Valley Medical Transport, Inc. v. Apple Valley Fire Protection Dist.
| Decision Date | 20 March 1997 |
| Docket Number | No. E017424,E017424 |
| Citation | 53 Cal.App.4th 732,62 Cal.Rptr.2d 53 |
| Parties | Previously published at 53 Cal.App.4th 732 53 Cal.App.4th 732, 97 Cal. Daily Op. Serv. 2067, 97 Daily Journal D.A.R. 3775 VALLEY MEDICAL TRANSPORT, INC., Plaintiff and Respondent, v. APPLE VALLEY FIRE PROTECTION DISTRICT et al., Defendants and Appellants; County of San Bernardino et al., Defendants and Respondents. |
| Court | California Court of Appeals Court of Appeals |
Stream & Stream, Inc., Theodore K. Stream, David D. Werner, Theresa Han Savage and Fred C. Hernandez, Riverside, for Defendants and Appellants.
Brunick, Alvarez & Battersby and Steven M. Kennedy, San Bernardino, for Plaintiff and Respondent.
Alan K. Marks, County Counsel, and Alan L. Green, Deputy County Counsel, for Defendants and Respondents.
This case is the logical successor to our decision in County of San Bernardino v. City of San Bernardino (1995) 47 Cal.App.4th 1397, 46 Cal.Rptr.2d 209, review granted January 31, 1996 (S050179). There we held that, under Health and Safety Code section 1797.201, a city or fire district which was providing any prehospital emergency medical services on June 1, 1980 may continue to do so unless and until it chooses to enter into a written agreement with the county; it also may expand such services, and may provide a type of services, such as ambulance services, it was not previously providing. We held further that, although the ambulance services provided by such a city or fire district are subject to the medical control of the county's local emergency medical services agency (local EMS agency), they are not subject to its power under Health and Safety Code section 1797.224 to create exclusive operating areas for ambulance service providers. 1
In County of San Bernardino v. City of San Bernardino, however, the city at issue never actually provided ambulance services itself, either on June 1, 1980 or at any other time; it merely claimed the right to regulate the private provider of ambulance services assigned to it by the local EMS agency.
By contrast, in this case, the trial court found that defendant Apple Valley Fire Protection District (the District) was providing ambulance services on June 1, 1980. In 1984, however, it sold its only ambulance and abandoned its role as a provider of ambulance services. In 1985, defendant Inland Counties Emergency Medical Agency (ICEMA), the local EMS agency of defendant County of San Bernardino (the County), adopted a transportation plan which divided the county into exclusive operating areas for ambulance service providers. ICEMA assigned the District's jurisdiction, plus certain other areas, to plaintiff Valley Medical Transport, Inc. (Valley). In 1994, the District purchased two ambulances and declared itself the exclusive provider of ambulance services within its jurisdiction. The trial court essentially found that the District was estopped to assert the right it would otherwise have under Health and Safety Code 1797.201 to resume providing ambulance services.
Because County of San Bernardino v. City of San Bernardino is currently under Supreme Court review, Valley urges us to revisit our holdings there, and to hold instead that counties and local EMS agencies have the exclusive right and power to authorize and regulate ambulance service providers. We decline to do so. County of San Bernardino v. City of San Bernardino, however, did not raise, and we therefore did not address, any issue of estoppel or any other equitable defense. Valley, the County and ICEMA all urge us to uphold the trial court's finding of estoppel here. We agree that this factor distinguishes County of San Bernardino v. City of San Bernardino. We also agree that, even though the District is a public agency and there is a higher standard for applying estoppel against the government, the trial court could properly find it estopped. Accordingly, we will affirm.
In 1980, the Legislature enacted the Emergency Medical Services System and Prehospital Emergency Medical Care Personnel Act (the EMS Act). (§ 1797 et seq.) The stated purpose of the EMS Act is "to provide the state with a statewide system for emergency medical services...." (§ 1797.1.) It does so primarily by establishing the state Emergency Medical Services Authority (the Authority), which is responsible for coordinating and integrating all state activities concerning emergency medical services. (§§ 1797.1, 1797.100.)
On the local level, "[e]ach county may develop an emergency medical services program." (§ 1797.200.) However, any county which elects to do so must designate a local EMS agency. This may be the county health department, a separate entity established by the county, an entity with which the county contracts, or a joint powers agency. (Ibid.) The local EMS agency must "plan, implement, and evaluate an emergency medical services system...." (§ 1797.204.)
As part of its local EMS plan, "[a] local EMS agency may create one or more exclusive operating areas...." (§ 1797.224.) An "exclusive operating area" is an area "defined by the emergency medical services plan for which a local EMS agency, on the recommendation of a county, restricts operations to one or more emergency ambulance services or providers of limited advanced life support or advanced life support." (§ 1797.85.) Section 1797.224, however, expressly provides, "Nothing in this section supersedes Section 1797.201."
Section 1797.201 provides, in pertinent part:
As of June 1, 1980, the primary provider of ambulance services in the Apple Valley area was Valley's predecessor in interest, McCormick Ambulance Service (McCormick). 2 The District had a "rescue squad" vehicle, Unit 4675. Unit 4675 was capable of functioning as an ambulance, and the District did occasionally use it to provide ambulance services, although generally only if a McCormick ambulance was not available. The District also provided emergency medical services consisting of "first responder" basic life support.
Following the passage of the EMS Act, the County entered into a joint powers agreement with Inyo and Mono Counties by which they created ICEMA.
In 1984, the Legislature amended the EMS Act so as to permit a local EMS agency to create exclusive operating areas. (§ 1797.224; Stats.1984, ch. 1349, § 3.) Thereafter, the County Board of Supervisors authorized the County Health Officer, Dr. George Pettersen, to draft the transportation element of the County's local EMS plan (the Transportation Plan). Dr. Pettersen and Assistant County Counsel Roger Kehew "pretty well wrote the plan together," although they obtained "a lot of input from other people." Dr. Pettersen also consulted with the County's Emergency Medical Care Committee (see §§ 1797.270-1797.276), and kept it advised throughout the drafting process. The Emergency Medical Care Committee was comprised of representatives of all the different types of emergency medical service providers, including "hospitals, doctors, nurses, paramedics, fire chiefs, cities, [and] teaching institutions...." Each member was expected to report back to his or her constituents.
On November 13, 1984, the District's board of directors declared Unit 4675 surplus and directed that it be sold. There was contradictory testimony with respect to whether the District held a public hearing on this decision. In place of Unit 4675, the District purchased a new rescue squad vehicle, Unit 4680, which had no gurney and therefore no capacity to transport patients.
The District continued to provide "first responder" basic life support. In 1988, it upgraded its emergency medical services to the EMT-D (defibrillator) level, and around 1994, to the EMT-P (paramedic) level.
In 1985, the County adopted the Transportation Plan. It divided the County up into exclusive and nonexclusive operating areas, and assigned providers of ambulance services to them. To the extent possible, existing providers were assigned to the areas where they were already operating. Any entity, public or private, which had been providing ambulance services continuously since January 1, 1981 was "grandfathered in." (See § 1797.224.) On this basis, the Transportation Plan assigned Exclusive Operating Area No. 12, including the District's jurisdiction, to Valley. No operating area was assigned to the District because it was not providing ambulance services.
ICEMA submitted the Transportation Plan to the state Authority for approval, as required (see § 1797.224), and in December 1985, the Authority approved it.
The District was aware of the Transportation Plan when it first came out. When its board members learned of it, "[they] weren't involved in ambulance services, so [they] weren't too concerned about it." From 1986 through 1993, the District let Valley keep its ambulances and personnel in District fire stations. The District never objected to the fact that it had not been designated to provide ambulance services. The District claimed it had no reason to do so, because it had the independent authority to provide...
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Valley Medical Transport, Inc. v. Apple Valley Fire Protection Dist.
...County of San Bernardino et al., Respondents. No. S060985. Supreme Court of California. July 16, 1997. Prior report: Cal.App., 62 Cal.Rptr.2d 53. Petition for review In addition to the issue of equitable estoppel, the parties are directed to brief the issue of whether Health and Safety Code......