Lake County supervisors advance revised ambulance ordinance; second reading set for Feb. 25, 2025

At a meeting of the Lake County Board of Supervisors, members voted to advance a revised ambulance ordinance that updates permitting and operations for public and private medical-transportation providers and defines interfacility transfers and priority-1 transfers from base hospitals.

The ordinance, presented by Dean Eichelman, emergency preparedness coordinator for Health Services, replaces rules last updated in February 2004 and was recommended by the county's Emergency Medical Care Committee. "We are seeking your support in approving a revised ambulance ordinance which was last updated in 02/2004," Eichelman said, summarizing the proposal and the committee review.

The updated ordinance establishes a permit process and operational standards for ambulances operating in Lake County, and separates public and private providers to preserve local 911-system control for county agencies. "This really separates public and private. This also hopefully will help out with some of the IFT problems that we've been enduring for decades here," Supervisor Sabatier said, describing the intent to protect life-and-limb 911 resources while allowing interfacility-transfer autonomy.

During public comment, Chief Cepeda, representing local fire-based EMS interests, described the county's historically fire-based EMS model and endorsed the ordinance changes. "We are the only county in the state of California that's predominantly fire based," Cepeda said, and noted the county previously relied on mutual-aid arrangements with private providers.

The board discussed fees for permits but did not adopt fee amounts during the meeting. Supervisor Paiske asked where fees were described in the ordinance; Eichelman replied that permit fees are not currently in the county's master fee schedule. Acting CAO Carter told the board the county conducts an annual master-fee update in May and that the ambulance-permit fees will be part of that study and considered in the May update to take effect July 1. A member of the board stated that previous permit fees had been $50, though the ordinance and master schedule do not currently list a fee.

Board members also addressed concerns raised during public comment about potential conflicts of interest and agency mandates. A board member said the Emergency Medical Care Committee voted to forward the ordinance and noted that the North Coast EMS physician referenced in public comment is not a member of the EMCC. "I do not believe that there is any conflict in the process that has occurred in order to bring this final document to us," the board member said.

The chair moved to approve the ordinance and to have the clerk read the ordinance title aloud; the motion passed with the board recorded as voting in favor and no opposition noted on the record. The board then moved and approved placing the ordinance's second reading on the next meeting agenda; a board member clarified that the next meeting would be Feb. 25, 2025.

Next steps: county staff will return with recommended permit fees during the May master-fee schedule update (effective July 1 if adopted), and the board will consider the ordinance's second reading on Feb. 25, 2025.