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Adopt an ordinance amending Chapter 7.1 of the Solano County Code relating to the Local Emergency Medical Services Agency (LEMSA)
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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 and County Counsel recommend that the Board of Supervisors adopt an ordinance designating the Solano County Health & Social Services Department, Public Health Division as the Local Emergency Medical Services Agency (LEMSA) for Solano County.
SUMMARY:
The proposed ordinance was introduced on November 18, 2025, to facilitate the return of direct governance for emergency medical services and designation as the Local Emergency Medical Services Agency (LEMSA) to Solano County.
Since 1996, Solano County has participated in the Solano Emergency Medical Services Cooperative (SEMSC), a Joint Powers Authority (JPA) that has acted as the County’s designated LEMSA pursuant to Health and Safety Code §1797.200. The SEMSC model was originally created to promote regional collaboration between the County, cities, and fire districts. While that structure has historically facilitated coordination, recent circumstances-including the pending award of a new exclusive ambulance services contract-have raised concerns about perceived conflicts of interest when governing members of SEMSC represent agencies that may benefit from the contracting process.
Returning LEMSA authority to the County ensures that oversight of emergency medical services, ambulance contracting, and related system management functions are conducted independently of potential provider interests and under the direct authority of this Board.
FINANCIAL IMPACT:
Ongoing costs of administering LEMSA functions are anticipated to be offset through established Emergency Medical Services program fees and existing cost-recovery mechanisms.
DISCUSSION:
The Emergency Medical Services System and Prehospital Emergency Medical Care Personnel Act (Health & Safety Code §§1797-1799.207) establishes a statewide framework for emergency medical services (EMS). Under §1797.200, each county may develop an EMS program and designate a local EMS agency. That agency may be:
• The county health department;
• Another county-operated agency;
• An entity with which the county contracts; or
• A joint powers agency.
Solano County previously delegated LEMSA responsibilities to the Solano Emergency Medical Services Cooperative (SEMSC) JPA. Over time, SEMSC provided valuable coordination among member agencies. However, during the current procurement of a new exclusive ambulance services contract, the SEMSC structure means that some entities serving on its Board are also participants in the EMS system and may have interests in the outcome of ambulance contracting, creating a perception of bias even absent any legal conflict.
To preserve public confidence in the fairness of the contracting process and maintain compliance with Health & Safety Code §1797.230-which requires counties to ensure the independence and transparency of ambulance contracting-the Board directed staff to prepare the necessary actions to return LEMSA authority to Solano County.
The proposed ordinance (Attachment A-redlined and Attachment B-clean) amends Solano County Code Chapter 7.1 to designate the Solano County Health and Social Services Department, Public Health Division as the LEMSA, maintaining the County Public Health Officer as the Medical Director, and other minor technical corrections. This action restores direct County oversight of emergency medical services, consistent with the structure used in most California counties.
In response to concerns raised by this Board at the October 28th Board meeting in proceeding forward with a change in LEMSA designation during the current Request for Proposals (RFP) process for exclusive ambulance services, staff consulted with the California Emergency Medical Services Authority (EMSA) regarding the effect of a LEMSA designation change on the current Request for Proposals (RFP) for exclusive ambulance services. EMSA confirmed that if the ordinance is implemented before the RFP process concludes, the County will need to submit an addendum updating the RFP to reflect the new LEMSA designation for EMSA’s review and approval. If the change occurs after the RFP is completed, EMSA will instead require submission of the executed ambulance services contract noting the new designation. Once the LEMSA change takes effect, the County must also provide an updated organizational chart and reporting structure identifying key positions and incumbents. EMSA advised that these materials may be submitted as an addendum to the existing EMS Plan, ensuring a smooth transition and continued compliance with state oversight requirements without disrupting service continuity.
ALTERNATIVES:
The Board could choose not to adopt the ordinance and maintain the SEMSC JPA as the designated LEMSA. However, this is not consistent with the direction provided by this Board at the October 28th Board meeting and the introduction of this ordinance on November 18th.
OTHER AGENCY INVOLVEMENT:
County Counsel and the Department of Health and Social Services collaborated in drafting the ordinance and consulted with the County Administrator’s Office regarding alignment with Board direction.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION