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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 ) ) SILVER CROSS HOSPITAL ) ) Petition for Permanent Waiver For Special ) Emergency Radio Service Paging Facilities on ) 453.075 MHz in Joliet, Illinois ) ORDER Adopted: January 29, 1999 Released: January 29, 1999 By the Chief, Public Safety and Private Wireless Division, Wireless Telecommunications Bureau: I. INTRODUCTION AND EXECUTIVE SUMMARY 1. We have before us a Request for Waiver (Waiver Request) filed on January 2, 1998, by Silver Cross Hospital (Silver Cross) of Joliet, Illinois, asking that the Commission grandfather its existing Special Emergency Radio Service (SERS) paging system operating on 453.075 MHz in Joliet, Illinois. Silver Cross contends that it meets the Commission's criteria for permanent waiver of such systems. Based on the record in this proceeding, we conclude that its Waiver Request 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 were in the 453 MHz band and were previously assigned for one-way paging operations under SERS. The International Municipal Signal Association and the International Association of Fire Chiefs, Inc. (IMSA/IAFC) were designated as the joint certified frequency coordinators for the EMRS because of their previous experience coordinating emergency medical communications. 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 -- 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 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 study by Trott Communications Groups, Inc. (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 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. In addition, the Bureau noted that 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 those frequencies were 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. Silver Cross Waiver Petition. On January 2, 1998, Silver Cross filed its request seeking waiver of Section 90.20(d)(60) of the Commission's Rules, so that it might continue to operate its paging system on frequency 453.075 MHz. There are currently over 220 pagers on its system, which essentially serves as a "nurse call communications system." Silver Cross asserts that its one-way medical paging operations should be grandfathered to avoid disruption of public safety radio transmissions. The hospital also submits that its Waiver Request should be granted because adequate spectrum remains in its geographical area to meet the communications needs of EMRS entities. 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, Silver Cross has met the requisite showing as to whether its request should be granted. 9. Relocation would significantly disrupt public safety communications. We conclude that Silver Cross has demonstrated that relocation of its system would significantly disrupt public safety communications. The Silver Cross call system notifies the medical staff when a patient requires a service. Specifically, the hospital's nurse call system is interfaced with the radio paging system to permit specific medical staff to be silently paged with specific patient requests, such as pain medication and difficulties with intravenous medical procedures. Additionally, local staff emergencies, such as a patient falling, are automatically paged to all unit staff when the staff emergency switch is activated in patient rooms and other clinical areas. As noted by Silver Cross, the most crucial use of the nurse call/paging system is in "code" situations, e.g., cardiac arrest, requiring immediate response to medical emergencies. In such situations, any delay in alerting critical care hospital personnel can have disastrous consequences. In addition to the nurse call system function, Silver Cross' system may include paging messages related to non-medical emergencies, such as fire, bomb threats, and threatening weather. These and other problematic situations often require dissemination of vital information through Silver Cross' 453 MHz paging operations in order to avoid any panic by hospital patients and visitors that could result from audio paging. Relocation to another channel would require changing the frequency of the base station and multiple pagers. This change could render the system partially inoperable during the transition period. We believe that granting Silver Cross' waiver request to grandfather its paging system on 453.075 MHz would prevent interruption of these vital communications because it would avoid the need to obtain new equipment and implement a process for switching to a new frequency. We, therefore, conclude that Silver Cross has demonstrated that relocation of its paging system to a new frequency would significantly disrupt public safety communications. 10. Adequate spectrum exists for emergency medical transmissions. Based on the record before us, we conclude that there is adequate spectrum available for entities engaged in providing emergency medical service in Joliet, Illinois. In support of its waiver request, Silver Cross offers the results of a "frequency search" of EMRS frequencies within 70 miles of the licensee's paging system in Joliet, Illinois. Silver Cross asserts that this large geographical area was studied even though, in the EMRS, large operating areas are counter-productive because many medical emergencies require emergency medical personnel to reach the victim within minutes. Consequently, it is unusual on emergency calls to require an ambulance or rescue squad to travel more than a few miles from its base. Nevertheless, the frequency search conducted by Silver Cross evaluated frequency assignments well beyond these mileage limits. Thus, although all of the channels in the range of 150.775 MHz to 155.400 MHz had stations licensed within 70 miles, the nearest assignment on 150.805 MHz was 41.4 miles away and the nearest assignment on 155.355 MHz was 38.1 miles away, at which distance frequency coordinators often reassign frequencies. The study also indicated that none of the seven new 7.5 kHz offset EMRS frequencies were assigned within 70 miles of the subject station, nor were any license applications for these channels pending. These frequencies have been available since August of 1996. Also, five pairs of frequencies in the 220-222 MHz band allocated to the EMRS now are available for assignment within 70 miles of Silver Cross' station. As a result, it appears that adequate spectrum remains to meet the communications needs of EMRS entities in Joliet, Illinois, even with Silver Cross' continued use of 453.075 MHz. IV. CONCLUSION 11. In sum, we conclude that Silver Cross has met the requirements established in the EMRS Report and Order for the permanent grandfathering of its SERS system. Therefore, we grant its request for permanent waiver and permit it to continue operating its medical paging system on 453.075 MHz in Joliet, Illinois. This action serves the public interest because Silver Cross' migration to another paging frequency would pose unnecessary risks to essential medical paging communications without significant concomitant public interest benefits, and because adequate alternative spectrum for EMRS communications exists where Silver Cross is operating its system. V. ORDERING CLAUSES 12. 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, 90.151 of the Commission's Rules, 47 C.F.R.  90.20(d)(60), 90.22, 90.151, that the Petition for Permanent Waiver filed by Silver Cross Hospital on January 2, 1998, to continue operating its paging station (KNAD743) on 453.075 MHz in Joliet, Illinois, IS GRANTED. 13. 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 Terry Chief, Public Safety and Private Wireless Division Wireless Telecommunications Bureau