LOS ANGELES COUNTY
ECONOMY AND EFFICIENCY COMMISSION
ROOM 163, H A L L OF ADMINISTRATION 1500 WEST TEMPLE / LOS ANGELES, CALIFORNIA 90012 1974-1491
December 7, 1977
George E. B o d e
Dr. Catherine G. B u r k e
John D. Byork
A n n e S. C o l l i n s
Dr. M a r i o D i G i o v a n n i
Dr. C a r o l y n L. Ellner
Jerry Epstein
M i l t o n G. G o r d o n
R i c h a r d S. G u n t h e r
H u g h L. Henshaw
M a r y Jane K i d d
L e o A. M a j i c h
R o b e r t R u c h t i , II
L u i s A. R u i z
George Shellenberger
L a r k i n Teasley
B r y a n Walker
Honorable Board of S u p e r v i s o r s
Los Angeles County
383, H a l l o f A d m i n i s t r a t i o n
Los Angeles, C a l i f . 90012
Gentlemen:
SUBJECT:
--
Dr. Warren H . S c h m i d t , C h a i r p e r s o n
G l o r i a Starr, V i c e Chairperson
ARBITRATION AND APPEALS FUNCTION OF THE
PARAMEDIC COMMISSION
Burke Roche
E x e c u t i v e Secretary
J o h n Campbell
S t a f f Specialist
M a x l y n n Larsen
c o m m i s s i o n Secretary
The Board o f S u p e r v i s o r s h a s r e c e i v e d a l e t t e r from t h e Paramedic
Commission, d a t e d November 1 6 , 1977, d e s c r i b i n g a n a p p a r e n t d i f f e r e n c e of
o p i n i o n between t h e Commission and t h e Department o f H e a l t h S e r v i c e s a s t o t h e
a u t h o r i t y of t h e Commission's d e c i s i o n s .
The l e t t e r concludes w i t h t h e r e q u e s t
t h a t t h e Board " r e a f f i r m t h e a r b i t r a t i o n and a p p e a l s f u n c t i o n o f t h e Paramedic
Commission and f u r t h e r i s s u e a supplementary Board Order making such a r b i t r a t i o n
and a p p e a l f u n c t i o n s b i n d i n g on a l l p a r t i e s ; e x c e p t i n t h o s e s p e c i f i c a r e a s s e t
f o r t h i n t h e Wedworth-Townsend Act where t h e County H e a l t h O f f i c e r h a s e x c l u s i v e
s t a t u t o r y authority."
You have s e t December 1 3 a s t h e d a t e f o r a h e a r i n g on t h i s m a t t e r .
Because o u r commission conducted t h e s t u d y which r e s u l t e d i n t h e e s t a b l i s h m e n t
of t h e Paramedic Commission and because w e f e e l t h a t a n u r g e n t need c o n t i n u e s
t o e x i s t f o r a n i m p a r t i a l a r b i t r a t i o n commission, w e a r e s u b m i t t i n g o u r comments
and recommendation t o you on t h i s i s s u e .
Honorable Board of S u p e r v i s o r s
Page 2
December 7, 1977
A u t h o r i t y and F u n c t i o n of t h e Commission
I f t h e Commission i s t o o p e r a t e e f f e c t i v e l y t o s e t t l e d i s p u t e s between
t h e Department of H e a l t h S e r v i c e s and o t h e r a g e n c i e s , p u b l i c and p r i v a t e , o v e r
t h e p r o v i s i o n of paramedic s e r v i c e s , t h e n i t seems o b v i o u s t h a t i t s d e c i s i o n s
must c a r r y a n a p p r o p r i a t e d e g r e e of a u t h o r i t y a s d e l e g a t e d t o i t by t h e Board
of S u p e r v i s o r s .
The u t i l i t y o f t h e Commission would b e s e v e r e l y damaged i f t h e
p a r t i e s involved do n o t u n d e r s t a n d t h a t t h e Commission i s a c t i n g f o r t h e Board
of S u p e r v i s o r s and c o n s e q u e n t l y conclude t h a t they a r e f r e e t o f o l l o w i t s
decisions o r not a s they see f i t .
I f t h i s happens, t h e c a p a b i l i t y o f t h e Com-
m i s s i o n t o r e s o l v e d i s p u t e s e q u i t a b l y and r e s p o n s i b l y w i l l b e e f f e c t i v e l y
destroyed.
The l e t t e r of t h e Paramedic Commission c o n t a i n s a s a t t a c h m e n t s two
l e t t e r s from t h e S o u t h e a s t / F o o t h i l l F i r e C h i e f s ' A s s o c i a t i o n and t h e South Bay
F i r e C h i e f s ' A s s o c i a t i o n opposing c r i t e r i a proposed by t h e Department o f Health
S e r v i c e s t o q u a l i f y a g e n c i e s as p r o v i d e r s of paramedic s e r v i c e s .
A s t h e ordi-
nance e s t a b l i s h i n g t h e Paramedic Commission states, i t i s t h e e x p r e s s purpose
of t h e Commission t o " a r b i t r a t e d i f f e r e n c e s i n t h e f i e l d o f paramedic s e r v i c e s
and t r a i n i n g between t h e Department of H e a l t h S e r v i c e s and o t h e r s e c t o r s o f t h e
community
. . . ."
Thus, i n accordance w i t h t h e i n t e n t o f t h e o r d i n a n c e , i f t h e
f i r e c h i e f s and t h e department cannot r e s o l v e t h e i r d i f f e r e n c e s , t h e i r r e c o u r s e
is t o t a k e t h e c a s e t o t h e Paramedic Commission.
I f t h e Commission h a s no a u t h o r i t y t o s e t t l e s u c h d i s p u t e s , t h e n t h e
Board of S u p e r v i s o r s w i l l b e r e q u i r e d t o r e s o l v e them.
I n t h a t c a s e , t h e Commis-
s i o n o f h i g h l y q u a l i f i e d p r o f e s s i o n a l s i n t h e new and t e c h n i c a l s p e c i a l t y o f
Honorable Board of S u p e r v i s o r s
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December 7, 1977
emergency medicine w i l l b e by-passed,
and t h e Board of S u p e r v i s o r s w i l l b e
r e q u i r e d t o make medical, p r o c e d u r a l , and t e c h n o l o g i c a l d e c i s i o n s w i t h a potent i a l impact on t h e s u r v i v a l o f emergency p a t i e n t s .
Moreover, by t h e t i m e t h e s e
d i s p u t e s have reached t h e Board l e v e l t h e y a r e l i k e l y t o have e s c a l a t e d i n
i n t e n s i t y and d e v i s i v e n e s s , t h u s i n c r e a s i n g t h e l i k e l i h o o d o f c o u r t a p p e a l s o r
State intervention.
For t h e s e r e a s o n s , w e a g r e e w i t h and s u p p o r t t h e omm mission's r e q u e s t
t h a t t h e Board d e l e g a t e a p p r o p r i a t e a u t h o r i t y t o i t t o c a r r y o u t i t s p r e s c r i b e d
function.
S p e c i f i c a l l y , we b e l i e v e t h a t i t should b e a u t h o r i z e d t o a c t on
b e h a l f of t h e Board and t h a t i t s d e c i s i o n s i n s o a c t i n g should b e honored by
t h e p a r t i e s involved.
L i m i t a t i o n on Commission A u t h o r i t y
On t h e o t h e r hand, w e do n o t b e l i e v e t h a t t h e Commission's d e c i s i o n s
should b e c o n s i d e r e d " f i n a l and b i n d i n g , " i f by t h i s e x p r e s s i o n it i s meant t h a t
t h e p a r t i e s i n v o l v e d have no r i g h t of a p p e a l .
n e i t h e r l e g a l nor a p p r o p r i a t e .
Such a n i n t e r p r e t a t i o n would b e
The Board o f S u p e r v i s o r s is t h e s o v e r e i g n body
and d e c i s i o n s by t h e Commission must remain a p p e a l a b l e t o i t .
I f one of t h e
p a r t i e s does n o t a g r e e w i t h t h e Commission's d e c i s i o n and f e e l s s t r o n g l y t h a t
t h e Commission h a s e r r e d , i t s h o u l d have t h e r i g h t t o a p p e a l t h e d e c i s i o n t o t h e
Board o f S u p e r v i s o r s .
I n o u r view, i f t h e Commission o p e r a t e s as i n t e n d e d , few a p p e a l s w i l l
b e made.
The Commission is s t r u c t u r e d t o i n s u r e i m p a r t i a l i t y , and i t s members
a r e s e l e c t e d on t h e b a s i s of t h e i r e x p e r t i s e i n t h e paramedic a r e a .
Since its
Honorable Board of S u p e r v i s o r s
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December 7, 1977
c o n c l u s i o n s w i l l r e f l e c t s u b s t a n t i a l e x p e r i e n c e , r e c e n t r e s e a r c h , and p r o f e s s i o n a l knowledge, t h e y o r d i n a r i l y should b e a c c e p t a b l e t o a l l p a r t i e s .
Recommendation:
We recommend t h a t t h e Board of S u p e r v i s o r s r e q u e s t t h e County
Counsel t o review t h e o r d i n a n c e c r e a t i n g t h e Paramedic C o m i s s i o n and make such changes a s a r e n e c e s s a r y t o c l a r i f y t h e
d e l e g a t i o n by t h e Board t o t h e Commission t o a c t w i t h a p p r o p r i a t e
a u t h o r i t y as a n a r b i t r a t i o n board, i t s d e c i s i o n s s u b j e c t t o
a p p e a l t o t h e Board of S u p e r v i s o r s .
Sincerely ,
WARREN H. SCHMIDT
Chairperson