January 20, 2022
Final Reports
San Mateo Courts - Civil Grand Jury 1998 Final Report: Pre-Hospital Emergency Medical Services
Background | Findings | Recommendations

In September 1997, the Joint Powers Agency (JPA) called the San Mateo County Hospital Emergency Service Providers Group was established with broad powers to:

  • Negotiate with ambulance companies
  • Enter into contracts
  • Apportion revenues received
  • Accept grants
  • Acquire, hold, manage or dispose of real and personal property
  • Hire employees
  • Sue or be sued
  • Incur debts
  • Levy and collect fees or administrative and operating costs
  • Invest surplus funds

The Governing Board of the JPA consists of one elected member from the governing body of each party to the JPA agreement. Each Board member serves until replaced.

The member parties consist of the following cities: Brisbane, Burlingame, Daly City, Foster City, Hillsborough, Millbrae, Pacifica, Redwood City, San Bruno, San Mateo, Half Moon Bay Fire Protection District, Menlo Park Fire Protection District (including Atherton, Menlo Park, and East Palo Alto), Point Montara Fire Protection District, and South County Fire Protection District (including Belmont and San Carlos) and Woodside Fire Protection District (including Woodside and Portola Valley). The Colma volunteer Fire Protection District and South San Francisco are ex-officio members.


The creation of the JPA requires that all county fire engines be staffed with a paramedic. This has the effect of reducing the number of paramedics per ambulance from two to one. The new Emergency Medical Service System (EMS), which will go into effect in January 1999, combines fire departments and a private provider approach to EMS and will require about 200 paramedics.

A contract has been signed by the San Mateo County Department of Health Services and American Medical Response to provide paramedics for ambulance services. By January 1999, there will be well over 200 paramedics available. American Medical Response has entered into a contract with the JPA that will provide additional paramedics for County-wide first response through fire departments.

The new San Mateo County EMS system will conform to the state’s requirement of 1500 hours of training. The contract between the San Mateo County Department of Health Services and American Medical Response provides for additional expertise and training above and beyond the state’s requirements.

Recommendation 29: The San Mateo County Board of Supervisors should ensure that information regarding the Emergency Medical Service System be available to the public by February 1999. Such information should be disseminated to each household in the County by including it with materials mailed regularly to residents, such as water, utility and other bills.
Recommendation 30: The San Mateo County Board of Supervisors should require the Governing Board of the Joint Powers Agency to prepare a report by June 30, 1999, which should include county-wide response times, problems encountered and financial findings, compared to the old system.


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