Sonoma County Fire District launches lawsuit against county over EMS operating areas

By Katherine Minkiewicz-Martine, Staff Writer, SoCoNews, December 7, 2021

Mark Heine

Mark Heine, pictured here in 2019, heads the Sonoma County Fire District. Photo Andrew Pardiac

The Sonoma County Fire District and the California Fire Chiefs Association, Inc. filed a joint lawsuit against the County of Sonoma late last month after the Sonoma County Board of Supervisors approved an agreement on Nov. 16 that would allow Bell’s Ambulance to stay operational via the creation of an Exclusive Operating Area (EOA). The two entities have turned to litigation because they claim they were not afforded the chance to have a hearing with the county to be able to weigh in on the matter, which according to Sonoma County Fire District Chief Mark Heine, breaks the county’s own emergency medical services (EMS) ordinance and state law.

The lawsuit was filed in Sonoma County Superior Court on Nov. 24. Judicial Officer Arthur Wick is presiding over the case. The lead attorney representing the fire district is Bill Adams of Johnson Thomas law firm.

Since the lawsuit was filed, the county has agreed to pause the creation of a second EOA, which would be called EOA 2, until there’s a ruling.

A case management conference with all parties involved is set for April 7, 2022.

“The County of Sonoma is proposing to create what is called an Exclusive Operating Area of service. They currently have EOA 1 which is the area that is currently served by AMR under contract, that’s Santa Rosa, the surrounding unincorporated areas, Rohnert Park. They are proposing to create EOA 2, which is the current area served by Bell’s Ambulance, and by creating an EOA they are basically saying ‘you may continue to provide the ambulance service without being contested’ and provide it exclusively indefinitely,” Heine said.

“It’s not that they can’t do it — they can do that as a county — however, they have an EMS ordinance in the county that the board of supervisors adopted back in 2019. EMS law and state government code dictates how you do that, and the county has not been in compliance with any of those documents,” he said.

A Nov. 24 press release from the Sonoma County Fire District states, “The county must obtain support of any local agency that provides ambulance services before it can create a new EOA.” The press release, penned by Heine, claims that prior to the board of supervisors vote on Nov. 16, the board failed to consult with the fire district and obtain its support despite multiple attempts by the fire district to engage in talks with the county.

Heine said in the interview with SoCoNews, the fire district has repeatedly tried to communicate with the county.

District 4 Supervisor James Gore said even though Heine is talking about consultations, what they are doing is trying to invoke rights, “that states that since they are a fire district in that area and they pull service in that area, they have rights to be able to either provide those services directly or that they have the right to negotiate on that,” Gore said.

Gore said the Nov. 16 vote was a “pro forma method,” reinitiation of the county’s contract with Bell’s.

“It has been a long time in the works. The reason that it’s languished so long is because the county went through a process (with) two of my colleagues on an ad hoc on EMS services. What they did is they effectively went through a process of rewriting, with staff, the request for proposals. A group like Bell’s is interesting because it is a service that arose from community … which is a little bit different from the rest of the county contract and franchise, which is now underneath AMR, and so that is a bigger contract, it is like a bid contract,” Gore said. “It delayed the Bell’s process. Part of what my colleagues came back to my board with was that they wanted all contracts — whether it was the bigger one through AMR and the one fire companies want or Bell’s or others — and wanted transparency and accountability in their contract.”

Gore said an important point is that the Sonoma County Fire District was leading the charge on an effort with the ad hoc subcommittee and were big advocates along with others in the Sonoma County Fire Chiefs Association to change the contracting system to provide greater opportunity for public agencies to bid on those contracts.

“This is a state issue. You can see in their lawsuit that they are supported by the California State Fire Chiefs Association. There are basically challenges going on around the state that fire districts are stating a preeminence to be able to provide those services as opposed to the county providing those services through a contract,” Gore said.

Heine said the fire district has been trying to communicate with the county regarding the EOA and to communicate to the county that they are allegedly in violation of their EMS Ordinance and state law.

“We’ve sent multiple emails, multiple letters requesting a meeting with them to discuss it,” Heine said.

He said they eventually did get a meeting with the county this past summer, but after listening to the district, the county said they needed to look into the matter more and would get back to the district.

“They never got back to us despite again multiple emails and letters requesting a follow up,” Heine said.

He said turning to litigation to resolve the matter is the last thing he and the fire district board wanted to do.

“We felt that the fact that we were just simply being ignored we had to take this step to protect our taxpayers and the right for our taxpayers to receive emergency ambulance services from us that they basically already pay for,” Heine said.

According to Heine, the reason why the California Fire Chiefs Association, Inc. became involved with the lawsuit is because “the potentiality for a county not to follow proper law in establishing ambulance service areas has statewide implications.”

He made it clear that the lawsuit is not about Bell’s Ambulance.

“I actually have deep respect for Pamela Bell and her family and what they’ve been doing for many years here,” Heine said.

He said he’s had several collaborative meetings with Bell’s to discuss the best way to provide emergency medical service to the Sonoma County Fire District’s taxpayers, particularly in the Town of Windsor, which is within the fire district.

Steve Busher, who’s worked with Bell’s for 25 years and is an operations manager for the company, said they haven’t received any official documentation from the county or anyone regarding the lawsuit. He said they are still waiting to find out what is going to happen.

“As far as we know, we’re still going forward with the contract that we’ve been working on for almost 20 years,” Busher said.

Heine reiterated that the suit is about the county following its own EMS ordinance.

Specifically, the lawsuit asks the court to invalidate the new EOA-2 because it was created in violation of the EMS Ordinance and state law, according to the press release.

“There are very specific provisions in the ordinance that says if the county wishes to create an exclusive operating area any EMS entity — that is defined as any public agency, such as the fire district, that is currently providing ambulance services which we are — has the right to have a hearing so that we can be heard on the matter,” Heine said.

He said they requested that hearing pursuant to the ordinance through multiple communications, but the request was allegedly denied.

Still, the district and Heine are pleased that the county has agreed to pause the creation of the EOA until there is a ruling. He added that no EMS services will be affected during this time.

“We continue to provide the services that we provide, Bell’s continues to provide the services that Bell’s provides,” Heine said.

Bell’s’ primary coverage area includes Healdsburg to Shiloh Road in Windsor. The company also holds mutual aid agreements outside of what would be EOA-2 with providers in Larkfield/Wikiup, Santa Rosa, Forestville, Guerneville, Monte Rio, Cloverdale and Knights Valley.

Bell’s came into the picture of EMS services and EOAs when the county, in March 2021, made a proposal to the board of supervisors to consolidate several ambulance service areas including Occidental, posing a threat of closure to Bell’s. The proposal was supported by county staff and an EMS Ad Hoc Group of stakeholders. On the other hand, Gore had offered full support for the continuance of Bell’s.

Gore said he’s a big champion of Bell’s because of not who they are as individuals, but because of what he knows growing up in north county and the trusted connection of who serves the community in their most important hour of need.

Pamela Bell Simmons, one of Bell’s founders, had said they would not be interested in extending their services to other areas if one large, consolidated ambulance service area was created.

Later in March of 2021, the board of supervisors endorsed a path that would allow Bell’s to continue serving Northern Sonoma County. If finalized, Bell’s would have to agree to a franchise contract with the county that would require data reports, increased transparency and a condition that the agreement could not be transferred if the business is sold. The agreement would be for five years, with a potential additional five-year extension subject to adequate performance reviews.

On Nov. 16, the county board of supervisors voted on the Bell’s contract to allow Bell’s to continue operating in its service area through the second EOA.

“I’ve been pushing in front of the scenes, during that board meeting in March, and since then behind the scenes to make sure we honor the contract that needs to be out there for them to have certainty. I’m a big champion of Bell’s because our community is a big champion of Bell’s,” Gore said.

Heine said regarding the creation of a second EOA, “As a fire agency, we’re simply saying we’d just like to be heard on the matter.”

Heine stated in the press release, “A​​s an independent local agency serving 72,000 residents within Sonoma County, the Fire District Board of Directors and I take our oath to serve our taxpayers very seriously. While this dispute has no immediate impact on services to our residents, we must protect the right of our taxpayers to receive emergency ambulance services from their fire district.”

Heine said they hope to reach a quick resolution on this with the county. He said they harbor no “ill-will” toward the county.

Busher said all Bell’s wants to do is to be able to provide emergency services and transport to the area that they’ve served for decades.

The court will take an immediate look at the action that the board of supervisors took on Nov. 16 and will decide whether or not the board followed the county EMS Ordinance and state law.

Heine predicted that the county board “is likely to take up the bigger issue of who has what rights to provide what service to what areas.”

Sonoma County has a long history of private ambulance services. The main EOA, EOA 1, is currently serviced by AMR, a contract set to expire next June.

“The county simultaneously is going through a request for proposals process for bidders to bid on who will be the next ambulance provider for that large EOA area. We will be one of those bidders,” Heine said.

Unlike public fire and emergency response agencies that receive tax funds, Bell’s derives its operating revenues from patients they serve and or from private insurance reimbursements. Bell’s has never had a county contract and operates under the California Health and Safety Code, the “EMS Act.” Because Bell’s has provided paramedic and ambulance services since at least 1981, it is eligible to be “grandfathered” and allowed to continue operations as a private company.

Gore said that the Sonoma County Board of Supervisors is set to discuss the Sonoma County Fire District and EOA matter in a closed session meeting set for Dec. 7.

“I can’t speak out of closed session, but I can confirm with you that we are reviewing this continuing in closed session and reviewing it in terms of not what we think is right or wrong, but in terms of the legality of it,” Gore said. “Our position has been firm and stated publicly at the board of supervisors meetings by our county counsel that our legal position is one which states that this is definitely within the rights of the county and it has been for a long time.”

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