District of Columbia Fire and Emergency Medical Services Department
In June 2015, Jullette M. Saussy was named the medical director of DC Fire and EMS. On January 29, 2016, she announced her resignation from that position in a letter to Mayor Muriel Bowser. In her letter, she called the department's culture "highly toxic to the delivery of any semblance of quality pre-hospital medical care."
British Columbia Ambulance Service
In British Columbia, responsibility for the provision of ambulance services is granted to British Columbia Emergency Health Services (BCEHS) under the auspices of the "Emergency and Health Services Act." BCEHS reports to PHSA. The members of the Emergency Health Services Commission act as a Board of Directors to the BC Ambulance Service. The commission membership consists of health service administrators, medical professionals, and government representatives. BCEHS is also responsible for the operation of the BC Patient Transfer Network, which assists physicians when it is necessary to transfer a patient to a higher level of care.