Only One Unit Must Remain in City : Oceanside Paramedic Restrictions Eased

City Council members on Wednesday modified a policy prohibiting the city’s two paramedic units from transporting trauma victims outside the city limits, deciding to permit one ambulance to leave Oceanside as long as the second remains in town.

On a 4-1 vote, with Councilman Walter Gilbert opposed, the council agreed to allow paramedics to comply with county instructions and transport patients to certified trauma centers outside Oceanside, providing one ambulance remains in the city limits. Should the second ambulance be out on call, however, paramedics are under orders to take victims to Tri-City Hospital, which is in southeastern Oceanside.

For now, the policy change applies for only two weeks. Council members hope that negotiations with the county will have produced a long-term solution to the trauma dispute by that time.

Mayor Larry Bagley described the compromise--the latest chapter in Oceanside’s ongoing feud with the county over trauma care and the transport of patients--as an effort to protect the city’s paramedics from future “harassment.”

“We have a serious problem with the county, and I have in no way changed my feelings about it,” Bagley said. “But we cannot afford to buttress what we want to do with individual paramedics by subjecting them to further harassment.”

Bagley, who proposed the change adopted Wednesday, was referring to the county’s suspension last week of Oceanside paramedic David Snyder. Snyder, who was reinstated by county health authorities Tuesday, was suspended after he violated a trauma physician’s orders to take an accident victim to Palomar Memorial Hospital’s trauma center, transporting her instead to Tri-City. (Tri-City has failed three times to win a spot in the county’s year-old trauma network and is now suing to be included in the system.)

Since the suspension, council members have been concerned that their paramedics have become the rope in a political tug of war. On Monday, city leaders held a press conference to condemn the suspension as “capricious and retaliatory” and threatened to take the county to court to prevent similar “interference” by the agency.

But after the county reinstated Snyder, the city’s anger appeared to wane. And on Wednesday, Bagley asked his colleagues to modify the policy, in part because “the county withdrew the suspension independently as an act of good faith.”

The mayor further noted that it was unfair to put paramedics’ jobs in jeopardy while the city attempts to resolve its differences with the county.

Only Gilbert opposed the policy change, saying he preferred to stand firm and “take legal action against the county immediately if they ever do anything again to our paramedics.”

Further, Gilbert suggested that the county be forced to bear the cost of transporting trauma patients outside the city.

“Why don’t we ask the county to furnish a paramedic unit to receive our patients . . . until a decision on this has been made?” Gilbert said. “It might hurry them up a little to make up their minds if they had to pay for that.”

Councilman John MacDonald, however, urged approval of the policy change as a way to “reduce the tension” and prevent the battle with the county from escalating any further.

Fire Chief James Rankin agreed. He called the council’s action “a clear message that we are serious about negotiating in good faith to come up with a permanent, long-range solution to our differences.”

Rankin, who has said previously that the conflict between the city’s orders and the county’s trauma policy has put his paramedics under considerable stress, added that Wednesday’s decision helped defuse that tension.

“But even so, I think it’s important to realize that (with the second ambulance), there is still potential for medical conflict,” Rankin said. “If the trauma doctor says go to the trauma center and the paramedic knows he’s the only one in town and he’s got to go to Tri-City, the problem remains.”

Rankin said he could not estimate how often both ambulances are working simultaneously but said that each paramedic unit receives about six calls a day.

Oceanside officials initially adopted the policy prohibiting city paramedics from leaving the city limits on grounds that sending an ambulance on a 30-minute drive to Scripps Memorial Hospital in La Jolla--the closest certified trauma center--would leave the city vulnerable for too long in the event of another emergency.

In addition, they believe the county should bear the costs of transporting patients beyond city borders.

So far, negotiations over the matter have involved city and county staff members and have focused on providing a county-funded back-up ambulance to serve Oceanside, neighboring cities and unincorporated areas.

On Wednesday, the council decided to take negotiations directly to the Board of Supervisors level, appointing Bagley and MacDonald to serve as the city’s representatives.