The current process raises concerns about conflicts of interest that undermine the integrity of the County’s EMS governance. To illustrate, one of several examples, I attached additional information for review… Starting, I will highlight a situation involving Dr. Matthew (Matt) Karp, who holds the following roles (based on online search):

1. Regional Medical Director for North Coast EMS (the County’s LEMSA),
2. Emergency Medicine Physician at Sutter Health Lake County, and
3. Member of the Emergency Medical Care Committee (EMCC), which is or has actively been shaping the County’s EMS ordinance and aspects of EMS services to Lake County.

These overlapping roles raise significant ethical and procedural concerns. As the Regional Medical Director, Dr. Karp is tasked with impartial oversight of the EMS system. However, his professional ties to Sutter Health, a key EMS stakeholder, and his influence on the EMCC Policy and EMS ordinance policies create an inherent risk of bias and self + organizational preservation. The ordinance and EMS reports govern critical aspects of EMS operations, including resource allocation and ambulance services, making impartiality essential. However, this set-up benefits the Board of Supervisors, Karp, and several others financially.

Concern: These roles create the appearance—and potential reality—of favoritism, jeopardizing equitable governance and public trust. As stated, this isn’t just isolated to Dr. Karp, this conflict also extends to EMS providers, and the Board.

Public officials are prohibited from participating in or influencing decisions in which they have a financial interest. If the Board and/or Dr. Karp’s dual roles benefit his/her/their employer, Sutter Health, NCEMS, and/or the COUNTY, this may constitute a violation of § 1090. Same goes to the Board as they seem to be engaging with this group to create policy that contributes to financial interests of their/his/her desired and/or current stakeholders.

Any appearance of impropriety or conflict of interest erodes public confidence in County processes and undermines the Board’s responsibility to ensure impartiality. The Board has a duty to ensure appointees/participants act impartially and without conflicts of interest. Allowing individuals with overlapping professional and financial roles to influence critical policies, draft-contribute-review performance reports undermines public trust and the Board’s role as stewards of the public interest.

Thanks,

Chuck.