The following opinion is presented on-line for informational use only and does not replace the official version. (Mich Dept of Attorney General Web Site - www.ag.state.mi.us) STATE OF MICHIGAN FRANK J. KELLEY, ATTORNEY GENERAL Opinion No. 5254 January 17, 1978 COUNTIES: Ambulance service TOWNSHIPS: Ambulance service AMBULANCES: Establishment of ambulance service by a county There is no statutory requirement that a county provide ambulance service to its residents. A township may provide ambulance service for its residents. If a county establishes ambulance service for its residents, such service must be equally available to all residents of the county; however, the physical location of the service is a matter within the judgment of the county board of commissioners and is not prescribed by law. There is no statutory limit on the distance within which a public ambulance may respond to an emergency call. Honorable Stanley M. Powell State Representative 88th District The Capitol Lansing, Michigan You have requested my opinion on several questions relating to public ambulance service provided by county government. Your questions raise a number of issues, and I shall answer them seriatim. 1. Is there a specific law which establishes responsibility for providing ambulance service? If so, is this responsibility on the part of the county or the townships? No statutory authority presently mandates either counties or townships to provide ambulance service to their residents. However, 1937 PA 176, Sec. 2; MCLA 46.252; MSA 16.308, places the responsibility on the county for paying the cost of transporting indigent persons who are injured 'on the highways of this state.' It reads in pertinent part: 'In case any ambulance shall transport any such person to any hospital or other place where medical care and treatment can be provided, and the person so injured and transported is financially unable to pay for such transportation, and there are no relatives or other persons liable for the care of such person who can pay for such transportation, the cost of such transportation, when approved by the board of supervisors, or the board of county auditors in counties having a board of county auditors, shall be paid from the general fund of the county, . . .' The act has been liberally construed in favor of ambulance service providers to encourage emergency transportation through reasonable assurances of payment regardless of the financial means of the injured party. I OAG, 1959-1960, No 3427, p 191 (September 22, 1959). The act has also been read broadly to include indigents injured on 'all public ways used by the public.' II OAG, 1955-1956, No 2650, p 470, 471 (August 14, 1956). While the act does not mandate that the county provide emergency medical transportation to its citizenry, it does require payment of the cost of such services, provided by others, to indigents injured on the public ways. Both counties and townships may, however, choose to provide or contract for ambulance service for their residents. Two separate statutes specifically empower either governmental unit to do so. 1960 PA 50, as amended by 1967 PA 217 and 1968 PA 163, MCLA 41.711; MSA 5.160, provides: 'The township board of any township and the board of supervisors of any county may operate or join with another municipality or contract with persons, firms, organizations or corporations in operating or furnishing an ambulance and inhalator servide for the use and benefit of the residents of the township or county. The service by the township or the county may be in connection with fire protection service or as a separate operation.' [Emphasis added] 1976 PA 330, MCLA 257.1232; MSA 14.528(512), provides: 'A city, township, charter township, village or county may contract with a person to furnish ambulance service for the use and benefit of its residents and may pay for the entire cost of any part thereof from funds that may be available. A city, village or township that is a party to a contract or an interlocal agreement may defray all or any part of its share of the cost by special assessments created, levied, collected, and annually determined pursuant to a procedure conforming as near as may be possible to the procedure set forth in section 1 of Act No. 33 of the Public Acts of 1951, as amended, being section 41.801 of the Michigan Compiled Laws. This procedure shall not prohibit the right of referendum set forth under Act No. 33 of the Public Acts of 1951, as amended, being sections 41.801 to 41.810 of the Michigan Compiled Laws.' [Emphasis added] Each of these provisions allow local governmental units to operate or contract for ambulance service, but neither places any affirmative responsibility for so operating or contracting upon either the county or the township. 2. If a county finances an ambulance service pursuant to 1967 PA 217, Sec. 1, et seq, MCLA 41.711 et seq; MSA 5.160 et seq, must the service be equally available to the entire county or may the service be located so that it is substantially more convenient to one part of the county? 1960 PA 50, as amended by 1967 PA 217 and 1968 PA 163, supra, quoted above, authorizes institution of public ambulance service 'for the use and benefit of the residents of the . . . county.' This means that the instituted ambulance service must be available to all the residents of the county. The physical location of the service, however, is a matter within the judgment of the county board of commissioners and is not prescribed by law. 3. If a township is not adequately provided ambulance service and, therefore, furnishes its own ambulance program, are the residents of the townships still obligated to finance the county service through taxes? Any township may provide ambulance service for its residents pursuant to 1960 PA 50, supra, and 1976 PA 330, supra, if it so decides. The fact that township officials feel that the county is providing inadequate service will not excuse the payment of legally imposed taxes for the county. Their concerns are properly addressed to the county board of commissioners through their area representatives. 4. Is there any way whereby these local officials representing the southern portion of the county can force the county board of commissioners or the County Social Services Board, which in Gratiot County is administering the ambulance service, to provide equitable service? By the term 'equitable service,' I assume that you are referring to the placement of ambulance stations evenly throughout the county. As noted earlier, that is a matter within the discretion of the county board of commissioners and is not prescribed by statute. The fact that the service is based closer to some population centers than to others, or that it is more convenient to particular citizens, is no indication that the service is not operating 'for the use and benefit' of the residents of the county. If it can be shown, however, that a portion of the county is excluded from the service's benefits, appropriate court action may be available. 5. Is there a 20-mile limit beyond which these county ambulances should not be sent on ambulance calls? No statutory authority places a limit on the distance within which a public ambulance may respond to an emergency call. If the county institutes an ambulance service, it must provide county-wide availability of that service. Due to the practical problems implicit in establishing and funding an ambulance service, however, it will inevitably be more convenient to those persons living in a closer proximity to the service's location, especially if the ambulance fleet is small. This fact does not, of course, indicate that the service is discriminatory in favor of the near-residents. Rather, it may only be reflective of the administrative difficulty in operating an ambulance service, within specific funding limits, over a large geographical area. In practical terms, this means that those residents living further from the service's location may seldom utilize the service. They may very well opt for a private service operating in a closer range when time is of the essence. The solution to these administrative problems may lie in the cooperation of all the local units of government within the county, as well as among the neighboring counties, in a joint effort to establish more efficient services to aid a greater number of citizens. The lgeislature has provided for these interlocal agreements through such statutes as 1960 PA 50, supra, which authorizes the cooperative operation of ambulance services by the various local units of government. Similarly, see the urban cooperation act of 1967, 1967 PA 7; MCLA 124.501 et seq; MSA 5.4088(1) et seq. Additionally, it should be noted that the legislature has recently passed the emergency medical services system act, 1976 PA 288; MCLA 325.3001 et seq; MSA 14.528(401) et seq, which provides for the planning, coordination and administration of a statewide emergency medical services system through the Department of Public Health. Under 1976 PA 288, supra, Sec. 3, the Department of Public Health is charged with coordinating and evaluating a state-wide emergency medical service, including ambulance service. This includes review of applications for federal, state and private grants. If inadequate ambulance service is being provided to people in some parts of the county, it should be brought to the attention of the Department of Public Health for appropriate action. Frank J. Kelley Attorney General