This opinion represents the views of the Office of the State Comptroller at the time it was rendered. The opinion may no longer represent those views if, among other things, there have been subsequent court cases or statutory amendments that bear on the issues discussed in the opinion.

AMBULANCE SERVICE -- Regional Coordination (establishment of county office to coordinate training)
COUNTIES -- Powers and Duties (power to coordinate training of emergency medical service providers)
LOCAL LAWS -- Preemption (county coordination of emergency medical service training)

PUBLIC HEALTH LAW, §§3000, 3051, 3052: A county may establish the position of emergency medical services coordinator provided that the responsibilities of the position are limited to the coordination and facilitation of training activities and do not extend to the coordination and regulation of the actual delivery of ambulance services within the county. 1987 Opns St Comp No. 87-55, p 83 is clarified.

This is in reply to your letter concerning the establishment of the position of emergency medical services (EMS) coordinator for a county. You indicate that the county is contemplating the appointment of an EMS coordinator who would be responsible for the development of a "formal quality assurance program", the development and coordination of EMS training, the coordination of continuing education for EMS providers and others, and the recruitment of volunteers. You inquire whether the county may establish such a position.

This Office has previously expressed the opinion that a county may not establish an EMS coordinator and advisory board to coordinate the activities of volunteer ambulance corps within the county (1987 Opns St Comp No. 87-55, p 83). At issue in our earlier opinion was a proposal for the establishment of a system for the coordination of ambulance services modeled on the county-wide mutual aid programs for fire and other public emergencies authorized by section 225-a of the County Law. Under that section of the County Law, a county may create a county fire advisory board and the office of county fire coordinator to develop and maintain programs for fire training, fire service-related activities and mutual aid in case of fire and other emergencies. It was, and remains our conclusion, that no existing statute authorizes a county to establish a program for the coordination and regulation of the actual delivery of services of private volunteer ambulance corps as may be done for fire services in mutual aid programs authorized by County Law, §225-a and that a county's home rule powers relative to the regulation of emergency medical and ambulance services have been pre-empted by the Legislature's enactment of Article 30 of the Public Health Law. It also continues to be our opinion, as discussed in Opn No. 87-55, supra, that pursuant to the provisions of General Municipal Law, §122-b, a county and other municipalities in the county may coordinate the delivery of services of private volunteer ambulance corps by entering into joint agreements with these corps and including appropriate provisions relative to the coordination of the delivery of services.

We note, however, that while we believe that the conclusions reached in Opn No. 87-55, supra, are still valid with respect to the coordination and regulation of actual delivery of services, the role of the EMS coordinator described in your letter appears to be quite different from that discussed in the earlier opinion. As outlined in your letter, the EMS coordinator would not be responsible for coordinating or regulating the actual delivery of ambulance services. Rather, the EMS coordinator in your county would facilitate the training of EMS providers and others, disseminate information to EMS providers, and assist in the recruitment of volunteers.

Under Article 30-A of the Public Health Law, the Legislature recognizes "...a need to provide flexible, diverse and high quality training opportunities which are reasonably available, particularly to volunteers who devote considerable time, effort, and often personal resources, to improve or retain their knowledge and skills" (Public Health Law, §3051). To this end, section 3052(3) of the Public Health Law requires the Commissioner of Health to provide, upon request:

. . . management advice and technical assistance to regional emergency medical services councils, county emergency medical services coordinators, and course sponsors and instructors to stimulate the improvement of training courses and the provision of courses in a manner which encourages participation. Such advice and technical assistance may relate to, but need not be limited to the location, scheduling and structure of courses. (Emphasis added)

We believe that the Legislature's recognition that a county EMS coordinator may have a role in training EMS providers necessarily implies that counties are authorized to establish the position of EMS coordinator with responsibilities with respect to the coordination and facilitation of training activities (see also 10 NYCRR 40-1.52[i][1] indicating that the coordination of emergency medical services program activities and training programs is eligible for State aid reimbursement when such coordination is specifically identified in the county public health services plan approved by the Commissioner of Health).

In light of the foregoing, it is our opinion that the county may establish the position of EMS coordinator provided that the responsibilities of that position are limited to the coordination and facilitation of EMS training activities and, in the absence of a joint agreement pursuant to General Municipal Law, §122-b, do not extend to the coordination and regulation of the actual delivery of ambulance services within the county. In this regard, we note that it is not entirely clear what would be entailed in the EMS coordinator's development of the "formal quality assurance program" referred to in your letter. We caution that, based on the policies and purposes the Legislature has set forth in the Public Health Law, it is our opinion that the county would be pre-empted from unilaterally establishing and enforcing training standards or equipment and communication standards for EMS providers (see Public Health Law, §3000; see also Opn No. 87-55, supra).

Opn No. 87-55, supra, is clarified to the extent it suggests that a county may not establish the position of EMS coordinator to coordinate and facilitate EMS training activities.

December 15, 1989
Mr. Dominic Mazza, County Administrator
Livingston County