Abruzzo v. City of Park Ridge

Docket No. 104935.

IN THE

SUPREME COURT

OF

THE STATE OF ILLINOIS

JO ANN ABRUZZO, Independent Adm’r of the Estate of Joseph

Furio, Deceased, Appellant, v. THE CITY OF PARK RIDGE,

Appellee.

Opinion filed October 2, 2008.

JUSTICE KILBRIDE delivered the judgment of the court, with

opinion.

Chief Justice Fitzgerald and Justices Freeman, Thomas, Garman,

Karmeier, and Burke concurred in the judgment and opinion.

OPINION

Plaintiff Jo Ann Abruzzo sued the City of Park Ridge, alleging

the City’s emergency medical technicians were dispatched to provide

medical care to her minor son, Joseph Furio, but left without

examining him or providing any treatment. Plaintiff alleged Joseph

died as a result of the City’s willful and wanton misconduct. The City

filed a motion to dismiss under section 2–619 of the Code of Civil

Procedure (Code) (735 ILCS 5/2–619(a)(9) (West 2004)), asserting

immunity under the Local Governmental and Governmental

Employees Tort Immunity Act (Tort Immunity Act) (745 ILCS

10/1–101 et seq. (West 2004)). The circuit court of Cook County

granted the motion to dismiss, and the appellate court affirmed. 374

Ill. App. 3d 743. We allowed plaintiff’s petition for leave to appeal.

210 Ill. 2d R. 315(a).

In this appeal, we must decide whether the Tort Immunity Act

immunizes the City from liability for the acts alleged in the

complaint. We hold that the limited immunity provision of the

Emergency Medical Services (EMS) Systems Act (EMS Act) (210

ILCS 50/3.150(a) (West 2004)) applies to these facts over the Tort

Immunity Act. Accordingly, we reverse the dismissal of plaintiff’s

complaint and remand for further proceedings.

I. BACKGROUND

Plaintiff filed a complaint as the independent administrator of

Joseph’s estate seeking damages under the Wrongful Death Act (740

ILCS 180/0.01 et seq. (West 2004)), the Survival Act (755 ILCS

5/27–6 (West 2004)), and the Rights of Married Persons Act (750

ILCS 65/15 (West 2004)). Plaintiff’s amended complaint alleged that

Joseph was 15 years old and staying with his father, Lawrence Furio,

in the City of Park Ridge on October 31, 2004. At 1:06 a.m.,

Lawrence called 911 to request emergency assistance for Joseph, “a

nonresponsive child who required CPR.”

The City dispatched a fire engine and an ambulance staffed by

emergency medical technicians (EMTs), paramedics, and firefighters.

Upon their arrival, Joseph was unresponsive. Plaintiff alleged the

EMTs, paramedics, and firefighters did not evaluate, assess, provide

advanced life support, or transport Joseph to a hospital despite his

condition requiring immediate medical treatment. The complaint

further alleged that the EMTs and paramedics knew or should have

known that Joseph had a history of drug abuse. Plaintiff alleged the

City acted with willful and wanton disregard for Joseph’s health and

safety by responding to the request for emergency medical services

and failing to evaluate or assess him, failing to transport him to a

hospital, and failing to prepare a “run sheet” for the 911 call. Plaintiff

further alleged that Joseph died as a result of the alleged acts or

omissions.

Plaintiff attached to her amended complaint a certificate of merit

with a physician’s report, as required by section 2–622 of the Code

(735 ILCS 5/2–622 (West 2004)). The physician’s report notes that

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the EMTs and paramedics did not prepare a run sheet for the

emergency response and there is no record of any assessment or

treatment during the response. The report states that basic principles

of training, standing orders and protocols, and accepted emergency

procedures require EMTs to evaluate and assess any person with an

altered mental status. The treatment for a person with an altered

mental status requires initiation of advanced life support and

assessment of airway, breathing, and circulation. Joseph was

presumed to have an altered mental status because he was

unresponsive.

The physician’s report further states that a second 911 call was

made on Joseph’s behalf at 9 a.m. on October 31, 2004. Joseph was

in cardiac arrest upon the emergency responders’ arrival. The

emergency responders began resuscitation and transported Joseph to

a local hospital where he died. The cause of death was anoxic

encephalopathy due to cocaine and opiate intoxication. The

physician’s report concluded that failures of the emergency

responders were a proximate cause of Joseph’s death.

The City filed a motion to dismiss the complaint under section

2–619, claiming immunity based on sections 6–105 and 6–106(a) of

the Tort Immunity Act (745 ILCS 10/6–105, 6–106(a) (West 2004)).

The City asserted that plaintiff’s allegations fell within the absolute

immunity of sections 6–105 and 6–106(a), barring liability against a

local public entity for failure to evaluate, diagnose, or prescribe

treatment for an illness or physical condition.

Plaintiff responded that the Tort Immunity Act did not immunize

the alleged act of failing to provide any assistance to her unresponsive

son. Along with her response, plaintiff filed a motion to amend the

complaint to conform with the physician’s report. Plaintiff sought to

add allegations that the City acted with willful and wanton disregard

for Joseph’s health by failing to initiate advanced life support and

failing to assess his airway, breathing, and circulation. Plaintiff

alleged that those actions were required due to Joseph’s altered

mental status. The City replied that the EMTs’ alleged failure to

provide services fell squarely within the provisions of the Tort

Immunity Act.

The trial court found that the Tort Immunity Act applied to the

allegations of the complaint. The trial court did not rule on plaintiff’s

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motion to amend the complaint, but noted that the proposed

amendment would not alter or prevent application of the Tort

Immunity Act to these facts. Accordingly, the trial court granted the

City’s motion to dismiss the complaint with prejudice.

On appeal, plaintiff argued that the Tort Immunity Act is

inapplicable because the immunity provision of the EMS Act is more

specifically directed to the facts alleged in the complaint. Plaintiff

contended that the EMS Act does not provide immunity in this case

because the emergency responders were willful and wanton in failing

to provide any treatment to Joseph. The City maintained that the

absolute immunity provision of the Tort Immunity Act applied

because no treatment was provided by the emergency responders.

The appellate court held that the plain language of the Tort

Immunity Act applied to plaintiff’s allegations that the EMTs and

paramedics failed to examine, diagnose, or otherwise treat the

decedent. The Tort Immunity Act applied to the exclusion of the

immunity provision of the EMS Act. The City was, therefore,

immune from liability. Accordingly, the appellate court affirmed the

trial court’s dismissal of the complaint. 374 Ill. App. 3d 743.

We allowed plaintiff’s petition for leave to appeal. 210 Ill. 2d R.

315(a). We then allowed the Associated Firefighters of Illinois to file

an amicus curiae brief in support of the City. 210 Ill. 2d R. 345.

II. ANALYSIS

The sole issue in this appeal is whether sections 6–105 and

6–106(a) of the Tort Immunity Act apply to immunize the City from

liability for the acts alleged in plaintiff’s complaint. Plaintiff contends

that the EMS Act’s immunity provision applies here because that Act

is comprehensive legislation designed to ensure delivery of

emergency medical services. Plaintiff also argues that the limited

immunity provision in the EMS Act is more specific and should apply

over the more general provisions of the Tort Immunity Act. The

City’s alleged willful and wanton misconduct is not immunized under

the EMS Act. Accordingly, plaintiff contends that the trial court erred

in granting the City’s section 2–619 motion to dismiss the complaint.

The City responds that the Tort Immunity Act applies before

providing any emergency medical services. The EMS Act immunity

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provision applies only after medical services are undertaken in good

faith. The Tort Immunity Act, therefore, applies to plaintiff’s

allegations that the emergency responders arrived, but failed to

examine, diagnose, or prescribe any treatment for Joseph. The City

also argues that the EMS Act does not impose a duty to provide

emergency medical services in responding to a 911 call. Rather, the

EMS Act applies only upon providing actual emergency medical

services. The City contends, therefore, that the trial court properly

found plaintiff’s claim barred by the Tort Immunity Act.

We note the facts alleged in the complaint are unusual. Ordinarily,

it is accepted that emergency responders will provide necessary aid

upon arriving at an emergency. In this case, however, plaintiff alleges

that the emergency responders arrived at the residence and then left

without evaluating or giving necessary treatment to her unresponsive

minor son. Although these alleged facts are unusual, we must accept

them as true in reviewing the dismissal under section 2–619. See

Kedzie & 103rd Currency Exchange, Inc. v. Hodge, 156 Ill. 2d 112,

115 (1993) (a defendant filing a section 2–619(a)(9) motion to

dismiss admits the legal sufficiency of the complaint, but asserts a

defense to defeat the claim other than negation of the plaintiff’s

essential allegations). Thus, although plaintiff’s factual allegations

seem unusual, we must determine whether sections 6–105 and

6–106(a) of the Tort Immunity Act or the EMS Act’s immunity

provision governs those allegations.

Section 2–619(a)(9) of the Code provides for dismissal of a claim

if it is barred by “affirmative matter.” 735 ILCS 5/2–619(a)(9) (West

2004). Immunity under the Tort Immunity Act is an affirmative

matter properly considered in a section 2–619 motion to dismiss.

DeSmet v. County of Rock Island, 219 Ill. 2d 497, 504 (2006).

Governmental entities bear the burden of establishing immunity under

the Tort Immunity Act. Van Meter v. Darien Park District, 207 Ill. 2d

359, 370 (2003). In ruling on a section 2–619 motion to dismiss, the

court must interpret the pleadings and supporting materials in the

light most favorable to the nonmoving party. Van Meter, 207 Ill. 2d

at 367-68, quoting In re Chicago Flood Litigation, 176 Ill. 2d 179,

189 (1997). We review de novo the dismissal of a complaint under

section 2–619. Glisson v. City of Marion, 188 Ill. 2d 211, 220 (1999).

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In this case, we must construe the provisions of the Tort Immunity

Act and the EMS Act. We review de novo the interpretation of a

statute as a question of law. People v. Roberts, 214 Ill. 2d 106, 116

(2005). The cardinal rule of statutory construction is to ascertain and

give effect to the intent of the legislature. People v. Cordell, 223 Ill.

2d 380, 389 (2006). The best indication of the legislature’s intent is

the statutory language given its plain and ordinary meaning.

Rosewood Care Center, Inc. v. Caterpillar, Inc., 226 Ill. 2d 559, 567

(2007). When the language of a statute is clear and unambiguous, it

must be applied without resort to other aids of construction. Murray

v. Chicago Youth Center, 224 Ill. 2d 213, 235 (2007).

The City contends that if the statutes appear to conflict, they must

be interpreted in pari materia giving effect to both. When the plain

language of two statutes conflicts, we will attempt to construe them

together, in pari materia, if such an interpretation is reasonable.

Moore v. Green, 219 Ill. 2d 470, 479 (2006). Legislative intent

remains the foremost consideration, however. Moore, 219 Ill. 2d at

479. In determining that intent, we may consider the statutes in their

entirety, their purposes, the problems they target, and the goals they

seek to achieve. Moore, 219 Ill. 2d at 479-80, citing In re Detention

of Lieberman, 201 Ill. 2d 300, 308 (2002). Words and phrases should

not be interpreted in isolation, but must be construed in light of other

relevant provisions of the statute. Town & Country Utilities, Inc. v.

Illinois Pollution Control Board, 225 Ill. 2d 103, 117 (2007).

The first step in our analysis is to determine whether both statutes

actually apply to plaintiff’s complaint. Section 6–105 of Tort

Immunity Act provides:

“Neither a local public entity nor a public employee acting

within the scope of his employment is liable for injury caused

by the failure to make a physical or mental examination, or to

make an adequate physical or mental examination of any

person for the purpose of determining whether such person

has a disease or physical or mental condition that would

constitute a hazard to the health or safety of himself or

others.” 745 ILCS 10/6–105 (West 2004).

Section 6–106(a) provides:

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“Neither a local public entity nor a public employee acting

within the scope of his employment is liable for injury

resulting from diagnosing or failing to diagnose that a person

is afflicted with mental or physical illness or addiction or

from failing to prescribe for mental or physical illness or

addiction.” 745 ILCS 10/6–106(a) (West 2004).

On its face, the plain language of these statutory provisions

applies to plaintiff’s complaint. In particular, section 6–105 grants

local public entities immunity for failing to perform a physical

examination to determine whether a person has a condition

constituting a hazard to that person’s health or safety. 745 ILCS

10/6–105 (West 2004). It is undisputed that the City is a local public

entity. Plaintiff alleges that the City failed to evaluate or assess

Joseph or otherwise provide any assistance. Plaintiff’s allegations,

therefore, fall within the City’s immunity for failing to examine

Joseph.

Alternatively, the EMS Act’s immunity provision states:

“Any person, agency or governmental body certified,

licensed or authorized pursuant to this Act or rules

thereunder, who in good faith provides emergency or non-

emergency medical services during a Department approved

training course, in the normal course of conducting their

duties, or in an emergency, shall not be civilly liable as a

result of their acts or omissions in providing such services

unless such acts or omissions, including the bypassing of

nearby hospitals or medical facilities in accordance with the

protocols developed pursuant to this Act, constitute willful

and wanton misconduct.” 210 ILCS 50/3.150(a) (West 2004).

In American National Bank & Trust Co. v. City of Chicago, 192

Ill. 2d 274 (2000), this court interpreted a previous version of the

EMS Act immunity provision. We find that our decision in American

National Bank is directly applicable to our interpretation of the

current version of that provision. In American National Bank, the

plaintiff alleged that the City of Chicago and two of its paramedics

failed to respond properly to an emergency call for medical

assistance. According to the plaintiff, the decedent suffered an asthma

attack at her apartment and called 911. She provided her address and

telephone number and informed the 911 operator that she lived on the

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third floor of the building. Upon arrival, the paramedics were let into

the building by her neighbor and went to the third floor. The neighbor

informed the paramedics that he had not called for help.

The paramedics knocked on the door of the only other third-floor

apartment, but received no response. The neighbor escorted a

firefighter though his apartment to the back of the building. The

firefighter received no response when he knocked on the back door,

and he could not see into the apartment. The dispatcher confirmed

that the paramedics were at the correct address. The dispatcher also

stated the caller did not give her age and an attempted return call

reached an answering machine. The neighbor informed the

paramedics that a young couple with no apparent medical problems

lived in the apartment. The paramedics concluded that they were not

needed at the apartment and left the building. That afternoon, the

paramedics returned to the apartment in response to another

emergency call. A man let them into the apartment, where they found

the decedent on the floor. American National Bank, 192 Ill. 2d at 276-

77.

The plaintiff alleged, in pertinent part, that the front door of the

decedent’s apartment was unlocked when the paramedics arrived, and

that they acted negligently, willfully, and wantonly in failing to

attempt to open the door and enter the apartment. The City and the

paramedics moved to dismiss the complaint, contending they were

immune from liability under the EMS Act. American National Bank,

192 Ill. 2d at 277-78. At that time, the EMS Act provided that:

“Any person, agency or governmental body licensed or

authorized pursuant to this Act or its rules, who in good faith

provides life support services during a Department approved

training course, in the normal course of conducting their

duties, or in an emergency shall not be civilly or criminally

liable as a result of their acts or omissions in providing those

services unless the acts or omissions, including the bypassing

of nearby hospitals or medical facilities for the purpose of

transporting a trauma patient to a designated trauma center in

accordance with the protocols developed pursuant to Section

27 of this Act, are inconsistent with the person’s training or

constitute willful and wanton misconduct.” 210 ILCS

50/17(a) (West 1994).

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The plaintiff responded that the EMS Act immunity provision did

not apply to bar the claims. Similar to the City’s argument in this

case, the plaintiff contended that section 17(a) applied only when

emergency responders actually furnished life support treatment to a

patient and that the provision was inapplicable because the

paramedics failed to administer any treatment. American National

Bank, 192 Ill. 2d at 282. This court rejected the plaintiff’s argument,

stating that the scope of the immunity provision was not as narrow as

the plaintiff contended. American National Bank, 192 Ill. 2d at 283.

Although the EMS Act defined the terms “advanced life

support–mobile intensive care services,” “basic life support services,”

and “intermediate life support services” to include acts or procedures

directly involving patient care, this court noted that those definitions

are designed to distinguish one level of care from another. The

legislature could have reasonably decided to omit from those

definitions conduct common to them all or, though preparatory to

providing actual medical care, is no less integral in providing life

support services. American National Bank, 192 Ill. 2d at 283.

This court further noted that section 17(a) also referred to

transportation of patients and reasoned that “[i]f transporting a patient

to a hospital is an aspect of life support services, then so too is

locating a patient in the first place.” American National Bank, 192 Ill.

2d at 283. Finally, this court observed that the EMS Act’s regulation

of matters including communications, response time, and ambulance

operation standards revealed the Act’s broad scope. Accordingly, we

held that the term “life support services” must be given an equally

broad meaning. American National Bank, 192 Ill. 2d at 283.

We, therefore, concluded that the EMS Act’s immunity provision

applied to the plaintiff’s allegations, even though the alleged acts and

omissions did not relate to providing actual life support treatment.

American National Bank, 192 Ill. 2d at 283. We reasoned that

“[l]ocating a person in need of emergency medical treatment is the

first step in providing life support services.” American National Bank,

192 Ill. 2d at 286.

The City argues that American National Bank does not control our

interpretation of the EMS Act immunity provision because that

provision was amended after American National Bank. The City

observes that the term “life support services” has been changed to

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“emergency or non-emergency medical services.” As noted by the

appellate court, however, the amended statute is at least as broad as

the prior version. 374 Ill. App. 3d at 754. In fact, we believe that the

phrase “emergency or non-emergency medical services” is broader in

scope because it encompasses medical services in response to either

an emergency or a nonemergency.

In the previous version of the Act, the definitions of advanced,

intermediate, and basic life support services referred to providing

“emergency care” for the treatment of life-threatening conditions. 210

ILCS 50/4.01, 4.02, 4.06, 4.19, 4.20 (West 1994). Those provisions

did not mention nonemergency care or services. The amended statute,

however, expressly includes “non-emergency medical care” in the

definitions of advanced, intermediate, and basic life support services.

210 ILCS 50/3.10(a), (b), (c) (West 2004). “Non-emergency medical

care” is defined to include medical services given to patients during

transportation to health-care facilities to obtain nonemergency

services. 210 ILCS 50/3.10(g) (West 2004). The phrase “emergency

or non-emergency medical services” is broader in scope because it

includes both emergency and nonemergency services. Thus, the

substitution of “emergency or non-emergency medical services” for

“life support services” cannot provide a basis for giving the immunity

provision a narrower meaning.

The other changes to the statute identified by the City also do not

affect our interpretation in American National Bank. The City asserts

that the phrase “shall not be civilly or criminally liable” was changed

to “shall not be civilly liable.” The City does not explain how this

amendment affects the meaning of the statute as applied in American

National Bank or this case. We find that the deletion of criminal

liability from the immunity provision does not affect our

interpretation in American National Bank and is irrelevant to this case

involving a claim for civil damages.

The City also notes that the phrase “for purposes of transporting

a trauma patient” was deleted from the statute. The City argues that

the holding of American National Bank is inapplicable because the

reference to “transporting” was eliminated. The previous statute

provided immunity for acts or omissions, “including the bypassing of

nearby hospitals or medical facilities for the purpose of transporting

a trauma patient to a designated trauma center.” The amended statute

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still refers to “bypassing of nearby hospitals or medical facilities.”

Transportation of patients is implied by that reference. In fact,

deleting the phrase “for purposes of transporting a trauma patient”

broadened the statute because that phrase limited the immunity for

bypassing hospitals to circumstances when the purpose was to

transport a trauma patient to a designated trauma center. Now the

immunity for bypassing a hospital does not contain that specific

limitation. We conclude that deletion of the term “transporting” does

not support a narrower interpretation of the immunity statute. If

anything, it supports a broader interpretation.

Finally, the City notes that the previous immunity statute provided

for an exception to immunity if the acts or omissions were

“inconsistent with the person’s training or constitute willful and

wanton misconduct,” while the amended statute only allows for an

exception to immunity if the acts or omissions “constitute willful and

wanton misconduct.” Again, the City does not explain how this

amendment supports a narrower interpretation of the EMS Act

immunity provision. In American National Bank, the plaintiff alleged

that the acts were willful and wanton. American National Bank, 192

Ill. 2d at 284-85. The plaintiff did not allege that the paramedics acted

beyond their level of training. American National Bank, 192 Ill. 2d at

284-85. Thus, the phrase “inconsistent with the person’s training”

was not at issue in that case, and it could not have affected the

interpretation of the immunity provision. As in American National

Bank, the plaintiff here alleges that the acts or omissions of the

emergency responders constituted willful and wanton misconduct.

The deletion of the phrase “inconsistent with the person’s training”

does not affect our interpretation of the immunity provision as applied

here.

We conclude that the City’s efforts to distinguish American

National Bank are not persuasive. This court’s broad interpretation of

the EMS Act immunity provision in American National Bank is not

nullified by the cited amendments to that provision. In fact, the

amendments further broadened the scope of the immunity provision.

Additionally, in American National Bank, we relied upon the

broad scope of the EMS Act to support our interpretation of the

immunity provision. See American National Bank, 192 Ill. 2d at 283.

The EMS Act continues to regulate expansively the delivery of

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emergency medical services in Illinois. The express intent of the Act

is to:

“provide the State with systems for emergency medical

services by establishing within the State Department of Public

Health a central authority responsible for the coordination and

integration of all activities within the State concerning pre-

hospital and inter-hospital emergency medical services, as

well as non-emergency medical transports, and the overall

planning, evaluation, and regulation of pre-hospital

emergency medical services systems.

***

This legislation is intended to provide minimum standards

for the statewide delivery of EMS services.” 210 ILCS 50/2

(West 2004).

The Act’s provisions are directed at accomplishing the broad

purpose of planning, delivering, evaluating, and regulating emergency

medical services. The Act requires establishment of Emergency

Medical Services Systems (EMS Systems) including hospitals,

vehicle service providers, and personnel approved by the Department.

210 ILCS 50/3.20(a) (West 2004). Responsibility for each EMS

System is vested in a resource hospital through the EMS medical

director. 210 ILCS 50/3.155 (West 2004). The EMS Systems

coordinate and provide prehospital and interhospital emergency care

under a System program plan approved by the Department. 210 ILCS

50/3.20(a) (West 2004).

“Pre-hospital care” is defined to include “emergency medical

services rendered to emergency patients for analytic, resuscitative,

stabilizing, or preventive purposes, precedent to and during

transportation of such patients to hospitals.” 210 ILCS 50/3.10(e)

(West 2004). The Act defines various levels of care, including

advanced, intermediate, and basic life support services. 210 ILCS

50/3.10(a), (b), (c) (West 2004). Those levels of care encompass a

wide range of emergency and nonemergency medical services. 210

ILCS 50/3.10(a), (b), (c) (West 2004). The Act requires the delivery

of care to be initiated as authorized by the EMS medical director or

under the direction of a physician or emergency communications

registered nurse. 210 ILCS 50/3.10(a), (b), (c) (West 2004).

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The Department is given expansive authority and responsibility

to regulate EMS Systems. 210 ILCS 50/3.20(c) (West 2004). The

Department’s responsibilities include, among other things: approving

EMS Systems meeting its minimum standards and criteria;

monitoring EMS Systems based on its standards for continuing

operation; renewing EMS System approvals following an inspection;

suspending, revoking, or refusing to renew approval of an EMS

System; and requiring EMS Systems to adopt written protocols for

transporting patients to hospitals. 210 ILCS 50/3.20(c) (West 2004).

The EMS Act provides for licensing of EMTs, the scope of their

practice, and their training and continuing education. 210 ILCS 50/

3.50, 3.55, 3.65 (West 2004). Additionally, the Act governs training

and certification of registered nurses providing emergency care within

EMS Systems. 210 ILCS 50/3.75, 3.80 (West 2004). The Act also

provides for training, certification, continuing education, and overall

regulation of emergency medical dispatchers. 210 ILCS 50/3.70

(West 2004). The Department is responsible for regulating

ambulances and other emergency vehicles, including their design,

specifications, equipment and staffing requirements, and operation

and maintenance standards. 210 ILCS 50/3.85 (West 2004).

The Act provides for investigation of complaints (210 ILCS

50/3.125 (West 2004)) and fines for noncompliance (210 ILCS

50/3.140 (West 2004)). The Department may also enforce the Act by

seeking an injunction to prevent operation without a license or

authorization. 210 ILCS 50/3.180 (West 2004).

Thus, our review of the EMS Act reveals that it is a

comprehensive, omnibus source of rules governing the planning,

delivery, evaluation, and regulation of emergency medical services in

Illinois. Our broad construction of the immunity provision in

American National Bank to include preparatory conduct integral to

providing emergency treatment continues to be supported by the EMS

Act’s comprehensive scope.

The City argues, nonetheless, that the EMS Act applies only after

emergency services in the form of treatment are provided, and the

Tort Immunity Act applies before any examination, assessment, or

treatment is undertaken. Thus, the City contends that the EMS Act

and the Tort Immunity Act do not conflict, but operate “each in its

own sphere.” In support of its argument, the City relies on this court’s

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decision in Henrich v. Libertyville High School, 186 Ill. 2d 381

(1998).

In Henrich, this court considered whether the Tort Immunity Act

or the School Code immunity provisions applied to the plaintiff’s

complaint. Henrich, 186 Ill. 2d at 383. The plaintiff alleged that he

underwent spine fusion surgery and his surgeon advised him that he

was permanently restricted from participating in contact sports during

his high school physical education class. The high school knew of the

restriction. A substitute teacher, nevertheless, required the plaintiff to

participate in a water basketball game during physical education

class. During the game, the plaintiff was severely and permanently

injured. Henrich, 186 Ill. 2d at 384.

The plaintiff alleged, in pertinent part, that the school district’s

actions constituted willful and wanton misconduct. The district filed

a motion to dismiss, asserting absolute immunity under sections

3–108(a) and 3–109 of the Tort Immunity Act (745 ILCS

10/3–108(a), 3–109 (West 1994)). The plaintiff responded that his

claim was controlled by sections 24–24 and 34–84a of the School

Code (105 ILCS 5/24–24, 34–84a (West 1994)), providing immunity

against negligence claims, but not for willful and wanton misconduct.

Henrich, 186 Ill. 2d at 384-85. The trial court dismissed the plaintiff’s

claims based on the Tort Immunity Act, and the appellate court

affirmed. Henrich, 186 Ill. 2d at 385-86.

This court affirmed the appellate court, holding that the plain

language of the Tort Immunity Act controlled the disposition of the

plaintiff’s complaint. Henrich, 186 Ill. 2d at 395. The plaintiff’s

argument that the specific provisions of the School Code controlled

over the general provisions of the Tort Immunity Act was not

dispositive. Rather, in construing the relevant provisions together, we

found that “each stands in its own sphere.” Henrich, 186 Ill. 2d at

391-92. Section 24–24 of the School Code applies to both public and

private schools while section 3–108(a) of the Tort Immunity Act

applies only to public schools. Henrich, 186 Ill. 2d at 392. This court

concluded that the plain language of the Tort Immunity Act indicated

the legislature’s intent to grant public school districts and teachers

greater immunity than private schools and their teachers. Henrich,

186 Ill. 2d at 392.

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The City argues that the provisions of the EMS Act and the Tort

Immunity Act can be harmonized as in Henrich. The City asserts that

the Tort Immunity Act should be construed to apply before

emergency treatment is provided and the EMS Act to apply after

emergency treatment is given.

We disagree with the City’s argument that the EMS Act and Tort

Immunity Act can be harmonized. As the appellate court noted, the

City’s interpretation of the EMS Act immunity provision to apply

only after treatment has begun is counter to our decision in American

National Bank. See 374 Ill. App. 3d at 752-53. In American National

Bank, we rejected the argument that the immunity provision applied

only when treatment was actually administered to a patient. American

National Bank, 192 Ill. 2d at 282-83. Instead, we held that the

immunity provision encompassed preparatory conduct integral to

providing emergency treatment. American National Bank, 192 Ill. 2d

at 283. Our interpretation is considered part of the statute itself until

the legislature amends it contrary to that interpretation. Henrich, 186

Ill. 2d at 387, citing Miller v. Lockett, 98 Ill. 2d 478, 483 (1983). The

legislature has not amended the immunity provision contrary to our

interpretation to limit its meaning. If anything, the legislature’s

amendments have broadened the scope of that provision. Thus, we

cannot harmonize the EMS Act immunity provision with the Tort

Immunity Act by construing it in the manner suggested by the City.

Our decision in Moore v. Green, 219 Ill. 2d 470 (2006), is also

applicable here. In Moore, the plaintiff alleged that the City of

Chicago and two of its police officers were willful and wanton in

failing to respond properly to a call for assistance from a domestic

violence victim. Moore, 219 Ill. 2d at 474-75. The sole issue was

whether the absolute immunity provisions of the Tort Immunity Act

(745 ILCS 10/4–102, 4–107 (West 2002)), or the limited immunity

provision of the Illinois Domestic Violence Act of 1986 (750 ILCS

60/305 (West 2002)), governed the plaintiff’s allegations. Moore, 219

Ill. 2d at 474.

This court held that the immunity provisions could not be

harmonized because they both clearly applied to the plaintiff’s

allegations. Moore, 219 Ill. 2d at 487. We rejected as unreasonable

the defendants’ contention that the Domestic Violence Act immunity

provision should be limited to law enforcement officers who were

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outside the scope of the Tort Immunity Act. Moore, 219 Ill. 2d at

487-88. We determined that “[i]t would pervert the broad purposes of

the Domestic Violence Act to conclude that the immunity created by

section 305 was intended to apply only to law enforcement agencies

and agents beyond the Tort Immunity Act’s shield, who are less likely

to investigate domestic violence calls or to enforce the Act.” Moore,

219 Ill. 2d at 488. This court held that the defendant’s interpretation

would undermine the Domestic Violence Act provisions outlining the

duties of municipal police officers in responding to domestic violence

calls. Moore, 219 Ill. 2d at 488.

In this case, both the Tort Immunity Act and the EMS Act

immunity provisions apply to plaintiff’s complaint. Thus, those

statutes cannot be harmonized. See Moore, 219 Ill. 2d at 487

(immunity provisions could not be harmonized because both applied

to the plaintiff’s complaint). While we will attempt to interpret

conflicting statutes together, in pari materia, when such an

interpretation is reasonable (Moore, 219 Ill. 2d at 479), the City’s

proposed construction of the EMS Act immunity provision is not

reasonable because it directly contradicts our construction of the EMS

Act in American National Bank.

Moreover, the City’s construction is inconsistent with the EMS

Act’s comprehensive scope. The EMS Act provides for the

coordination and integration of all prehospital and interhospital

emergency medical services. 210 ILCS 50/2 (West 2004). The Act is

an omnibus source of rules governing all aspects of emergency

medical services, including overall planning, delivery, evaluation, and

regulation. The City’s narrow interpretation of the EMS Act

immunity provision cannot be squared with that Act’s comprehensive

scope. See American National Bank, 192 Ill. 2d at 283 (EMS Act

immunity provision must be given a broad meaning in light of the

Act’s expansive scope).

Our interpretation of the EMS Act immunity provision in

American National Bank remains valid. That provision has been

interpreted broadly to include preparatory actions integral to

providing emergency treatment. Plaintiff here alleges that the City

failed to assess, examine, or transport Joseph to a hospital.

Assessment and evaluation are integral to providing emergency

medical services. One of the first steps in providing emergency care

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is assessing the patient to determine the necessary medical services.

No treatment or emergency care can be provided until the patient’s

condition is assessed.

We also note that the EMS Act immunizes “acts or omissions” in

providing emergency medical services unless those acts or omissions

constitute willful and wanton misconduct. 210 ILCS 50/3.150(a)

(West 2004). The failure to assess or examine is an “omission” in

providing emergency medical services under our interpretation of the

immunity provision. See also Moore, 219 Ill. 2d at 490 (police

officers’ failure to offer any emergency assistance fell within

Domestic Violence Act immunity for acts or omissions in providing

emergency assistance). Thus, we conclude that the EMS Act

immunity provision applies to the allegations of plaintiff’s complaint.

Having determined that both immunity provisions may apply to

these facts, we must decide whether the EMS Act or the Tort

Immunity Act governs here. When a general statutory provision and

a more specific one relate to the same subject, we will presume that

the legislature intended the more specific statute to govern. Moore,

219 Ill. 2d at 480, citing Knolls Condominium Ass’n v. Harms, 202

Ill. 2d 450, 459 (2002). We will also presume that the legislature

intended the more recent provision to control. Moore, 219 Ill. 2d at

480, citing State v. Mikusch, 138 Ill. 2d 242, 254 (1990).

The EMS Act is directed specifically to the planning, delivery,

evaluation, and regulation of emergency medical services. The

immunity provision applies to all people, agencies, and governmental

bodies licensed or authorized under the Act to provide those services.

210 ILCS 50/3.150(a) (West 2004). Thus, the EMS Act is designed

to apply to the delivery of emergency medical services. In contrast,

the relevant sections of the Tort Immunity Act have a more general

application to tort claims against local public entities and public

employees for failing to perform, or adequately perform, an

examination or a diagnosis. 745 ILCS 10/6–105, 6–106(a) (West

2004). We conclude that the EMS Act is more specifically related to

the facts here involving emergency responders and the delivery of

emergency medical care.

The EMS Act was also enacted more recently than the Tort

Immunity Act provisions. Sections 6–105 and 6–106(a) of the Tort

Immunity Act were enacted in 1965 (745 ILCS 10/6–105, 6–106(a)

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(West 2004)), while the EMS Act immunity provision was enacted 30

years later, in 1995 (210 ILCS 50/3.150(a) (West 2004)).

Accordingly, we presume that the EMS Act controls here because it

is the more specific and recent provision.

In Moore, we also looked to the legislature’s intent in deciding

whether the Tort Immunity Act or the Domestic Violence Act

governed the plaintiff’s allegations. We reaffirmed that our “singular

concern” is to ascertain and give effect to the intent of the legislature.

Moore, 219 Ill. 2d at 488. We concluded that the legislature’s intent

was clear from the language of the Domestic Violence Act, stating:

“The structure of that Act reflects a comprehensive statutory

scheme for reform of the legal system’s historically

inadequate response to domestic violence. The Domestic

Violence Act, in effect, is an omnibus source for rules

regarding such cases. It begins with a broad statement of its

purposes [citation] and a broad statement of the persons it

protects [citation]. Most importantly for this case, it details

the responsibilities of law enforcement officers.” Moore, 219

Ill. 2d at 488-89.

We concluded that the limited immunity provision of the Domestic

Violence Act was a direct expression of legislative intent, and it

governed the plaintiff’s allegations. Moore, 219 Ill. 2d at 489-90.

Similar to the Domestic Violence Act, the EMS Act begins with

a broad statement of its purpose. The purpose of the Act includes

coordinating and integrating all prehospital emergency medical

services activities. 210 ILCS 50/2 (West 2004). The Act’s express

purpose also includes providing for the overall planning, delivery,

evaluation, and regulation of emergency medical services systems.

210 ILCS 50/2 (West 2004). The provisions of the Act are also an

omnibus source of rules aimed at achieving those broad purposes.

The broad purposes, comprehensive scheme, and entire structure of

the EMS Act indicate an intent for the immunity provision from that

Act to govern cases involving emergency medical services.

The City notes that the Domestic Violence Act details the

responsibilities of police officers in responding to domestic violence

situations, but the EMS Act does not enumerate any duties of

emergency responders. The City emphasizes this distinction, arguing

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that the EMS Act does not impose any duty to provide emergency

medical services.

We recognize that in Moore this court relied, in part, on the duties

imposed upon police officers in concluding that the Domestic

Violence Act governed. Moore, 219 Ill. 2d at 488-89. That factor was

not dispositive, however. Rather, it was only one factor weighing

upon the determination of the legislature’s intent. Our decision in

Moore was based on several factors. We presume that the EMS Act

controls here as the more specific and recent statute. Additionally, the

purpose, scheme, and structure of the EMS Act shows the legislature

intended for its immunity provision to govern.

We also note that the City has not challenged the existence of a

duty to provide emergency medical assistance in this case. In fact, the

City admitted the legal sufficiency of plaintiff’s tort claims, including

the existence of a duty, by filing a motion to dismiss the complaint

under section 2–619. Moore, 219 Ill. 2d at 477-78. The only issue

here is whether an immunity applies to bar plaintiff’s claims.

In sum, we conclude that the EMS Act limited immunity

provision governs here over sections 6–105 and 6–106(a) of the Tort

Immunity Act. The only basis for dismissal asserted in the City’s

section 2–619 motion to dismiss was absolute immunity under

sections 6–105 and 6–106(a) of the Tort Immunity Act. Given our

conclusion that the Tort Immunity Act does not govern here, we must

reverse the dismissal of the complaint and remand the matter for

further proceedings.

III. CONCLUSION

For the foregoing reasons, the judgments of the circuit and

appellate courts are reversed and the cause is remanded to the circuit

court for further proceedings.

Reversed and remanded.

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