Douglas County rewrites Chapter 5: code updates clarify EMS roles and enable licensed nonemergency ambulance providers

The Douglas County Board of County Commissioners on Jan. 15 adopted a rewrite of Chapter 5 of the county code and approved related resolutions and bylaws that reframe how the county provides emergency medical services and emergency management functions.

County and Lawrence Douglas County Fire Medical (LDCFM) leaders told the commission the rewrite removes outdated cross‑references, assigns responsibilities more clearly within current organizational structures and creates a process for licensing third‑party ambulance operators to handle nonemergency transfers. "Our current practice is that we use the same ambulances that provide 911 service to also provide those non emergency transfer services," said John Darling, director of emergency medical services. The change enables the county and city to license private vendors to perform nonemergency hospital transfers so that LDCFM can prioritize 911 emergency response.

Under the rewritten code and implementing resolution, the county and city would jointly issue ambulance service licenses for third‑party operators that must meet Kansas Board of EMS rules, minimum insurance and operational standards and pass review and inspection by LDCFM's medical director. The medical director will inspect applicants, may authorize specialty services (critical care, mobile NICU, bariatric, maternal fetal services) and may suspend or order immediate stop‑work if the director believes a public‑safety danger exists.

The code separates ‘‘emergency transports’’ (911 response) from ‘‘nonemergency transfers’’ (hospital‑to‑hospital or facility discharges) and authorizes the county to license nonemergency providers under a joint city‑county process that includes a public hearing within 45 days, review for unnecessary duplication and a requirement that proposed providers operate countywide without discrimination. Licenses will be issued in renewable five‑year terms.

LDCFM staff outlined fiscal and operational context: nonemergency transfers comprised roughly 12% of EMS revenue in 2023 and the agency recorded 832 nonemergency transfers that year; call volume overall has risen markedly in recent years. Acting Chief Joe Hardy and Darling said the county expects some revenue reduction if third‑party providers take transfers, but that improved billing efficiency and new software may offset most of the lost revenue while preserving emergency‑response availability.

The code rewrite removes fixed fee schedules from the county code (fees will still be adopted by commission resolution) and clarifies that LDCFM should maintain adequate staffed ambulances (the code references a baseline of seven staffed, operational ambulances) and that the county can use digital dispatching and oversight to manage contracted third‑party units.

Commissioner discussion ranged from staffing and service continuity to enforcement and public‑health equity. Commissioner Reid said he supports the approach because it prioritizes 911 resources without requiring immediate new capital investments: "testing for contamination" he said in a different context, but on EMS he noted the intent to preserve emergency capacity while allowing licensed nonemergency providers to operate. The board voted to adopt Resolution 25‑04 revising Chapter 5 and separately approved the updated joint city‑county emergency management resolution (25‑05) and bylaws for the Local Emergency Planning/Management Board. All three measures passed in voice votes recorded as "Aye."

Ending: The county will send the joint resolution to city councils across Douglas County for consideration; the medical director and LDCFM will lead inspection and licensing of any third‑party nonemergency providers. Staff said operational rules and fee schedules will be set by resolution going forward and that any service suspensions or revocations would follow the joint city‑county process.