Orange : City, State in Dispute Over Paramedic Service

The city’s 3-year-old paramedic subscription program is undergoing scrutiny by state officials who say the program is operating without a license.

According to City Atty. Furman Roberts, the state Department of Corporations has informed the city that its paramedic program is illegal because it is not licensed as a health-care service plan by the state. The department referred to the Knox-Keene Act, a 1975 state act that regulates the licensing of health-care service plans.

But Roberts said the city’s paramedic service does not require any license--which has an initial cost of $4,000--because the program does not meet the state’s criteria for a health-care service plan. Roberts said city paramedics provide services for subscribers and non-subscribers alike, and that a health-care service plan, by state definition, provides services only to enrollees.

Under the program, residents who want to become subscribers pay a yearly fee of $25 and receive the right to an unlimited number of paramedic calls. Non-subscribers also can receive service but must pay between $125 and $175 per call, Roberts said.

If the city is forced to register its program as a health-care service plan and pay the licensing fees, which could run as high as $4,000 for initial registration and $500 yearly, Roberts said, it may have to cut back on paramedic services or charge higher fees per ambulance call.

George Crawford of the Department of Corporations’ enforcement division said Orange’s plan violates state law. Crawford said the city is expected to comply with the law or prove exemption, but that no deadline has been set.

San Clemente, Fullerton and Anaheim have similar programs, but Orange is the only city that has been notified of possible violations by the state.

Under present statutes, state and private universities are exempted from such regulation, and Roberts said cities should have the same status. Assemblyman John R. Lewis (R-Orange) is proposing legislation to exempt cities from the law, Roberts said.