2009 California Health and Safety Code - Section 1797.200-1797.226 :: Article 1. Local Ems Agency

1797.200.  Each county may develop an emergency medical services
program. Each county developing such a program shall designate a
local EMS agency which shall be the county health department, an
agency established and operated by the county, an entity with which
the county contracts for the purposes of local emergency medical
services administration, or a joint powers agency created for the
administration of emergency medical services by agreement between
counties or cities and counties pursuant to the provisions of Chapter
5 (commencing with Section 6500) of Division 7 of Title 1 of the
Government Code.

1797.201.  Upon the request of a city or fire district that
contracted for or provided, as of June 1, 1980, prehospital emergency
medical services, a county shall enter into a written agreement with
the city or fire district regarding the provision of prehospital
emergency medical services for that city or fire district. Until such
time that an agreement is reached, prehospital emergency medical
services shall be continued at not less than the existing level, and
the administration of prehospital EMS by cities and fire districts
presently providing such services shall be retained by those cities
and fire districts, except the level of prehospital EMS may be
reduced where the city council, or the governing body of a fire
district, pursuant to a public hearing, determines that the reduction
is necessary.
   Notwithstanding any provision of this section the provisions of
Chapter 5 (commencing with Section 1798) shall apply.

1797.202.  (a) Every local EMS agency shall have a full- or
part-time licensed physician and surgeon as medical director, who has
substantial experience in the practice of emergency medicine, as
designated by the county or by the joint powers agreement, to provide
medical control and to assure medical accountability throughout the
planning, implementation and evaluation of the EMS system. The
authority director may waive the requirement that the medical
director have substantial experience in the practice of emergency
medicine if the requirement places an undue hardship on the county or
counties.
   (b) The medical director of the local EMS agency may appoint one
or more physicians and surgeons as assistant medical directors to
assist the medical director with the discharge of the duties of
medical director or to assume those duties during any time that the
medical director is unable to carry out those duties as the medical
director deems necessary.
   (c) The medical director may assign to administrative staff of the
local EMS agency for completion under the supervision of the medical
director, any administrative functions of his or her duties which do
not require his or her professional judgment as medical director.

1797.204.  The local EMS agency shall plan, implement, and evaluate
an emergency medical services system, in accordance with the
provisions of this part, consisting of an organized pattern of
readiness and response services based on public and private
agreements and operational procedures.

1797.206.  The local EMS agency shall be responsible for
implementation of advanced life support systems and limited advanced
life support systems and for the monitoring of training programs.

1797.208.  The local EMS agency shall be responsible for determining
that the operation of training programs at the EMT-I, EMT-II, and
EMT-P levels are in compliance with this division, and shall approve
the training programs if they are found to be in compliance with this
division. The training program at the California Highway Patrol
Academy shall be exempt from the provisions of this section.

1797.210.  (a) The medical director of the local EMS agency shall
issue a certificate, except an EMT-P certificate, to an individual
upon proof of satisfactory completion of an approved training
program, passage of the certifying examination designated by the
authority, completion of any other requirements for certification
established by the authority, and a determination that the individual
is not precluded from certification for any of the reasons listed in
Section 1798.200. The certificate shall be proof of the individual's
initial competence to perform at the designated level.
   (b) The medical director of the local EMS agency shall, at the
interval specified by the authority, recertify an EMT-I or EMT-II
upon proof of the individual's satisfactory passage of the
examination for recertification designated by the authority,
completion of any continuing education or other requirements for
recertification established by the authority, and a determination
that the individual is not precluded from recertification because of
any of the reasons listed in Section 1798.200.

1797.211.  Each local EMS agency shall submit certificate status
updates to the authority within three working days after a final
determination is made regarding a certification disciplinary action
taken by the medical director that results in a change to an EMT-I or
EMT-II certificate status.

1797.212.  The local EMS agency may establish a schedule of fees for
certification in an amount sufficient to cover the reasonable cost
of administering the certification provisions of this division.
However, a local EMS agency shall not collect fees for the
certification or recertification of an EMT-P.

1797.213.  (a) Any local EMS agency conducting a program pursuant to
this article may provide courses of instruction and training leading
to certification as an EMT-I, EMT-II, EMT-P, or authorized
registered nurse. When such instruction and training are provided, a
fee may be charged sufficient to defray the cost of such instruction
and training.
   (b) Effective July 1, 1990, any courses of instruction and
training leading to certification as an EMT-I, EMT-II, EMT-P, or
authorized registered nurse shall include a course of training on the
nature of sudden infant death syndrome which is developed by the
California SIDS program in the State Department of Health Services in
consultation with experts in the field of sudden infant death
syndrome, and effective January 1, 1990, any individual certified as
an EMT-I, EMT-II, EMT-P, or authorized registered nurse shall
complete that course of training. The course shall include
information on the community resources available to assist families
who have lost a child to sudden infant death syndrome. An individual
who was certified as an EMT-I, EMT-II, EMT-P, or authorized
registered nurse prior to January 1, 1990, shall complete
supplementary training on this topic on or before January 1, 1992.

1797.214.  A local EMS agency may require additional training or
qualifications, for the use of drugs, devices, or skills in either
the standard scope of practice or a local EMS agency optional scope
of practice, which are greater than those provided in this chapter as
a condition precedent for practice within such EMS area in an
advanced life support or limited advanced life support prehospital
care system consistent with standards adopted pursuant to this
division.

1797.215.  Notwithstanding any other provision of law, EMT-I's,
EMT-II's, and EMT-P's shall be required to renew their
cardiopulmonary resuscitation certificate no more than once every two
years.

1797.216.  Public safety agencies that are certifying entities may
certify and recertify public safety personnel as EMT-I. The state
fire marshal, subject to policy guidance and advice from the State
Board of Fire Services, may certify and recertify fire safety
personnel as EMT-I. All persons certified shall have completed a
program of training approved by the local EMS agency or the authority
and have passed a competency-based examination.

1797.217.  (a) Every certifying entity shall submit to the authority
certification data required by Section 1797.117.
   (b) The authority shall collect fees from each certifying entity
for the certification and certification renewal of each EMT-I and
EMT-II in an amount sufficient to support the authority's central
registry program and the local EMS agency administrative law judge
reimbursement program. Separate additional fees may be charged, at
the option of the authority, for services that are not shared by all
applicants.
   (c) The authority's fees shall be established in regulations, and
fees charged for individual services shall be set so that the total
fees charged shall not exceed the authority's actual total cost for
the authority's central registry program, state and federal criminal
offender record information search response program, and the local
EMS agency administrative law judge reimbursement program.
   (d) In addition to any fees collected by EMT-I or EMT-II
certifying entities to support their certification, recertification,
or enforcement programs, EMT-I or EMT-II certifying entities shall
collect fees to support the authority's central registry program, and
the local EMS agency administrative law judge reimbursement program.
In lieu of collecting fees from an individual, pursuant to an
employer choice, a collective bargaining agreement, or other
employment contract, the certifying entity shall provide the
appropriate fees to the authority pursuant to this subdivision.
   (e) All fees collected for or provided to the authority in a
calendar month by an EMT-I or EMT-II certifying entity pursuant to
this section shall be transmitted to the authority for deposit into
the Emergency Medical Technician Certification Fund within 30
calendar days following the last day of the calendar month in which
the fees were received by the certifying entity, unless a contract
between the certifying entity and the authority specifies a different
timeframe.
   (f) At the option of the authority, fees may be collected for the
authority by an entity that contracts with the authority to provide
any of the services associated with the registry program, or the
state and federal criminal offender record information search
response program, or the local EMS agency administrative law judge
reimbursement program. All fees collected for the authority in a
calendar month by any entity designated by the authority pursuant to
this section to collect fees for the authority shall be transmitted
to the authority for deposit into the Emergency Medical Technician
Certification Fund within 30 calendar days following the last day of
the calendar month in which the fees were received by the designated
entity, unless the contract between the entity and the authority
specifies a different timeframe.
   (g) The authority shall annually evaluate fees to determine if the
fee is sufficient to fund the actual costs of the authority's
central registry program, state and federal criminal offender record
information search response program, and local EMS agency
administrative law judge reimbursement program. If the evaluation
shows that the fees are excessive or are insufficient to fund the
actual costs of these programs, then the fees will be adjusted
accordingly through the rulemaking process as outlined in the
Administrative Procedures Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
   (h) The Emergency Medical Technician Certification Fund is hereby
created in the State Treasury. All moneys deposited in the fund shall
be made available, upon appropriation, to the authority for purposes
of the central registry program, state and federal criminal offender
record information search response program, and the local EMS agency
administrative law judge reimbursement program. The local EMS agency
administrative law judge reimbursement program is solely for the
purpose of making reimbursements to local emergency medical service
agencies for actual administrative law judge costs regarding EMT-I or
EMT-II disciplinary action appeals. Reimbursement to the local
emergency medical service agencies shall only be made if adequate
funds are available from fees collected for the authority's local EMS
agency administrative law judge reimbursement program.
   (i) The authority may transfer unused portions of the Emergency
Medical Technician Certification Fund to the Surplus Money Investment
Fund. Funds transferred to the Surplus Money Investment Fund shall
be placed in a separate trust account, and shall be available for
transfer to the Emergency Medical Technician Certification Fund,
together with interest earned, when requested by the authority.
   (j) The authority shall maintain a reserve balance in the
Emergency Medical Technician Certification Fund of 5 percent of
annual revenues. Any increase in the fees deposited in the Emergency
Medical Technician Certification Fund shall be effective upon a
determination by the authority that additional moneys are required to
fund expenditures of this section.

1797.218.  Any local EMS agency may authorize an advanced life
support or limited advanced life support program which provides
services utilizing EMT-II or EMT-P, or both, for the delivery of
emergency medical care to the sick and injured at the scene of an
emergency, during transport to a general acute care hospital, during
interfacility transfer, while in the emergency department of a
general acute care hospital until care responsibility is assumed by
the regular staff of that hospital, and during training within the
facilities of a participating general acute care hospital.

1797.219.  All investigatory and disciplinary processes for EMT-I
and EMT-II certificate holders shall be, subject to Chapter 9.6
(commencing with Section 3250) of Division 4 of Title 1 of the
Government Code, with respect to certificate holders who are
firefighters otherwise subject to these provisions, and Chapter 9.7
(commencing with Section 3300) of Division 4 of Title 1 of the
Government Code, with respect to certificate holders who are peace
officers otherwise subject to these provisions.

1797.220.  The local EMS agency, using state minimum standards,
shall establish policies and procedures approved by the medical
director of the local EMS agency to assure medical control of the EMS
system. The policies and procedures approved by the medical director
may require basic life support emergency medical transportation
services to meet any medical control requirements including dispatch,
patient destination policies, patient care guidelines, and quality
assurance requirements.

1797.221.  The medical director of the local EMS agency may approve
or conduct any scientific or trial study of the efficacy of the
prehospital emergency use of any drug, device, or treatment procedure
within the local EMS system, utilizing any level of prehospital
emergency medical care personnel. The study shall be consistent with
any requirements established by the authority for scientific or trial
studies conducted within the prehospital emergency medical care
system, and, where applicable, with Article 5 (commencing with
Section 111550) of Chapter 6 of Part 5 of Division 104. No drug,
device, or treatment procedure which has been specifically excluded
by the authority from usage in the EMS system shall be included in
such a study.

1797.222.  A county, upon the recommendation of its local EMS
agency, may adopt ordinances governing the transport of a patient who
is receiving care in the field from prehospital emergency medical
personnel, when the patient meets specific criteria for trauma, burn,
or pediatric centers adopted by the local EMS agency.
   The ordinances shall, to the extent possible, ensure that
individual patients receive appropriate medical care while protecting
the interests of the community at large by making maximum use of
available emergency medical care resources. These ordinances shall be
consistent with Sections 1797.106, 1798.100, and 1798.102, and shall
not conflict with any state regulations or any guidelines adopted by
the Emergency Medical Service Authority.
   This section shall not be construed as prohibiting the helicopter
program of the Department of the California Highway Patrol from a
role in providing emergency medical services when the best medically
qualified person at the scene of an accident determines it is in the
best interests of any injured party.

1797.224.  A local EMS agency may create one or more exclusive
operating areas in the development of a local plan, if a competitive
process is utilized to select the provider or providers of the
services pursuant to the plan. No competitive process is required if
the local EMS agency develops or implements a local plan that
continues the use of existing providers operating within a local EMS
area in the manner and scope in which the services have been provided
without interruption since January 1, 1981. A local EMS agency which
elects to create one or more exclusive operating areas in the
development of a local plan shall develop and submit for approval to
the authority, as part of the local EMS plan, its competitive process
for selecting providers and determining the scope of their
operations. This plan shall include provisions for a competitive
process held at periodic intervals. Nothing in this section
supersedes Section 1797.201.

1797.226.  Without altering or otherwise affecting the meaning of
any portion of this division as to any other county, as to San
Bernardino County only, it shall be competent for any local EMS
agency which establishes exclusive operating areas pursuant to
Section 1797.224 to determine the following:
   (a) That a minor alteration in the level of life support personnel
or equipment, which does not significantly reduce the level of care
available, shall not constitute a change in the manner and scope of
providing services.
   (b) That a successor to a previously existing emergency services
provider shall qualify as an existing provider if the successor has
continued uninterrupted the emergency transportation previously
supplied by the prior provider.