Motion by Supervisor Zev Yaroslavsky

December 12, 2000

MOTION BY SUPERVISOR ZEV YAROSLAVSKY

The County Department of Health Services (DHS) operates a Patient Transportation Service (PTS) consisting of 34 ambulances and eight passenger vans. These vehicles are used by the DHS primarily to transport patients among County hospitals and clinics. They are also used occasionally to transport certain critical patients from private hospitals to the County's six public hospitals. PTS is not assigned to perform emergency medical response but will do so if a situation is encountered en route.

The California Highway Patrol (CHP) is responsible for the licensing and inspection of all privately owned and operated ambulances. Unfortunately, current State regulations only extend the inspection requirement to those ambulances used to respond to emergency calls, and not to those used on non-emergency calls, such as the transportation of patients between medical facilities. Therefore, DHS ambulances are not presently subject to CHP inspection rules. Moreover, there is no requirement that public agencies be licensed by the CHP in order to operate ambulances.

The County is responsible for its own inspection and maintenance and has engaged a private firm for this purpose. Drivers, who are County employees, are required to complete a vehicle and equipment checklist at the beginning of each shift.

Any vehicle which is reported to have a problem, regardless of severity, is taken out of service and inspected and repaired by the maintenance contractor. At the County's request the CHP recently reviewed the adequacy of the maintenance program and determined that it is effective as performed. The CHP also conducted a random inspection of five vehicles and did not identify any violations requiring their immediate removal from the road; although CHP did identify the need for further maintenance on three of the five vehicles.

A motion recently adopted by the Los Angeles City Council noted the lack of CHP oversight of publicly-owned ambulances and suggested that the City and County join to seek legislation, if necessary, to resolve this problem. The County should join in this effort.

In addition, DHS officials note that 27 of the County's ambulances (nearly 80 per cent of the fleet), are over ten years old with an average mileage of 123,000 miles. Five of the eight passenger vans are more than ten years old with mileage in excess of 172,000 miles. An ongoing replacement program needs to be established to improve the safety and reliability of PTS.

Legislation that took effect on January 1, 2000 increased funding available for administration of the County's Emergency Medical Services program by about $680,000 a year. These funds may legitimately be spent to replace our EMS ambulances. The Department recommends that the County dedicate $400,000 a year for three years for the replacement of approximately 24 ambulances. During this time period, DHS will establish a long-term Accumulative Capital Outlay (ACO) Fund to permanently ensure that DHS' ambulance fleet remains modern and safe.

I, THEREFORE, MOVE that the Board instruct the Chief Administrative Officer and our Sacramento legislative advocates to:

Sponsor or support legislation jointly with the City of Los Angeles to specify clearly that the California Highway Patrol has the authority to require regular state inspection of both public agency emergency response ambulances and those ambulances used to transport patients between medical facilities;
Sponsor or support legislation jointly with the City of Los Angeles to require the California Highway Patrol to inspect all public and private ambulances used for emergency response or non-emergency services;
Sponsor or support legislation jointly with the City of Los Angeles to clarify that the licensing requirements set forth in Title 13 of the California Code of Regulations, § 1107 apply to both public and privately operated ambulances; and
Include this legislation as part of the County’s State Legislative Agenda for FY 2001-2002.

I FURTHER MOVE that:

$400,000 be appropriated from the SB 612 County EMS Trust Fund into the DHS Health Services Administration SB 612 Revenue Account, corresponding increase in DHS' Fixed Asset Appropriation Account, in order to replace approximately 8 ambulances or vans operated by the DHS Patient Transportation Services; and
the CAO be instructed to provide for similar appropriations of $400,000 in each of the next two fiscal years in order to replace approximately 8 of PTS' ambulances or vans in each of those years; and
DHS be instructed to establish an Accumulative Capital Outlay (ACO) fund to ensure that PTS ambulances and vans may continue to be replaced on a recurring and appropriate basis in the future.