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Receive a follow-up presentation regarding the establishment and composition of advisory committee structure for the Solano County Local Emergency Medical Services Agency (LEMSA); and Provide direction regarding the preferred advisory committee structure
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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 follow-up presentation regarding the establishment and composition of advisory committee structure for the Solano County Local Emergency Medical Services Agency (LEMSA); and
2. Provide direction regarding the preferred advisory committee structure.
SUMMARY:
Under California law, each county is required to operate or participate in a Local Emergency Medical Services Agency (LEMSA), which is responsible for Emergency Medical Services (EMS) system oversight, ambulance regulation, paramedic medical control, quality improvement activities, and disaster medical coordination through the County’s Medical Health Operational Area Coordinator (MHOAC) responsibilities.
On November 18, 2025, the Board introduced an ordinance amending Chapter 7.1 of the Solano County Code to return LEMSA authority directly 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 restored direct County oversight of EMS system functions, including ambulance contracting, regulatory compliance, medical control, quality monitoring, and overall system performance.
On May 12, 2026, the Board formally adopted a resolution withdrawing Solano County from the Solano Emergency Medical Services Cooperative (SEMSC) Joint Powers Authority. In addition, the Board considered a recommendation on the establishment and composition of a LEMSA advisory committee. At that time, the Board requested staff to return at a future meeting and provide comparative options or best practices from other counties to support an informed decision-making process.
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 Recommended Budget.
DISCUSSION:
With the return of LEMSA authority to Solano County and the County's withdrawal from the SEMSC, the Board may wish to consider several options for maintaining stakeholder engagement, system coordination, and public input regarding the County's Emergency Medical Services (EMS) system.
A review of neighboring counties indicates that maintaining a formal EMS advisory body is the regional standard, however, the structure and participating bodies varies. Attachment A outlines the structure of the EMS advisory bodies of several neighboring counties including San Juaquin, Sacramento, Contra Costa, Napa, Sonoma, and Yolo Counties which all utilize Emergency Medical Care Committees (EMCCs) or EMS advisory committees that provide a structured forum for stakeholder engagement, system review, and coordination. Membership varies but typically includes representatives from hospitals, physicians, fire agencies, ambulance providers, dispatch centers, law enforcement, and community members. These bodies generally serve in an advisory capacity to the Board of Supervisors and/or the LEMSA and do not exercise operational, contractual, or regulatory authority.
Counties utilize these committees to promote transparency, facilitate collaboration among EMS system partners, review system performance and emerging issues, support long-range planning, and provide stakeholder input on clinical, operational, and community EMS matters. While committee structures vary, the common objective is to maintain a formal mechanism for communication and coordination among the organizations responsible for delivering emergency medical services throughout the county.
The following is an overview of advisory and governance structures utilized by surrounding counties and that presents potential options for Solano County’s future EMS advisory framework.
Option 1: Establish a Solano County EMS Advisory Committee
Under this option, the Board establish a County-appointed EMS advisory committee. The committee would serve in an advisory capacity to the Board of Supervisors and the LEMSA, providing recommendations related to EMS system planning, stakeholder coordination, clinical and operational issues, public education, and system improvement initiatives.
This approach would provide the greatest flexibility for the County to tailor membership and representation to local needs and emerging priorities. Membership could include representatives from hospitals, physicians, fire agencies, emergency medical dispatch, behavioral health, ambulance providers, and community members. This model is consistent with advisory structures utilized by several neighboring counties, including San Joaquin and Sacramento, and allows the County to adapt membership over time as the EMS system evolves.
This approached is utilized by San Joaquin and Sacramento Counties. Advantages of this option include flexibility, broad stakeholder participation, and alignment with the County's transition to direct EMS system oversight. Potential disadvantages include the absence of a specific statutory framework and the need for the County to establish committee roles, responsibilities, and governance requirements through local policy.
Establishing an EMS advisory committee is the staff recommendation. Should the Board choose to establish an EMS advisory committee, the next step would be to define membership of the Committee. The recommended membership includes:
• Hospital representatives / Certified Medical Professionals from Emergency base-station systems (3)
• Trauma center physician representatives (2)
• Public Safety Answering Point (PSAP)/EMS dispatch representative (1)
• Fire Chiefs (1 urban, 1 rural) (2)
• Community member (1)
• Behavioral Health representative (1)
• Exclusive Operating Area (EOA) 911 ambulance provider (1)
• 201 ambulance provider (1)
• Basic Life Support Interfacility Transport (BLS IFT) provider (1)
The committee would also include participation and staffing of the committee by the County Health Officer, EMS Medical Director, and EMS Administrator.
Option 2 - Establish an Emergency Medical Care Committee (EMCC)
Under this option, the Board would establish an Emergency Medical Care Committee (EMCC) pursuant to California Health and Safety Code Sections 1797.270 through 1797.276. An EMCC serves as a formal advisory body with responsibilities defined in state law, including annual review of ambulance services, emergency medical care, first aid practices, and community CPR and lifesaving training programs.
State law prescribes certain membership categories and reporting requirements for an EMCC, including:
• One emergency medicine physician and surgeon who is board certified or board eligible practicing at an emergency department within the jurisdiction of the local EMS agency.
• One registered nurse practicing within the jurisdiction of the local EMS agency.
• One licensed paramedic practicing within the jurisdiction of the local EMS agency. Whenever possible, the paramedic shall be employed by a public agency.
• One acute care hospital representative with an emergency department that operates within the jurisdiction of the local EMS agency.
• Additional advisory members in the fields of public health, social work, hospice, substance use disorder detoxification and recovery, or mental health practicing within the jurisdiction of the local EMS agency.
The committee would be responsible for providing observations and recommendations to the Board of Supervisors, the LEMSA, and the California Emergency Medical Services Authority.
This structure is utilized by Sonoma, Yolo, Contra Costa, and Napa Counties. Maintaining an EMCC is required if the LEMSA is a community paramedicine or triage to alternate destination program; this is not the case for Solano County, so an EMCC is not required. Advantages of this option include a clearly defined statutory framework, established reporting responsibilities, and statewide recognition of the committee's role. Potential disadvantages include less flexibility regarding membership and structure.
Option 3 - No Formal Advisory Body
Under this option, the Board would not establish a successor advisory committee to the SEMSC. EMS system oversight, stakeholder engagement, and coordination activities would remain the responsibility of the LEMSA and County staff through existing operational relationships, public meetings, and regulatory processes.
Advantages of this option include reduced administrative burden and fewer meeting requirements. Potential disadvantages include the loss of a structured forum for stakeholder participation, reduced transparency, fewer opportunities for coordinated system planning and feedback, and the absence of a formal mechanism for reviewing and discussing EMS system issues across participating agencies and community partners.
Next Steps
Regardless of the option selected, Solano County will continue to fulfill all statutory responsibilities associated with operating a LEMSA. Staff believe that maintaining a formal stakeholder engagement structure provides value by promoting collaboration, transparency, system planning, and coordination among EMS partners. Accordingly, staff recommend that the Board provide direction regarding its preferred advisory structure moving forward.
ALTERNATIVES:
The Board may choose not to receive the presentation or provide directions on the Governing Board and transition its role into a LEMSA Advisory Committee. 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.
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