Kern County supervisors on Tuesday axed the core components of a policy that allowed Bakersfield-area hospitals to close their emergency rooms to ambulance traffic when they were busy.
The decision came after two years of debate and discussion behind the scenes.
Kern County Emergency Medical Services Director Ross Elliott called the closure policy a "crutch" that Bakersfield hospitals used to avoid improving their operational efficiency.
And he said it isn't fair for hospitals to solicit business then close their doors to customers when they fill up.
"Hospitals affect patient choice. They advertise and they contract with provider networks so people come to their hospital," Elliott said.
Supervisors proposed the changes after hearing the stories of people hit with major bills because an ambulance, unable to go to a closed first-choice hospital, took them to a hospital where their health insurance policy didn't cover them.
The Californian previously talked to Dan Lynch, the EMS director for Fresno, Kings, Tulare and Madera counties, who said the decision to require hospitals to stay open had good results.
"They become creative like they probably should have been in the first place, " he said in December 2011. "I think they used diversion as an excuse not to make changes in their own facility. Now, they're much more efficient because they know they're not going to be able to divert patients."
Elliott said he hopes Kern County's policy change will result in better service to patients.
A portion of the policy, he said, will remain in place. Hospitals can close in case of an "internal disaster." It adds definitions of what an internal disaster is.
Otherwise, Elliott said, hospitals would say, "We're overcrowded, it's an internal disaster."
Tuesday's decision came without comment from hospital or ambulance company representatives.
"Hospital administrators and ambulance companies support the change," Elliott said.
Supervisors discussed the change, asking Elliott to assure them that the policy change would help prevent people from being transported to out-of-network hospitals.
They then approved the change unanimously.
Supervisors also approved a routine "cost-of-living" increase in the rates Kern County's five ambulance companies charge.
Hall Ambulance, which covers much of western Kern County and Bakersfield, got a $141 increase to its rates. The base cost of an advanced life support ride on a Hall Ambulance ground transport is now $1,315.
Delano, CARE, Liberty and Kern ambulance companies also saw increases to their rates of between $50, in the case of Delano Ambulance, and $149, in the case of Kern Ambulance.
Supervisors, acting on a report from Engineering, Survey and Permit Services Director Chuck Lackey, reversed a $50,000 fine against the shuttered Chronically Inclined medical marijuana shop in Mojave.
Lackey said a previous determination by the county that the shop remained open for business in violation of Measure G -- a zoning ordinance that requires shops to locate more than one mile away from schools, churches, parks, day care centers and other medical marijuana shops -- may have been in error.
Owner Sandra Wood was called honest and professional by Supervisor Zack Scrivner, who made the motion for the fine to be rescinded.
But Supervisor David Couch suggested that Wood's husband work to improve his spelling, pointing to the spelling of the word "supervisors" on a sign posted at Chronically Inclined after supervisors denied the collective a zoning variance that would have allowed it to stay open.
"It's not (spelled) 'Stupidvisors,'" Couch said.