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APPROVE A MOTION TO EXECUTE A NEW FIVE-YEAR ADVANCED LIFE SUPPORT (ALS) SERVICES AGREEMENT WITH SAN JOAQUIN COUNTY
recommended action
RECOMMENDATION
It is recommended that the City Council authorize the City Manager to execute a new five-year agreement with San Joaquin County for the continued provision of non-transport Advanced Life Support (ALS) services by the Stockton Fire Department.
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Summary
Since 1975, the Stockton Fire Department (SFD) has been authorized to provide Advanced Life Support (ALS) services as part of the San Joaquin County emergency medical services (EMS) system. This authority is exercised under a written agreement between the City of Stockton and San Joaquin County, administered through the San Joaquin County Emergency Medical Services Agency (SJCEMSA), which serves as the Local Emergency Medical Services Agency (LEMSA) for the County. The current agreement will expire on September 30, 2025.
DISCUSSION
Background
Emergency medical services (EMS) in California operate under Division 2.5 of the California Health and Safety Code. Section 1797.200 authorizes each county to designate a local EMS agency (LEMSA) to plan, implement, and evaluate the local EMS system. In San Joaquin County, this role is fulfilled by the San Joaquin County Emergency Medical Services Agency (SJCEMSA), which coordinates all system components, including public and private providers, dispatch centers, and hospitals.
Within this system, SFD serves as a non-transport, Advanced Life Support (ALS) first-response agency. Paramedic-staffed fire companies provide ALS care on scene until transport ambulances arrive. ALS represents a higher level of prehospital care than Basic Life Support (BLS), including advanced airway management, cardiac monitoring, intravenous medication administration, and treatment of life-threatening emergencies. Early ALS response ensures that Stockton residents receive rapid, definitive care for critical conditions, such as cardiac arrest, respiratory failure, or major trauma, before ambulance transport to a hospital.
The City’s EMS operations function under clinical oversight by the County Medical Director through SJCEMSA. The County establishes protocols, performance standards, and quality improvement requirements. To meet these standards, the Stockton Fire Department also maintains its own medical director, who ensures internal compliance and coordinates with the County on clinical matters.
ALS coverage is provided 24 hours a day within the City of Stockton as well as the Lincoln, Eastside, Tuxedo-Country Club, and Boggs Tract Fire Protection Districts. Patient transport is not provided by the City but instead by private ambulance providers under contract with the County, completing the continuum of emergency medical care in the region.
Present Situation
The proposed agreement maintains the City’s existing ALS service model with no reduction in service levels or clinical standards. SFD will continue to provide 24-hour ALS coverage within the City and its contracted fire districts, ensuring residents receive timely, high-quality prehospital care during critical emergencies. SFD will also remain subject to all applicable state laws, County EMS policies, and directives issued by SJCEMSA, including participation in the County’s EMS Quality Improvement Program.
Approval of the new agreement is required to maintain the City’s legal authority to provide ALS services beyond September 30, 2025.
The agreement does not alter the City’s existing responsibilities, and no additional costs are introduced. The Fire Department will continue to bear full operational and financial responsibility for ALS service delivery, including the staffing of paramedic fire companies, the purchase and maintenance of equipment and medical supplies, ongoing training and certification of personnel, and medical oversight by a designated fire department medical director.
FINANCIAL SUMMARY
There are no new or additional costs associated with this agreement. The Fire Department's provision of ALS services is an existing function that has been incorporated into the Department’s annual operating budget.
Attachment A – ALS Agreement