Attorney General Interprets “Section 201” of the Emergency Medical Services Act
by Derek P. Cole on February 1, 2015
posted in Emergency Medical Services,
The Attorney General has recently issued an opinion covering questions that counties and cities have expressed concerning “Section 201” of the Emergency Medical Services (“EMS”) Act. The opinion addresses some ambiguities in the administration of Health & Safety Code section 1797.201 (known as “Section 201”) concerning “grandfathered” city and fire-district EMS providers. (A link to a comprehensive article I wrote in the Public Law Journal explaining Section 201 can be found here.)
Responding to an opinion request from the Los Angeles County Counsel, the Attorney General opined in a December 16, 2014 opinion that:
- “Regulation 100168,” which requires that “an approved paramedic service provider” enter into a written agreement with a local EMS agency “to participate in the EMS system” does not apply to grandfathered providers. The Attorney General noted local EMS agencies and grandfathered providers had differed on whether the latter were required to comply with this regulation. In answering this question, the Attorney General observed that the authority of grandfathered providers to provide EMS comes directly from the EMS statute not from the local EMS agency. The Attorney General also gave great weight to the interpretation of the State EMS Authority, which had concluded grandfathered providers were not subject to the regulation.
- Agreements between grandfathered providers and local EMS agencies concerning the provision of medical supplies and equipment do not terminate the providers’ grandfathered status. The Attorney General noted several providers had entered into agreements concerning the parties’ respective roles concerning the supplies and equipment and related matters as training, information sharing, and reimbursement. The Attorney General concluded such agreements were not the type of agreements that indicated a relinquishment of grandfathered rights under Section 201.
- Agreements by which grandfathered providers agree to be subject to medical control and oversight by the local EMS agency also do not terminate the providers’ grandfathered rights. The Attorney General noted that grandfathered providers are already subject to medical control notwithstanding their grandfathered status. So long as the agreements they enter into do not give agencies control over administrative matters, grandfathered rights are not extinguished.
The Attorney General opinion provides helpful guidance concerning questions that have existed for a number of years concerning Section 201 administration. The second and third questions, in particular, relate to standard agreements that have been commonly entered into between EMS providers and local EMS agencies.
Although the Attorney General opinion does not resolve all the interpretation issues concerning how and when grandfathered providers relinquish their grandfathered rights, it does emphasize that the hallmark of a “Section 201” agreement is one that clearly relinquishes provider control over administrative matters. Contracts that do something other than give away control over administration of EMS do not fall within this type of agreement.
