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If you need the complete document, download the WordPerfect version or Adobe Acrobat version, if available. ***************************************************************** Before the Federal Communications Commission Washington, D.C. 20554 In the Matter of ) ) BISHOP CLARKSON MEMORIAL HOSPITAL, ) ) DOCTORS HOSPITAL, ) WILLIAM BEAUMONT HOSPITAL, AND ) GOOD SAMARITAN HOSPITAL ) ) Requests for Permanent Waiver For Special ) Emergency Radio Service Paging Facilities on ) certain 453 MHz frequencies in Omaha, Nebraska; ) Columbus, Ohio; Royal Oak and Troy, Michigan; ) and Dayton, Ohio. ) ORDER Adopted: April 14, 1999 Released: April 14, 1999 By the Chief, Public Safety and Private Wireless Division, Wireless Telecommunications Bureau: I. INTRODUCTION AND EXECUTIVE SUMMARY 1. We have before us Requests for Waiver filed by Bishop Clarkson Memorial Hospital, Doctors Hospital, William Beaumont Hospital, and Good Samaritan Hospital, asking that the Commission grandfather their existing Special Emergency Radio Service (SERS) paging systems operating on 453.075, 453.175, 453.025 MHz, and 453.075 MHz, respectively. Each of these four hospitals contends that it meets at least one criterion required for permanent waiver of such systems. Based on the record in this proceeding, we conclude that these Requests for Waiver should be granted. II. BACKGROUND 2. Emergency Medical Radio Service Report and Order. On January 14, 1993, the Commission established the Emergency Medical Radio Service (EMRS) as a new Public Safety Radio Service (PSRS). The EMRS was created as a discrete radio service to enhance the reliability of emergency medical radio communications by dedicating specific frequencies solely to life support related transmissions. The Commission reallocated thirty-nine VHF and UHF frequencies for EMRS use, and limited eligibility to persons or entities who provide basic or advanced life support services on an ongoing basis. Four of these frequencies, 453.025/.075/.125/.175 MHz, were previously assigned for one-way paging operations under SERS. 3. In reassigning the four 453 MHz frequencies for EMRS use, the Commission recognized the concerns of existing SERS licensees on these channels and acknowledged that in certain situations an accommodation may be warranted to allow licensees to continue operating. It, therefore, provided a process by which one-way medical paging systems operating on the subject frequencies may permanently remain on their existing frequencies through waiver of the Commission's Rules. Under this process, a paging system may be grandfathered if a licensee currently operating on a one-way paging channel demonstrates that either: (1) adequate spectrum exists for emergency medical transmissions in its area of operation; or (2) relocation of its medical paging system would not serve the public interest; or (3) relocation would significantly disrupt public safety communications. Licensees were provided a five- year period -- that is, from January 14, 1993, through January 14, 1998, -- within which to request that their systems be grandfathered. Otherwise, licensees operating on these 453 MHz frequencies were required to cease one-way medical paging operations after January 14, 1998. 4. Waiver Grants. On February 8, 1996, the Commission released a Memorandum Opinion and Order reaffirming its decision to establish the EMRS and reallocate thirty-nine SERS frequencies for emergency medical communications. The Commission stated that the record supported the need for additional spectrum for emergency medical use because the substantial increase in the demand for emergency medical service frequencies nationwide significantly overburdened existing frequencies. Further, the Commission granted a request by ProNet, Inc. (ProNet) to permanently waive mandatory reassignment of 453.125 MHz in the greater Chicago metropolitan area to EMRS. The Commission concluded that although ProNet was only required to meet one criterion, it met all the established criteria. ProNet demonstrated, with findings from a study of spectrum usage (Trott Study I), that existing emergency medical service channels in the Chicago area displayed virtually no congestion, and that ProNet's SERS system was intensely utilized. The Commission noted that ProNet's migration to another channel other than ProNet's would involve significant cost, and, because of ProNet's intense use of 453.125 MHz, such migration would likely cause disruption to public safety communications. 5. On March 19, 1998, the Wireless Telecommunications Bureau (Bureau) granted Petitions for Permanent Waiver filed by Kaiser Foundation Hospitals/Kaiser Foundation Health Plan, Inc. (Kaiser), and New York Hospital-Cornell Medical Center (NYH). In the Kaiser case, the Bureau concluded that permanently grandfathering Kaiser's paging system on 453.025 MHz would avoid not only a considerable expenditure of resources, but would prevent interruption of these important communications. Further, a spectrum utilization study (Trott Study II), submitted by Kaiser, demonstrated that without the availability of 453.025 MHz there was sufficient EMRS spectrum in the Southern California metropolitan area to meet existing needs. The Bureau also concluded that considering the significant conversion costs, relocation of Kaiser's system to a new frequency would disserve the public interest. 6. In NYH, the Bureau concluded that granting the waiver request would prevent interruption of important communications because it would avoid the need to obtain new equipment and implement a process for switching to a new frequency. Also, a study of frequency utilization (Trott Study III) indicated that adequate spectrum remained to meet the needs of EMRS entities in New York City even with NYH's continued use of 453.025 MHz. The study also indicated that usage levels on other SERS and Business Radio Service frequencies considered as potential "replacement" channels was so high that that spectrum was insufficient to support the added volume of NYH's pagers. The Bureau held that both Kaiser and NYH met the requisite showing for grant of their waiver requests. 7. Subject Waiver Requests. Bishop Clarkson Memorial Hospital, Doctors Hospital, William Beaumont Hospital, and Good Samaritan Hospital filed waiver requests seeking to continue their medical paging operations on their respective frequencie. In support of its request, Bishop Clarkson Memorial Hospital submits that adequate spectrum is available for emergency medical transmissions in its service area; whereas, Doctors Hospital and William Beaumont Hospital assert that relocation of their paging systems would disrupt public safety communications and that there are no reasonable alternative frequencies on which to operate. On the other hand, Good Samaritan Hospital contends that it meets all three criteria warranting permanent grandfathering of its medical paging operations. III. DISCUSSION 8. To obtain a waiver of the frequency reassignment implemented by the EMRS Report and Order, a petitioner is required to meet any one of three established criteria. As discussed below, we conclude that all four hospitals have met the requisite showing as to whether their requests should be granted. 9. Bishop Clarkson Memorial Hospital. On January 9, 1998, Bishop Clarkson Memorial Hospital (Bishop Hospital) filed a Request for Waiver (Bishop Hospital Waiver) to continue its medical paging operations on 453.075 MHz. The hospital has demonstrated that in the Omaha metropolitan area, emergency medical service transmissions are conducted on MED 9 (462.950/467.950 MHz). In case of failure of the main and standby stations on MED 9, radio communications facilities are available on MED 10 (462.975\467.975 MHz). Bishop Hospital notes that in the event of a disaster or other emergency situations that would require multiple simultaneous radio conversations, MED 1 through MED 8 are licensed and available for use by EMRS agencies in Omaha. Bishop Hospital submits a list demonstrating that there is adequate UHF spectrum in the area. Included in the list is one of the former SERS paging channels (453.125 MHz), now reassigned for emergency medical radio use, which is not licensed within 70 miles of Bishop Hospital. 10. Bishop Hospital also notes that the City of Omaha and Douglas County are merging their emergency dispatch operations into a combined facility, with plans to implement an 800 MHz trunked radio system in the very near future. The plans for the new radio system include relocating emergency medical communications to the 800 MHz band which will eliminate any need for Bishop Hospital's paging frequency. In further support of its Waiver Request, Bishop Hospital submits correspondence from the State of Nebraska's Radio Communications Manager, and the City of Omaha's Chief of Communications, attesting to the above facts and favoring the continuation of Bishop Hospital's one-way medical paging operations on 453.075 MHz We, therefore, conclude that Bishop Hospital has demonstrated that adequate spectrum remains to meet the communications needs of EMRS entities in Omaha, Nebraska, even with the hospital's continued use of 453.075 MHz. 11. Doctors Hospital. On January 14, 1998, Doctors Hospital filed a Request for Waiver (Doctors Hospital Waiver) to continue to operate one-way medical paging operations on a permanent basis on frequency 453.175 MHz. Doctors Hospital is a regional non-profit hospital which operates two acute care facilities, Doctors Hospital North and Doctors Hospital West, which are located approximately twelve miles apart in Columbus, Ohio. The licensee notes that it is one of the leading training institutions for physicians and osteopathy medicine in the country. Principal users of the hospital's paging system include attending physicians, physicians-in-training (residents and interns), medical students and hospital staff (including trauma teams and nurses). Medical personnel in intensive care units, emergency rooms, laboratories, and radiology and pharmacy departments also use the hospital's paging system as their primary means of contact. Emergency surgical and trauma teams also have been assigned pagers on the subject system for use during life threatening situations such as cardiac failures. Five hundred and twenty (520) pagers are deployed to staff and physicians at both hospitals. 12. Doctors Hospital asserts that relocation of its medical paging operations would not serve the public interest because there is no reasonable alternative channel for the subject paging system. It submits that frequencies are either unavailable or changing to those frequencies that are available would necessitate costly and unaffordable new equipment. For example, 453.400 MHz was considered for use, but this frequency is currently licensed to the State of Ohio Department of Transportation for temporary fixed base and mobile repeaters throughout the state. As a non-profit entity, the hospital asserts that the current system represents the most cost effective and efficient communications means. Doctors Hospital contends that any change in frequency would produce a significant increase in operational costs, maintenance and overhead. It further contends that the cost of accommodating a change in frequency for Doctors Hospital's paging system would be $180,240. This amount comprises $70,000 for two base transmitters ($35,000 each), and $110,240 for 500 new pagers ($212 per pager). The hospital contends that it can ill-afford these costs. We note that the Commission established the EMRS waiver criteria, in part, to accommodate SERS operations that would otherwise sustain significant conversion costs. 13. According to Doctors Hospital, relocation of its paging operations to a frequency other than its current one would be an undue hardship for both the hospital and the community because it would cause disruption of essential communications services. Doctors Hospital contends that no commercial alternatives are available within the immediate vicinity that meet the coverage needs for communications throughout the hospital. We find that Doctors Hospital has demonstrated that the public interest would not be served by requiring the relocation of its paging system. In view of the above, we conclude that permanent grandfathering of the subject medical paging operations would avoid the impairment of the public safety and well-being of the residents of Columbus, Ohio. 14. William Beaumont Hospital. On January 28, 1998, William Beaumont Hospital (Beaumont Hospital) filed a Request for Waiver (Beaumont Hospital Waiver) to continue to operate its medical paging operations on frequency 453.025 MHz. It wishes to do so, however, only on a limited basis. Beaumont Hospital has operated a wide-area, simulcast paging system in Royal Oak, Michigan, and Troy, Michigan. Until January of 1998, approximately 4,000 pages per month were transmitted over the hospital's in-house paging system, while 5,000 pages per month were transmitted by the hospital over 931.2875 MHz, licensed to Paging Network of Michigan Inc. (PageNet). Since that time, PageNet -- at the request of Beaumont Hospital -- has been converting the hospital's remaining 1000 Motorola in-house pagers to long-range pagers. Consequently, 453.025 MHz only is needed by Beaumont Hospital during scheduled down times for system upgrades and non-scheduled down times for system hardware and software failures. According to the hospital, down times can be critical because all the hospital's telemetry monitoring devices, as well as ventilator alarms, are programmed to automatically broadcast a page when a patient is in distress. PageNet has estimated that the cumulative total for down time in the calendar year 1997 was approximately 15 hours. Should the PageNet system experience a long-term outage, Beaumont Hospital states its intention to use the 453.025 MHz paging system only for critical life sustaining situations. 15. Beaumont Hospital has been advised by its Motorola Maintenance provider, Comsource, that other frequencies (100 MHz frequency range) available for the hospital's rare emergency back-up use may already be crowded, which would cause the hospital's system to queue pages to transmit when a channel is available. Furthermore, other area businesses and hospitals use the 100 MHz frequency range. Beaumont Hospital asserts that Comsource has advised it that the cost to convert to a new frequency for the rare emergency back- up use would be approximately $60,000 to replace the base stations, transmitters and other related equipment at the two hospital facilities. Additionally, it would cost Beaumont $200,000 to replace 1000 pagers. Beaumont Hospital submits that this is not an economically viable option for the hospital. Moreover,Beaumont Hospital represents that Comsource does not believe that 453.025 MHz is used by any entity in Royal Oak and Troy, Michigan, other than Beaumont Hospital. Also according to Beaumont Hospital Comsource does not know of any immediate plans by emergency medical entities in the subject geographical areas to occupy 453.025 MHz. 16. Beaumont Hospital has used substantial financial resources to convert to a 900 MHz paging system. It requests only to be allowed to maintain the current 453.025 MHz facilities as a back-up system We agree with the hospital that the significant costs of converting to a frequency other than 453.025 MHz for use only as a back-up medical paging system is not a viable option. Further, we note that failure to receive a waiver would result in the discontinuance of the hospital's back-up system with potential loss of life. This would be contrary to the public interest. In view of the above, we conclude that Beaumont Hospital has demonstrated that its current paging operations on 453.025 MHz should continue on a back-up basis, otherwise significant public safety communications would be disrupted. 17. Good Samaritan Hospital. On October 21, 1997, Good Samaritan Hospital (Samaritan Hospital) filed a Request for Waiver (Samaritan Hospital Waiver) to continue to operate its medical paging operations on frequency 453.075 MHz. Samaritan Hospital's paging system -- with approximately 2,000 pagers -- is used often by the hospital staff to provide vital emergency communications to the physicians, nurses and technicians who staff the hospital. Samaritan Hospital employs its one-way paging system for medical alert operations, i.e., summoning attending physicians and other "on-call" staff to the bedsides of acute and critical patients. The hospital submits that conversion to another frequency would cost it a minimum of $25,000 in fixed equipment as well as replacements for 2,000 pagers. In the interim, Samaritan Hospital submits that it is the only licensee using the frequency in the Dayton area. Further, the hospital has monitored the various frequencies now available to it under current Commission rules, and determined that those frequencies are so congested that calls to Samaritan Hospital's ambulances and support staff would result in delays of up to five minutes. Samaritan Hospital contends that waits of such duration are impermissible in medical emergencies. In support of the waiver request, Samaritan Hospital submitted a letter of endorsement from the EMS Division of Emergency Medical Services of the Ohio Department of Public Safety. 18. If Samaritan Hospital is required to relocate to another frequency, public safety communications are likely to be disrupted. We believe that granting the waiver will permit the hospital to continue to utilize the frequency efficiently and economically while providing the needed emergency service. Further, Samaritan Hospital has demonstrated that adequate spectrum remains to meet the communications needs of EMRS entities in Dayton, Ohio, even with the hospital's continued use of 453.075 MHz. In view of the above, we conclude that permanent grandfathering of the subject medical paging operations would avoid the impairment of the public safety and the well-being of the residents of Dayton, Ohio. IV. CONCLUSION 19. In sum, we conclude that the subject four hospitals have met the requirements established in the EMRS Report and Order for the permanent grandfathering of their SERS systems. Therefore, we grant their requests for permanent waiver and permit them to continue operating their one-way medical paging systems on the subject frequencies in the 453 MHz band to the extent indicated herein. This action serves the public interest because the hospitals' migration to other paging frequencies would pose unnecessary risks to essential medical paging communications without significant concomitant public interest benefits. V. ORDERING CLAUSES 20. Accordingly, IT IS ORDERED, pursuant to the authority of Section 4(i) of the Communications Act of 1934, as amended, 47 U.S.C.  154(i), and Sections 1.925, 90.20(d)(60), 90.22 of the Commission's Rules, 47 C.F.R.  1.925, 90.20(d)(60), 90.22, that the Requests for Waiver filed by Bishop Clarkson Memorial Hospital on January 9, 1998, Doctors Hospital on January 14, 1998, William Beaumont Hospital on January 28, 1998, and Good Samaritan Hospital on October 21, 1997, to continue operating their paging stations on the subject 453 MHz frequencies ARE GRANTED. 21. This action is taken under delegated authority pursuant to Section 0.131 and 0.331 of the Commission's Rules, 47 C.F.R.  0.131, 0.331. FEDERAL COMMUNICATIONS COMMISSION D'wana R. Terry Chief, Public Safety and Private Wireless Division Wireless Telecommunications Bureau