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JOSEPH'S REGIONAL HEALTH CENTER,) UNIVERSITY OF IOWA HOSPITALS) AND CLINICS,) WINCHESTER MEDICAL CENTER, INC., AND) DEACONESS HOSPITAL) ` `  ,hh] ) Requests for Permanent Waiver For Special) Emergency Radio Service Paging Facilities on) 453.025, 453.075, 453.125 and 453.175 MHZ in ) Dayton, Ohio; Trenton, New Jersey; Hot Springs, ) Arkansas; Iowa City, Iowa; Winchester, )  S'Virginia; and &tL   &tL Cincinnati, Ohio, )  S' ORDER c  S'X` hp x (#%'0*,.8135@8:#~W zP 'ԍSee id.> Accordingly, we find that grant of MVH Waiver Request is warranted based on the circumstances described herein.  S5' xV10. Helene Fuld Medical Center (Helene Fuld) and Mercer Medical Center (Mercer). On January  !10, 1998, these two hospitals each submitted a Request for Waiver (Helene Fuld Waiver Request and  !Mercer Waiver Request) so that they could continue to operate their medical paging operations on 453.125  S ' !MHz and 453.025 MHz, respectively.o$X W xPM' x ԍHelene Fuld Waiver Request at 1; Mercer Waiver Request at 1. Helene Fuld's authorized base station for  !" 453.125 MHz is KNIY601 and Mercer's authorized base station for 453.025 was KNAY965. The latter license expired July 21, 1997, and there is an application for reinstatement pending.o By letter of February 20, 1998, Helene Fuld and Mercer advised  Sk ' !Mthat they were merging to become Capital Health System (Capital).%k 0 W xP;' x~ ԍSubsequently, Helene Fuld and Mercer did merge as Capital Health System. A license was issued for Capital Health System's authorized base station, Call Sign KNIY601, on May 14, 1998. The ultimate plan for Capital is to  S8 ' !Mhave one communications system covering both hospital locations, which are three miles apart.$&X8 W xP`' x ԍLetter from Helene Fuld Medical Center to Federal Communications Commission, dated February 20,  !  1998, at 1; Letter from Mercer Medical Center to Federal Communications Commission, dated February 20, 1998, at 1.$ The  !hospitals conducted research to determine if there were a significant number of emergency squads or other  !users on 453.125 MHZ or 453.025 MHz in the Trenton, New Jersey area. Their research showed that  S ' !tthose frequencies were not heavily loaded in that area.@' W zP'ԍId. at 2.@ Relocation to other frequencies would require  !the recystallization of approximately 550 pagers that are used to summon doctors, nurses and other  !hospital personnel, especially in emergency situations. According to the hospitals, switching to new  S' !frequencies would cost approximately $37,000.F(:W zP"'ԍId. at 1 and 2.F Based on the data submitted by Helene Fuld and Mercer,  !we conclude that they have demonstrated that relocation of their medical paging operations would  S' !3significantly disrupt public safety communications.u)W zP &'ԍSee Kaiser, 13 FCC Rcd 529798; NYH, 13 FCC Rcd at 5304.u As a result, we find that the Helene Fuld Waiver Request and the Mercer Waiver Request should be granted.  S' x11. St. Joseph's Regional Health Center (St. Joseph's). On January 14, 1998, St. Joseph's"^),C)C)UU"  !requested a permanent waiver (St. Joseph's Waiver Request) permitting it to continue its medical paging  S' !operations in the Hot Springs, Arkansas, area on the frequency 453.175 MHz.R*W xP5'ԍSt. Joseph's Waiver Request at 1.R St. Joseph's hired Trott  !cCommunications Group (Trott) to conduct a study regarding spectrum availability in the area of its  !}operations. According to St. Joseph's, the study showed that there is more than adequate spectrum  S4' !available for EMRS tranmissions in the Hot Springs, Arkansas area.@+4XW zP,'ԍId. at 5.@ The channel activity recorded by  S' !Trott showed that the MED channels~,W xP 'ԍThe ten EMRS channel pairs in the UHF band are referred to as "MED" channels.~ in St. Joseph's area of operations experienced a peak hour usage  S' !of between 0 percent and 1.5 percent and an average usage percentage of between 0% and 0.1%.R-zW xP 'ԍSt. Joseph's Waiver Request at 7.R Thus,  !existing EMRS channels are on the average unused over 99.9 percent of the time in the Hot Springs,  !pArkansas area. As a result, Trott concluded that a surplus of EMRS channel capacity exists in that  S5'location.:.5 W zP'ԍId.:  x10. St. Joseph's argues that the relocation of its medical paging system from frequency 453.175  !MHz would be contrary to the public interest because of the high costs such a relocation would impose  Si ' !Ion the hospital.:/i W zP'ԍId.: According to C & W Communications, consultants engaged by St. Joseph's, the  !kreplacement of existing transmitting facilities and pagers capable of operating on another frequency would  S ' !cost approximately $300,000.00.@0 . W zP'ԍId. at 8.@ St. Joseph's asserts that it would be unreasonable to require it to  !Qrelocate it paging system at such a signficant cost, with no apparent gain to public safety or quality of the  S ' !hospital's communications.:1 W zP'ԍId.: St. Joseph's also argues that relocation to a different paging frequency would  !significantly disrupt the hospital's public safety communication because relocating the approximately 2,640  !pages each day to its physicians, nurses and other personnel would require the purchase, installation and  S' !tconfiguration of an essentially new paging system.:2R W zP'ԍId.: St. Joseph's contends that such disruption would  !prevent doctors from responding to a "Code Blue" call to revive a patient in cardiac arrest and preclude  !technicians from quickly responding to outages of the hospital's computers which monitor patients' vital  Sl' !signs.@3lW zP"'ԍId. at 9.@ According to St. Joseph's, immediate termination of its medical paging operations on the  !frequency 453.175 would be catastrophic for example, dispatch of ambulances would be delayed and  S' !Code Blue teams would not be notified immediately of cardiovascular emergencies.;4vW zP&'ԍId. ; Based on the data  !submitted by St. Joseph's, we conclude that it has demonstrated that relocation of its medical paging  !koperations to another frequency would significantly disrupt public safety communications. Thus, we find"4,C)C)UU" that grant of the St. Joseph's Waiver Request is warranted.  S' x12. University of Iowa Hospitals and Clinics (UIHC). By letter, filed January 5, 1998, UIHC has  !requested a permanent waiver (UIHC Waiver Request) permitting it to continue its medical paging  S5' !operations in Iowa City, Iowa, area on the frequency 453.025 MHz.J55W xP'ԍUIHC Waiver Request at 1.J UIHC uses 3,000 pagers in  !Mconjunction with its medical paging system. UIHC states that the EMRS frequencies that are available  !can adequately support all current and future radiocommunications in its area. UIHC further states that  !&its continued use of the frequency 453.025 MHz would not compromise the level of EMRS service in  Si' !xeastern Iowa.:6iXW zPa 'ԍId.: According to UIHC, a frequency search on the frequency 453.025 MHz within a 75 miles  !radius of the hospital revealed that no interference was caused and that no other entity was using the  S' !tfrequency.:7W zP 'ԍId.: With respect to potential relocation, UIHC contends that each pager would have to be re !Qcrystallized or replaced at a minimum cost of $215,000. In addition, the radio transmitters supporting the  S ' !paging system would also need to be replaced and upgraded at a cost of approximately $30,000.:8 |W zP'ԍId.: UIHC  !notes that its current medical paging system processes over 10,000 pages each day and is used by doctors,  S7 ' !nurses, surgeons, specialists, critical care and other support staff.:97 W zP'ԍId.: UIHC argues that if this  !}communication capability were not available, it would detrimentally impact the services and level of  S ' !patient care.:: W zP'ԍId.: For example, UIHC contends that many of the pages transmitted are critical because they  !care intended for Code Blue Teams, Code Green Teams (patient violence management) and Disaster  Sk' !^Activation Teams.:;k2 W zP='ԍId.: UIHC also uses its medical paging system to provide basic and advanced life support  S8' !services. The paging system of UIHC is in use 24 hours a day, 7 days a week, 365 days a year.:<8 W zP'ԍId.: Based  !kon the data submitted by UIHC, we conclude that it has demonstrated that relocation of its medical paging  S' !operations to another frequency would significantly disrupt public safety communications.x=V W zP'ԍSee Kaiser, 13 FCC Rcd at 529798; NYH, 13 FCC Rcd at 5304.x Therefore, we find that grant of the UIHC Waiver Request is warranted.  S9' xV13. Winchester Medical Center, Inc. (Winchester). By letter of January 10, 1998, Winchester has  !requested a permanent waiver (Winchester Waiver Request) permitting it to continue to operate its medical  S' !paging system in Winchester, Virginia, on the frequency 453.025 MHz.J>W xP\%'ԍUIHC Waiver Request at 1.J Winchester indicated that the  !hospital is dependent upon its existing paging system operating on the frequency 453.025 MHz to  !Mcommunicate medical emergency codes and other life threatening situations to the appropriate medical"nx>,C)C)UUB"  S' !teams, such as the Neonatal Transport Team, the Cardiac Response Team, and the Fire Response Team.F?W zPh'ԍId. at 1 and 2.F  !xA frequency usage study conducted by Communications Engineering Technology, Inc. revealed that there  S' !gwere only seven other users of the frequency 453.025 MHz within a 100 miles radius of Winchester.|@ZW zP'ԍSee Communications Engineering Technology, Inc. Report, Attachment A.|  !In addition, replacement of the two base transmitters and the five hundred pagers in the system would cost  S4' !&$176,000.00.@A4W zP'ԍId. at 4.@ Further, Winchester states that the hospital's transmitters and pagers provide the only  !paging functions for all critical notifications for the hospital's emergency code teams, neonatal transport  S' !teams, physician paging, fire response, cardiac teams, and bedside patient call functions.B~W xP ' xA ԍAffidavit of George B. Calley, President, Winchester Medical Center, Inc., in support of Waiver Request at 2. Winchester also  !submits that the ability of the hospital to contact the appropriate medical teams necessary to react to  !emergency medical code or fire conditions within the hospital, to summon neonatal transport personnel,  S5' !to contact physicians and to enable patients to summon nurses and physicians is critical to patient care.:C5W zP'ԍId.:  !According to Winchester, all of these types of paging communications involve life and death situations,  S' !and the quality and consistency of these communications cannot be compromised.;Dh W zP'ԍId. ; Based on the data  !submitted by Winchester, we conclude that it has demonstrated that relocation of its medical paging  Si ' !operations to another frequency would significantly disrupt public safety communications.xEi W zP'ԍSee Kaiser, 13 FCC Rcd at 529798; NYH, 13 FCC Rcd at 5304.x Thus, we find that grant of the Winchester Waiver Request is warranted.  S ' x14. Deaconess Hospital (Deaconess). On April 17, 1998, Deaconess requested a permanent  S ' !@waiver (Deaconess Waiver Request)F W xP' x ԍDeaconess states that, through inadvertence and its failure to understand the legal requirements, it failed  ! to submit a waiver request by January 14, 1998. Therefore, it requests that its latefiled Waiver Request be  !p accepted. For good cause shown and because of the public safety aspects involved, the latefiled Waiver Request  ! is hereby accepted for filing. On March 18, 1998, Deaconess was granted Special Temporary Authority (STA) permitting it to transmit its medical paging operations on the frequency 453.075 MHz. permitting it to continue to operate its medical paging system in  Sk' !Cincinnati, Ohio, on the frequency 453.075 MHz.OGk<W xPG!'ԍDeaconess Waiver Request at 1.O Deaconess states that it has monitored other  !frequencies now available to it under the Rules and has concluded that the shared frequencies are heavily  !gloaded and that calls to ambulances and medical staff would have delays of several minutes. It further  S' !states that such delays would be intolerable given the emergency nature of the communications.@HW zP>%'ԍId. at 2.@  ! According to Deaconess, such delays would endanger the health and welfare of the public, especially  Sl' !acutely ill patients.@Il^W zPj('ԍId. at 3.@ It further argues that disruption of its medical paging system would cause extreme"lI,C)C)UU2"  !problems in that it currently operates 720 paging units on its system, and it is has made no provision for  !Dan alternative paging system. Further, Deaconess states that its current system is heavily used, providing  S' !kvital emergency communications to the doctors, nurses and technicians who staff its hospital.@JW zP'ԍId. at 2.@ Based on  !the data submitted by Deaconess, we conclude that it has demonstrated that relocation of its medical  S4' !ppaging operations to another frequency would significantly disrupt public safety communications.xK4ZW zP.'ԍSee Kaiser, 13 FCC Rcd at 529798; NYH, 13 FCC Rcd at 5304.x Therefore, we find that grant of the Deaconess Waiver Request is warranted.  S'd IV. CONCLUSION ă  xE15. In sum, we conclude that each of the seven subject hospitals has met at least one criterion  S' !established in the EMRS Report and Order for the permanent grandfathering of its medical paging system.  !Therefore, we grant their requests for permanent waiver to permit them to continue their oneway medical  !paging systems on the subject frequencies in the 453 MHz band. This action services the public interest  !Mbecause the hospitals' migration to other paging frequencies would pose unnecessary risks to essential medical paging communications without significant concomitant public interest benefits.  S 'M V. ORDERING CLAUSES ă  x<16. Accordingly, IT IS ORDERED, pursuant to Section 4(i) of the Communications Act of 1934,  !as amended, 47 U.S.C.  154(i), and Sections 90.20(d)(60), 90.22 and 90.125 of the Commission's Rules,  !47 C.F.R.  90.20(d)(60), 90.22 and 90.125, that the Requests for Waiver filed by Miami Valley  !VHospital, Helene Fuld Medical Center, Mercer Medical Center, St. Joseph's Regional Health Center,  ! University of Iowa Hospitals and Clinics, Winchester Medical Center, Inc. and Deaconess Hospital to continue operating their medical paging systems on 453 MHz frequencies ARE GRANTED.  x17. 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 and 0.331. ` `  ,hh]FEDERAL COMMUNICATIONS COMMISSION ` `  ,hh]D'wana R. Terry ` `  ,hh]Chief, Public Safety and Private Wireless Division ` `  ,hh]Wireless Telecommunications Bureau  S<' " $ K,C)C)UU$"Ԍj:\prd\depont\miami.mjd