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December 2, 1970
Honorable Paul Conner
Acting Chairman, Subcommittee on Safety
Route 3, Box 472
Sequim, Washington 98382
Cite as: AGLO 1970 No. 151
By letter previously acknowledged you requested an opinion of this office on certain questions pertaining to the availability of emergency ambulance services in this state, as follows:
"1. Do statutes relating to cities and counties give these jurisdictions authority to guarantee the availabiliility [[availability]]of emergency ambulance service within their jurisdictions?
"2. May the State Board of Health require cities and counties to meet the provisions of Standard 11, Emergency Medical Services, of the Federal Highway Safety Bureau, as outlined above?"
We surmise from a reading of the full text of your letter that these questions are being asked as a means of ascertaining the sufficiency of our existing statutes to enable the state to comply with the provisions of the federal standard on emergency medical services which is referred to in your second question; accordingly, we will respond in this same vein.
Standard 11, Emergency Medical Services, provides that:
"'Each State, in cooperation with its local political subdivisions, shall have a program to insure that persons involved in highway accidents receive prompt emergency medical care under the range of emergency conditions encountered. The program shall provide, as a minimum, that:
"'I. There are training, licensing, and related [[Orig. Op. Page 2]] requirements (as appropriate) for ambulance and rescue vehicle operators, attendants, drivers, and dispatchers.
"'II. There are requirements for types and numbers of emergency vehicles including supplies and equipment to be carried.
"'III. There are requirements for the operation and coordination of ambulances and other emergency care systems.
"'IV. There are first aid training programs and refresher courses for emergency service personnel, and the general public is encouraged to take first aid courses.'"
With respect to the statutory authority of counties, cities and towns to provide emergency ambulance services, the only existing statutes in point are RCW 35.24.306 and RCW 35.27.370 (16). Under these statutes cities of the third and fourth class, respectively, have been specifically authorized to operate municipally owned ambulances.
However, even in the absence of such statutory authority it would be our opinion that in so far as emergency ambulance service is concerned, every class of city and town, and all counties, have the authority to provide this type of service ‑ either through their own operations or by contract with private operators ‑ under their constitutionally granted police power as provided for in Article XI, § 11 Washington State Constitution.1/ Accord, our opinion of January 26, 1967, to State Senator Robert Greive, copy attached. Yet the mere existence of this authority on the part of the various cities, towns and counties to act individually would not appear sufficient to assure the adoption of any sort of a coordinated state‑wide [[statewide]]plan designed to insure ". . . that persons involved in highway accidents receive prompt emergency medical care under the range of emergency conditions encountered. . . ."2/ Unless some [[Orig. Op. Page 3]] state agency, such as the state board of health as suggested by your second question, may be said to possess the authority to require all cities and counties to utilize their ambulances (if any) in order to provide such emergency medical care as is contemplated by the federal standard, the formulation of any sort of a state‑wide [[statewide]]program involving the various cities, towns and counties which would insure, or "guarantee" the availability of municipally operated emergency ambulance services would not be legally attainable.
With this in mind, we have examined all of the existing statutes relating to the state board of health, and have found nothing therein, nor in any other statutes involving the regulation of ambulances by any state agency, which would empower either the state board of health or any other existing state agency to require the various cities, towns and counties of this state to comply with the provisions of Standard 11, supra. Thus, we must advise you that before this state can be said to be in a position to adopt the type of program which would meet the criteria apparently set forth in this federal standard, specific enabling legislation will be necessary.
It is hoped that the foregoing will be of assistance to you.
Very truly yours,
FOR THE ATTORNEY GENERAL
Philip H. Austin
Assistant Attorney General
*** FOOTNOTES ***
1/"Any county, city, town or township may make and enforce within its limits all such local police, sanitary and other regulations as are not in conflict with general laws."
2/See, the preamble to Standard 11, supra.