County of Butte v. EMERGENCY MEDICAL SERVICES AUTHORITY

The Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act (EMS Act; Health & Saf. Code, § 1797 et seq.) was enacted in 1980 to “provide the state with a statewide system for emergency medical services” and to “ensure the provision of effective and efficient emergency medical care” to the people of California. (Stats. 1980, ch. 1260, § 7, pp. 4261-4277; Health & Saf. Code, §§ 1797.1, 1797.6, subd. (a); further section references are to the Health and Safety Code unless otherwise specified.)

Through the EMS Act, the Legislature created essentially a two-tiered regulatory system “governing virtually every aspect of prehospital emergency medical services.” (County of San Bernardino v. City of San Bernardino (1997) 15 Cal.4th 909, 915 [ 64 Cal.Rptr.2d 814 , 938 P.2d 876 ] (hereafter County of San Bernardino).) The first tier is occupied by the Emergency Medical Services Authority (the Authority), a division of the California Health and Human Services Agency, “which is responsible for the coordination and integration of all state activities concerning emergency medical services.” (§ 1797.1; see § 1797.100.) The second tier of governance is…