolution to formally withdraw from the SEMSC as required by the Joint Powers Agreement. If approved by the Board, communication will be sent to SEMSC member agencies providing recommended next steps of dissolving the SEMSC and where applicable, inviting agencies to identify representatives to the new EMS advisory committee.
The EMS advisory committee would review and evaluate the county’s ambulance and EMS system and provide recommendations to the Board of Supervisors and Local EMS Agency. The committee will help ensure compliance with applicable laws and regulations, bring together a diverse group of stakeholders, and serve as a liaison between the community and EMS providers to address system issues and improvements.
Staff are making the following recommendations regarding membership of the committee:
Advisory committee voting members:
A. Hospital representatives from each healthcare system/group serving as ALS base stations (3)
B. Physician representatives from each designated trauma center (2)
C. EMS communications/dispatch (Public Safety Answering Points or PSAPs), selected by Police Chiefs Association (1)
D. Urban and rural fire chief representation, nominated by the Fire Chiefs’ Association (2- 1 urban and 1 rural)
E. Community member representative (1)-application/interview process-EMS Administration would recommend
F. Behavioral Health Representative (1)-selected by the director of H&SS
The following offices or positions will be non-voting members:
A. County Health Officer
B. EMS Medical Director
C. EMS Administrator
D. Emergency Management/Office of Emergency Services
E. Exclusive Operating Area (EOA) ambulance provider and 911 emergency medical transport (201 transport) agency representatives
Should the Board approve the composition of the advisory committee, staff will reach out to the appropriate agencies to invite nominations to come forward for Board approval.
ALTERNATIVES:
The Board may choose not to receive the presentation. This is not recommended, as clarity on EMS governance and stakeholder structure is necessary to support ongoing system operations, contracting, and compliance with state requirements. The Board may also choose not to adopt the resolution withdrawing from the SEMSC. This is not recommended as the resolution is necessary to withdraw from the SEMSC and is consistent with prior Board action. The Board may choose not to establish an EMS Advisory Committee. This is not recommended as stakeholder participation is critical to overall system function. The Board may choose to alter the Membership of the EMS Advisory Committee.
OTHER AGENCY INVOLVEMENT:
County Counsel has been consulted regarding the ordinance and governance transition. Coordination with the California Emergency Medical Services Authority (EMSA) will continue as part of LEMSA oversight responsibilities.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION