City of Newport Beach Hewpo*

R1

As recommended in the 2012 and 2014 OCFA Standards of Coverage and Deployment Plans, as well as other studies, the Grand Jury recommends that, by 2024, all Orange County fire agencies utilize criteria-based dispatch protocols and send a single unit response to those incidents triaged as non-life-threatening (BLS). F1, F2, F5. Response: The Grand Jury's Recommendation #1 has not yet been implemented as it pertains to Newport Beach as discussed below. The Newport Beach Fire Department has been using criteria-based dispatch protocols for over 20 years. The department's priority is to efficiently provide community members with the highest level of customer service and medical care possible. The Grand Jury's recommendation to send a single unit response to all non-life-threatening calls could be detrimental to the public. Recommendation #1 can be read to mean a single ambulance or single first response unit. For the purposes of the City's response, we will assume the Grand Jury desires a single ambulance vehicle response for a "non-life threatening (BLS)" request for emergency medical assistance. In Newport Beach, all 911 calls are screened through an Emergency Medical Dispatch protocol that has been approved, and is continually reviewed and updated, by a team that includes the NBFD Medical Director, the NBFD EMS Division Chief, the NBFD Operations Chief, a dispatch supervisor, and the dispatch 17 Orange County EMS Agency Policy/Procedure, #720.50 Ambulance Rules and Regulations, Section IV.C. Response to 2021-2022 Grand Jury Report August 23, 2022 manager. Thus, the NBFD is already implementing this portion of

R4

While OCEMS should recognize how certain policy changes may pose operational challenges to emergency responders in the field, fire leadership should recognize and respect the independent oversight authority and expertise of OCEMS. F4. Response: The recommendation has been implemented as it pertains to Newport Beach. The City does not challenge the independent medical control and regulatory authority of the OCEMS nor its regulatory expertise in this area. Rather, the City's concerns arise when medical control authority is used to unduly usurp the City's administrative control over the NBFD operations. OCEMS is not a first response organization with expertise in executing day-to-day emergency response operations within their sphere of influence. A similar comparison can be made to the Orange County Health Care Agency's regulatory inspections of restaurants. Inspections are conducted to ensure a standard of cleanliness to operate but does not include advising the restaurant owner on how to operate their business. Using this comparison, OCEMS regulates medical control but should not advise EMS providers on how to best provide services to their communities. Further, the NBFD agrees with statement in Recommendation #4 that the OCEMS processes for the implementation of medical policies can pose operational challenges in the field. However, thru effective collaboration and communication, those operational challenges can be mitigated.

R5

Departments with publicly owned ambulances should allow OCEMS to inspect their ambulances for compliance with State EMS guidelines and adopt OCEMS recommendations, F9. NBFD partially agrees with the Grand Jury's Recommendation #5 as it pertains to Newport Response: Beach. Response to 2021-2022 Grand Jury Report August 23, 2022 The NBFD partially agrees and as such, looks forward to developing a workable and cost-effective ambulance inspection plan with OCEMS. Refer to comments in Finding F9 regarding licensure and permitting purposes by OCEMS for public providers. The NBFD is a public agency providing 24/7/365 response to fire, rescue, ALS and BLS medical care, and emergency transportation services. All fire apparatus follows the State of California's strict regulations to ensure compliance with safety and service. The City of Newport Beach employs trained professionals to service the apparatus and performs annual preventative maintenance, and as needed repairs, installations, and upgrades. Private, for-profit ambulance providers have contractual "agreements with the County of Orange to provide for the County of Orange to license and regulate ambulance services operating in" the listed contracted cities.19 OCEMS is the regulating authority with the responsibility of providing permits to operate, annual inspections, and all oversight of these private, for-profit ALS and BLS service and patient transport providers. OCEMS is not the regulatory authority over publicly owned ambulances for licensing and permitting purposes. Orange County EMS Policy/Procedure, section #720,