Chapter 5 - Medical Control

California Health and Safety Code — §§ 1798-1798.8

Sections (38)

Amended by Stats. 1988, Ch. 1390, Sec. 6.

(a)The medical direction and management of an emergency medical services system shall be under the medical control of the medical director of the local EMS agency. This medical control shall be maintained in accordance with standards for medical control established by the authority.

(b)Medical control shall be within an EMS system which complies with the minimum standards adopted by the authority, and which is established and implemented by the local EMS agency.

(c)In the event a medical director of a base station questions the medical effect of a policy of a local EMS agency, the medical director of the base station shall submit a written statement to the medical director of the local EMS agency requesting a review by a panel of medical directors of other base stations. Upon receipt of the request, the medical director of a local EMS agency shall promptly convene a panel of medical directors of base stations to evaluate the written statement. The panel shall be composed of all the medical directors of the base stations in the region, except that the local EMS medical director may limit the panel to five members.

This subdivision shall remain in effect only until the authority adopts more comprehensive regulations that supersede this subdivision.

§ 1798.2

Amended by Stats. 1988, Ch. 1390, Sec. 7.

The base hospital shall implement the policies and procedures established by the local EMS agency and approved by the medical director of the local EMS agency for medical direction of prehospital emergency medical care personnel.

§ 1798.3

Added by Stats. 1988, Ch. 1390, Sec. 8.

Advanced life support and limited advanced life support personnel may receive medical direction from an alternative base station in lieu of a base hospital when the following conditions are met:

(a)The alternative base station has been designated by the local EMS agency and approved by the medical director of the local EMS agency, pursuant to Section 1798.105, to provide medical direction to prehospital personnel because no base hospital is available to provide medical direction for the geographical area assigned.

(b)The medical direction is provided by either of the following:

(1)A physician and surgeon who is trained and qualified to issue advice and instructions to prehospital emergency medical care personnel.

(2)A mobile intensive care nurse who has been authorized by the medical director of the local EMS agency, pursuant to Section 1797.56, as qualified to issue instructions to prehospital emergency medical care personnel.

§ 1798.6

Added by Stats. 1983, Ch. 206, Sec. 2.

(a)Authority for patient health care management in an emergency shall be vested in that licensed or certified health care professional, which may include any paramedic or other prehospital emergency personnel, at the scene of the emergency who is most medically qualified specific to the provision of rendering emergency medical care. If no licensed or certified health care professional is available, the authority shall be vested in the most appropriate medically qualified representative of public safety agencies who may have responded to the scene of the emergency.

(b)If any county desires to establish a unified command structure for patient management at the scene of an emergency within that county, a committee may be established in that county comprised of representatives of the agency responsible for county emergency medical services, the county sheriff’s department, the California Highway Patrol, public prehospital-care provider agencies serving the county, and public fire, police, and other affected emergency service agencies within the county. The membership and duties of the committee shall be established by an agreement for the joint exercise of powers under Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code.

(c)Notwithstanding subdivision (a), authority for the management of the scene of an emergency shall be vested in the appropriate public safety agency having primary investigative authority. The scene of an emergency shall be managed in a manner designed to minimize the risk of death or health impairment to the patient and to other persons who may be exposed to the risks as a result of the emergency condition, and priority shall be placed upon the interests of those persons exposed to the more serious and immediate risks to life and health. Public safety officials shall consult emergency medical services personnel or other authoritative health care professionals at the scene in the determination of relevant risks.

§ 1798.8

Added by Stats. 2019, Ch. 389, Sec. 4. (SB 438) Effective January 1, 2020.

(a)Notwithstanding any provision of this division, medical control by a local EMS agency medical director, or medical direction and management of an emergency medical services system, as described in this chapter, shall not be construed to do any of the following:

(1)Limit, supplant, prohibit, or otherwise alter a public safety agency’s authority to directly receive and process requests for assistance originating within the public safety agency’s territorial

jurisdiction through the emergency “911” system established pursuant to Article 6 (commencing with Section 53100) of Chapter 1 of Part 1 of Division 2 of Title 5 of the Government Code. This paragraph does not supersede the local EMS agency’s authority to adopt and implement emergency lifesaving instructions or EMD prearrival instructions.

(2)Authorize or permit a local EMS agency to delegate, assign, or enter into a contract in contravention of subdivision (b) of Section 53110 of the Government Code.

(3)Authorize or permit a local EMS agency to

unilaterally reduce a public safety agency’s response mode below that of the EMS transport provider, prevent a public safety response, or alter the deployment of public safety emergency response resources within the public safety agency’s territorial jurisdiction.

(4)Authorize or permit a local EMS agency to prevent a public safety agency from providing mutual aid pursuant to the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code).

(b)A public safety agency’s adherence to the

policies, procedures, and protocols adopted by a local EMS agency does not constitute a transfer of any of the public safety agency’s authorities regarding the administration of emergency medical services.

§ 1798.100

Amended by Stats. 1988, Ch. 1390, Sec. 10.

In administering the EMS system, the local EMS agency, with the approval of its medical director, may designate and contract with hospitals or other entities approved by the medical director of the local EMS agency pursuant to Section 1798.105 to provide medical direction of prehospital emergency medical care personnel, within its area of jurisdiction, as either base hospitals or alternative base stations, respectively. Hospitals or other entities so designated and contracted with as base hospitals or alternative base stations shall provide medical direction of prehospital emergency medical care provided for the area defined by the local EMS agency in accordance with policies and procedures established by the local EMS agency and approved by the medical director of the local EMS agency pursuant to Sections 1797.220 and 1798.

§ 1798.101

Amended by Stats. 1988, Ch. 1390, Sec. 11.

(a)In rural areas, as determined by the authority, where the use of a base hospital having a basic emergency medical service special permit pursuant to subdivision (c) of Section 1277 is precluded because of geographic or other extenuating circumstances, a local EMS agency, in order to assure medical direction to prehospital emergency medical care personnel, may utilize other hospitals which do not have a basic emergency medical service permit but which have been approved by the medical director of the local EMS agency for utilization as a base hospital, if both of the following apply:

(1)Medical control is maintained in accordance with policies and procedures established by the local EMS agency, with the approval of the medical director of the local EMS agency.

(2)Approval is secured from the authority.

(b)(1)

In rural areas, as determined by the authority, when the use of a hospital having a basic emergency medical service special permit is precluded because of geographic or other extenuating circumstances, as determined by the authority, the medical director of the local EMS agency may authorize another facility which does not have this special permit to receive patients requiring emergency medical services if the facility has adequate staff and equipment to provide these services, as determined by the medical director of the local EMS agency.

(2)A local EMS agency which utilizes in its EMS system any facility which does not have a special permit to receive patients requiring emergency medical care pursuant to paragraph (1) shall submit to the authority, as part of the plan required by Section 1797.254, protocols approved by the medical director of the local EMS agency to ensure that the use of that facility is in the best interests of patient care. The protocols addressing patient safety and the use of the nonpermit facility shall take into account, but not be limited to, the following:

(A)The medical staff, and the availability of the staff at various times to care for patients requiring emergency medical services.

(B)The ability of staff to care for the degree and severity of patient injuries.

(C)The equipment and services available at the facility necessary to care for patients requiring emergency medical services and the severity of their injuries.

(D)The availability of more comprehensive emergency medical services and the distance and travel time necessary to make the alternative emergency medical services available.

(E)The time of day and any limitations which may apply for a nonpermit facility to treat patients requiring emergency medical services.

(3)Any change in the status of a nonpermit facility, authorized pursuant to this subdivision to care for patients requiring emergency medical services, with respect to protocols and the facility’s ability to care for the patients shall be reported by the facility to the local EMS agency.

§ 1798.102

Amended by Stats. 1984, Ch. 1391, Sec. 17.

The base hospital shall supervise prehospital treatment, triage, and transport, advanced life support or limited advanced life support, and monitor personnel program compliance by direct medical supervision.

§ 1798.104

Amended by Stats. 1984, Ch. 1391, Sec. 18.

The base hospital shall provide, or cause to be provided, EMS prehospital personnel training and continuing education in accordance with local EMS policies and procedures.

§ 1798.105

Added by Stats. 1988, Ch. 1390, Sec. 12.

The medical director of the local EMS agency may approve an alternative base station, as defined in Section 1798.53, to provide medical direction to advanced life support or limited advanced life support personnel for an area of the local EMS system for which no qualified base hospital is available, to provide that medical direction, providing that both the following conditions are met:

(a)Medical control is maintained in accordance with policies and procedures established by the local EMS agency, with the approval of the medical director of the local EMS agency.

(b)Any responsibilities of a base station hospital, including review of run reports or provision of continuing education, which are not assigned to the alternative base station, are assigned to either the local EMS agency, a base hospital for another area of the local EMS system, or a receiving hospital which has been approved by the medical director to, and has agreed to, assume the responsibilities.

§ 1798.150

Added by Stats. 1980, Ch. 1260.

The authority may establish, in cooperation with affected medical organizations, guidelines for hospital facilities according to critical care capabilities.

§ 1798.160

Amended by Stats. 1984, Ch. 1735, Sec. 5. Effective September 30, 1984.

Except where the context otherwise requires, the following definitions govern the construction of this article:

(a)“Trauma case” means any injured person who has been evaluated by prehospital personnel according to policies and procedures established by the local EMS agency pursuant to Section 1798.163 and who has been found to require transportation to a trauma facility.

(b)“Trauma facility” means a health facility, as defined by regulation, which is capable of treating one or more types of potentially seriously injured persons and which has been designated as part of the regional trauma care system by the local EMS agency. A facility may be a trauma facility for one or more services, as designated by the local EMS agency.

(c)“Trauma care system” means an arrangement under which trauma cases are transported to, and treated by, the appropriate trauma facility.

§ 1798.161

Amended by Stats. 1984, Ch. 1735, Sec. 6. Effective September 30, 1984.

(a)The authority shall submit draft regulations specifying minimum standards for the implementation of trauma care systems to the commission on or before July 1, 1984, and shall adopt the regulations on or before July 1, 1985. These regulations shall provide specific requirements for the care of trauma cases and shall ensure that the trauma care system is fully coordinated with all elements of the existing emergency medical services system. The regulations shall be adopted as provided in Section 1799.50, and shall include, but not be limited to, all of the following:

(1)Prehospital care management guidelines for triage and transportation of trauma cases.

(2)Flow patterns of trauma cases and geographic boundaries regarding trauma and nontrauma cases.

(3)The number and type of trauma cases necessary to assure that trauma facilities will provide quality care to trauma cases referred to them.

(4)The resources and equipment needed by trauma facilities to treat trauma cases.

(5)The availability and qualifications of the health care personnel, including physicians and surgeons, treating trauma cases within a trauma facility.

(6)Data collection regarding system operation and patient outcome.

(7)Periodic performance evaluation of the trauma system and its components.

(b)The authority may grant an exception to a portion of the regulations adopted pursuant to subdivision (a) upon substantiation of need by a local EMS agency that, as defined in the regulations, compliance with that requirement would not be in the best interests of the persons served within the affected local EMS area.

§ 1798.162

Amended by Stats. 1984, Ch. 1735, Sec. 7. Effective September 30, 1984.

(a)A local emergency medical services agency may implement a trauma care system only if the system meets the minimum standards set forth in the regulations for implementation established by the authority and the plan required by Section 1797.257 has been submitted to, and approved by, the authority. Prior to submitting the plan for the trauma care system to the authority, a local emergency medical services agency shall hold a public hearing and shall give adequate notice of the public hearing to all hospitals and other interested parties in the area proposed to be included in the system. This subdivision does not preclude a local EMS agency from adopting trauma care system standards which are more stringent than those established by the regulations.

(b)Notwithstanding subdivision (a) or any other provision of this article, the Santa Clara County Emergency Medical Services Agency may implement a trauma care system prior to the adoption of regulations by the authority pursuant to Section 1798.161. If the Santa Clara County Emergency Medical Services Agency implements a trauma care system pursuant to this subdivision prior to the adoption of those regulations by the authority, the agency shall prepare and submit to the authority a trauma care system plan which conforms to any regulations subsequently adopted by the authority.

§ 1798.163

Amended by Stats. 1984, Ch. 1735, Sec. 8. Effective September 30, 1984.

A local emergency medical services agency implementing a trauma care system shall establish policies and procedures which are concordant and consistent with the minimum standards set forth in the regulations adopted by the authority. This section does not preclude a local EMS agency from adopting trauma care system standards which are more stringent than those established by the regulations.

§ 1798.164

Amended by Stats. 1988, Ch. 768, Sec. 1.

(a)A local emergency medical services agency may charge a fee to an applicant seeking initial or continuing designation as a trauma facility in an amount sufficient to cover the costs directly related to the designation of trauma facilities pursuant to Section 1798.165 and to the development of the plans prepared pursuant to Sections 1797.257 and 1797.258, and subdivision (b) of Section 1798.162.

(b)Each local emergency medical services agency charging fees pursuant to subdivision (a) shall annually provide a report to the authority and to each trauma facility having paid a fee to the agency. The report shall contain sufficient detail to apprise facilities of the specific application of fees collected and to assure the authority that fees collected were expended in compliance with subdivision (a).

(c)The authority may establish a prescribed format for the report required in subdivision (b).

§ 1798.165

Amended by Stats. 1985, Ch. 570, Sec. 1.

(a)Local emergency medical services agencies may designate trauma facilities as part of their trauma care system pursuant to the regulations promulgated by the authority.

(b)The health facility shall only be designated to provide the level of trauma care and service for which it is qualified and which is included within the system implemented by the agency.

(c)No health care provider shall use the terms “trauma facility,” “trauma hospital,” “trauma center,” “trauma care provider,” “trauma vehicle,” or similar terminology in its signs or advertisements, or in printed materials and information it furnishes to the general public, unless the use is authorized by the local EMS agency.

§ 1798.166

Added by Stats. 1983, Ch. 1067, Sec. 2.

A local emergency medical services agency which elects to implement a trauma care system on or after January 1, 1984, shall develop and submit a plan to the authority according to the regulations established prior to the implementation.

§ 1798.167

Added by Stats. 1983, Ch. 1067, Sec. 2.

Nothing in this article shall be construed to restrict the authority of a health care facility to provide a service for which it has received a license pursuant to Chapter 2 (commencing with Section 1250) of Division 2.

§ 1798.168

Added by Stats. 1983, Ch. 1067, Sec. 2.

Nothing in this article shall be construed as changing the boundaries of any local emergency medical services agency in existence on January 1, 1984.

§ 1798.169

Added by Stats. 1983, Ch. 1067, Sec. 2.

Nothing in this article shall be construed as restricting the use of a helicopter of the Department of the California Highway Patrol from performing missions which the department determines are in the best interests of the people of the State of California.

§ 1798.170

Amended by Stats. 1987, Ch. 1240, Sec. 16.

A local EMS agency may develop triage and transfer protocols to facilitate prompt delivery of patients to appropriate designated facilities within and without its area of jurisdiction. Considerations in designating a facility shall include, but shall not be limited to, the following:

(a)A general acute care hospital’s consistent ability to provide on-call physicians and services for all emergency patients regardless of ability to pay.

(b)The sufficiency of hospital procedures to ensure that all patients who come to the emergency department are examined and evaluated to determine whether or not an emergency condition exists.

(c)The hospital’s compliance with local EMS protocols, guidelines, and transfer agreement requirements.

§ 1798.172

Amended by Stats. 1988, Ch. 888, Sec. 6. Effective September 14, 1988.

(a)The local EMS agency shall establish guidelines and standards for completion and operation of formal transfer agreements between hospitals with varying levels of care in the area of jurisdiction of the local EMS agency consistent with Sections 1317 to 1317.9a, inclusive, and Chapter 5 (commencing with Section 1798). Each local EMS agency shall solicit and consider public comment in drafting guidelines and standards. These guidelines shall include provision for suggested written agreements for the type of patient, initial patient care treatments, requirements of interhospital care, and associated logistics for transfer, evaluation, and monitoring of the patient.

(b)Notwithstanding subdivision (a), and in addition to Section 1317, a general acute care hospital licensed under Chapter 2 (commencing with Section 1250) of Division 2 shall not transfer a person for nonmedical reasons to another health facility unless that other facility receiving the person agrees in advance of the transfer to accept the transfer.

§ 1798.175

Added by Stats. 1986, Ch. 1377, Sec. 1.

(a)No person or public agency shall advertise itself as, or hold itself out as, providing emergency medical services, by using in its name or advertising the word “emergency,” or any derivation thereof, or any words which suggest that it is staffed and equipped to provide emergency medical services, unless the person or public agency satisfies one of the following requirements:

(1)Is a general acute care hospital providing approved standby, basic, or comprehensive emergency medical services regulated by this chapter.

(2)Meets all of the following minimum standards:

(A)Emergency services are available in the facility seven days a week, 24 hours a day.

(B)Has equipment, medication, and personnel experienced in the provision of services needed to treat life-, limb-, or function-threatening conditions.

(C)Diagnostic radiology and clinical laboratory services are provided by persons on duty or on call and available when needed.

(D)At least one physician who is trained and experienced in the provision of emergency medical care who is on duty or on call so as to be immediately available to the facility.

(E)Medical records document the name of each patient who seeks care, as well as the disposition of each patient upon discharge.

(F)A roster of speciality physicians who are available for referral, consultation, and speciality services is maintained and available.

(G)Policies and procedures define the scope and conduct of treatment provided, including procedures for the management of specific types of emergencies.

(H)The quality and appropriateness of emergency services are evaluated at least annually as part of a quality assurance program.

(I)Provides information to the public that describes the capabilities of the facility, including the scope of services provided, the manner in which the facility complies with the requirements of this section pertaining to the availability and qualifications of personnel or services, and the manner in which the facility cooperates with the patient’s primary care physician in followup care.

(J)Clearly identifies the responsible professional or professionals and the legal owner or owners of the facility in its promotion, advertising, and solicitations.

(K)Transfer agreements are in effect at all times with one or more general acute care hospitals which provide basic or comprehensive emergency medical services wherein patients requiring more definitive care will be expeditiously transferred and receive prompt hospital care. Reasonable care shall be exercised to determine whether an emergency requiring more definitive care exists and the person seeking emergency care shall be assisted in obtaining these services, including transportation services, in every way reasonable under the circumstances.

(b)Nothing in this article shall be construed to require the licensing or certification of any person or public agency meeting the minimum standards of paragraph (2) of subdivision (a), nor to exempt from licensure those health facilities covered by paragraph (1) of subdivision (a).

(c)Nothing in this article shall be construed to:

(1)Prohibit a physician in private practice, an outpatient department of a general acute care hospital whether located on or off the premises of the hospital, or other entity authorized to offer medical services from advertising itself as, or otherwise holding itself out as, providing urgent, immediate, or prompt medical services, or from using in its name or advertising the words “urgent,” “prompt,” “immediate,” any derivative thereof, or other words which suggest that it is staffed and equipped to provide urgent, prompt, or immediate medical services.

(2)Prohibit prehospital emergency medical care personnel certified pursuant to, or any state or local agencies established pursuant to, this division, or any emergency vehicle operating within the emergency medical services system from using the word “emergency” in the title, classification, or designation of the personnel, agency, or vehicle.

(d)Any person or public agency using the word “emergency” or any derivation thereof in its name or advertising on January 1, 1987, but which would be prohibited from using the word or derivation thereof by this article, shall have until January 1, 1988, to comply with this article.

§ 1798.180

Amended by Stats. 1987, Ch. 972, Sec. 2.

(a)The authority shall establish minimum standards for the operation of poison control centers.

(b)The authority shall establish geographical service areas and criteria for designation of regional poison control centers. The authority may designate poison control centers which have met the standards established pursuant to subdivision (a), in accordance with the criteria adopted pursuant to this subdivision.

(c)No person or persons, business, agency, organization, or other entity, whether public or private, shall hold itself out as providing a poison advice service or use the term poison control center, poison advice center, or any other term which implies that it is qualified to provide advice on the treatment or handling of poisons in its advertising, name, or in printed materials and information it furnishes to the general public unless that entity meets one of the following conditions:

(1)Has been designated as a poison control center by the authority.

(2)Is a company or organization which provides a poison information service for products or chemicals which it manufactures or distributes.

(d)Nothing in this section shall prohibit a qualified health care professional, within his or her level of professional expertise, from providing advice regarding poisoning or poisons to his or her patient or patients upon request or whenever he or she deems it warranted in the exercise of his or her professional judgment, as otherwise permitted by law.

§ 1798.181

Added by Stats. 1992, Ch. 1366, Sec. 1. Effective October 27, 1992.

The authority shall consolidate the number of poison control centers if it is determined by the authority that the consolidation will result in cost savings.

§ 1798.182

Added by Stats. 1993, Ch. 236, Sec. 1. Effective January 1, 1994.

The authority may authorize a poison control center, instead of providing poison control services directly, to contract with an entity in another state to provide poison control services during any part of the 24-hour period for which the center is required to provide poison control services, if both of the following conditions are met:

(a)The center is unable to provide poison control services 24 hours a day.

(b)The entity in the other state provides substantially the same poison control services as required under Section 1798.180, and regulations adopted pursuant thereto. An entity in another state shall not be deemed not to provide substantially the same poison control services solely because the staff of the entity is licensed in the other state, and not licensed in the State of California.

§ 1798.183

Added by Stats. 1993, Ch. 236, Sec. 2. Effective January 1, 1994.

The authority may authorize a poison control center to provide poison control services for fewer than 24 hours a day, as the authority deems necessary.

§ 1798.200

Amended by Stats. 2022, Ch. 28, Sec. 85. (SB 1380) Effective January 1, 2023.

(a)(1) (A) Except as provided in paragraph (2), an employer of an EMT-I or EMT-II may conduct investigations, as necessary, and take disciplinary action against an EMT-I or EMT-II who is employed by that employer for conduct in violation of subdivision (c). The employer shall notify the medical director of the local EMS agency that has jurisdiction in the county in which the alleged violation occurred within three days when an allegation has been validated as a potential violation of subdivision (c).

(B) Each employer of an EMT-I or EMT-II employee shall notify the medical director of the local EMS agency that has jurisdiction in the county

in which a violation related to subdivision (c) occurred within three days after the EMT-I or EMT-II is terminated or suspended for a disciplinary cause, the EMT-I or EMT-II resigns following notification of an impending investigation based upon evidence that would indicate the existence of a disciplinary cause, or the EMT-I or EMT-II is removed from EMT-related duties for a disciplinary cause after the completion of the employer’s investigation.

(C) At the conclusion of an investigation, the employer of an EMT-I or EMT-II may develop and implement, in accordance with the guidelines for disciplinary orders, temporary suspensions, and conditions of probation adopted pursuant to Section 1797.184, a disciplinary plan for the EMT-I or EMT-II. Upon adoption of the disciplinary plan, the employer shall submit that plan to the local EMS

agency within three working days. The employer’s disciplinary plan may include a recommendation that the medical director of the local EMS agency consider taking action against the holder’s certificate pursuant to paragraph (3).

(2)If an EMT-I or EMT-II is not employed by an ambulance service licensed by the Department of the California Highway Patrol or a public safety agency or if that ambulance service or public safety agency chooses not to conduct an investigation pursuant to paragraph (1) for conduct in violation of subdivision (c), the medical director of a local EMS agency shall conduct the investigations, and, upon a determination of disciplinary cause, take disciplinary action as necessary against the EMT-I or EMT-II. At the conclusion of these investigations, the medical director shall develop and implement, in accordance with the

recommended guidelines for disciplinary orders, temporary orders, and conditions of probation adopted pursuant to Section 1797.184, a disciplinary plan for the EMT-I or EMT-II. The medical director’s disciplinary plan may include action against the holder’s certificate pursuant to paragraph (3).

(3)The medical director of the local EMS agency may, upon a determination of disciplinary cause and in accordance with regulations for disciplinary processes adopted pursuant to Section 1797.184, deny, suspend, or revoke any EMT-I or EMT-II certificate issued under this division, or may place any EMT-I or EMT-II certificate holder on probation, upon the finding by that medical director of the occurrence of any of the actions listed in subdivision (c) and the occurrence of one of the following:

(A)The EMT-I or EMT-II employer, after conducting an investigation, failed to impose discipline for the conduct under investigation, or the medical director makes a determination that the discipline imposed was not according to the guidelines for disciplinary orders and conditions of probation and the conduct of the EMT-I or EMT-II certificate holder constitutes grounds for

disciplinary action against the certificate.

(B)Either the employer of an EMT-I or EMT-II further determines, after an investigation conducted under paragraph (1), or the medical director determines, after an investigation conducted under paragraph (2), that the conduct requires disciplinary action against the certificate.

(4)The medical director of the local EMS agency, after consultation with the employer of an EMT-I or EMT-II, may temporarily suspend, prior to a hearing, any EMT-I or EMT-II certificate or both EMT-I and EMT-II certificates upon a determination that both of the following conditions have been met:

(A)The certificate holder has engaged in acts or omissions that constitute grounds for

revocation of the EMT-I or EMT-II certificate.

(B)Permitting the certificate holder to continue to engage in the certified activity without restriction would pose an imminent threat to the public health or safety.

(5)If the medical director of the local EMS agency temporarily suspends a certificate, the local EMS agency shall notify the certificate holder that their EMT-I or EMT-II certificate is suspended and shall identify the reasons therefor. Within three working days of the initiation of the suspension by the local EMS agency, the agency and employer shall jointly investigate the allegation in order for the agency to make a determination of the continuation of the temporary suspension. All investigatory information not otherwise protected by law held by the agency and

employer shall be shared between the parties via facsimile transmission or overnight mail relative to the decision to temporarily suspend. The local EMS agency shall decide, within 15 calendar days, whether to serve the certificate holder with an accusation pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code. If the certificate holder files a notice of defense, the hearing shall be held within 30 days of the local EMS agency’s receipt of the notice of defense. The temporary suspension order shall be deemed vacated if the local EMS agency fails to make a final determination on the merits within 15 days after the administrative law judge renders the proposed decision.

(6)The medical director of the local EMS agency shall refer, for investigation and discipline, any complaint received

on an EMT-I or EMT-II to the relevant employer within three days of receipt of the complaint, pursuant to subparagraph (A) of paragraph (1) of subdivision (a).

(b)(1) The authority may deny, suspend, or revoke an EMT-P license issued under this division, or may place an EMT-P license issued under this division, or may place an EMT-P licenseholder on probation upon the finding by the director of the occurrence of any of the actions listed in subdivision (c). Proceedings against an EMT-P license or licenseholder shall be held in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.

(2)On and after January 1, 2023, the Paramedic Disciplinary Review Board shall act on appeals of the authority’s

final decision to place a licenseholder on probation, suspend or revoke an EMT-P license, and consider appeals regarding denial of licensure, pursuant to Article 2.5 (commencing with Section 1797.125) of Chapter 3 of this division.

(c)Any of the following actions shall be considered evidence of a threat to the public health and safety and may result in the denial, suspension, or revocation of a certificate or license issued under this division, or in the placement on probation of a certificate holder or licenseholder under this division:

(1)Fraud in the procurement of any certificate or license under this division.

(2)Gross negligence.

(3)Repeated

negligent acts.

(4)Incompetence.

(5)The commission of any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, and duties of prehospital personnel.

(6)Conviction of any crime that is substantially related to the qualifications, functions, and duties of prehospital personnel. The record of conviction or a certified copy of the record shall be conclusive evidence of the conviction.

(7)Violating or attempting to violate directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision of this division or the regulations adopted by the authority pertaining to

prehospital personnel.

(8)Violating or attempting to violate any federal or state statute or regulation that regulates narcotics, dangerous drugs, or controlled substances.

(9)Addiction to, the excessive use of, or the misuse of, alcoholic beverages, narcotics, dangerous drugs, or controlled substances.

(10)Functioning outside the supervision of medical control in the field care system operating at the local level, except as authorized by any other license or certification.

(11)Demonstration of irrational behavior or occurrence of a physical disability to the extent that a reasonable and prudent person would have reasonable cause to believe that the ability to

perform the duties normally expected may be impaired.

(12)Unprofessional conduct exhibited by any of the following:

(A)The mistreatment or physical abuse of any patient resulting from force in excess of what a reasonable and prudent person trained and acting in a similar capacity while engaged in the performance of their duties would use if confronted with a similar circumstance. Nothing in this section shall be deemed to prohibit an EMT-I, EMT-II, or EMT-P from assisting a peace officer, or a peace officer who is acting in the dual capacity of peace officer and EMT-I, EMT-II, or EMT-P, from using that force that is reasonably necessary to effect a lawful arrest or detention.

(B)The failure to maintain confidentiality of

patient medical information, except as disclosure is otherwise permitted or required by law in Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code.

(C)The commission of any sexually related offense specified under Section 290 of the Penal Code.

(d)The information shared among EMT-I, EMT-II, and EMT-P employers, medical directors of local EMS agencies, the authority, and EMT-I and EMT-II certifying entities shall be deemed to be an investigative communication that is exempt from public disclosure as a public record pursuant to Article 1 (commencing with Section 7923.600) of Chapter 1 of Part 5 of Division 10 of Title 1 of the Government Code. A formal disciplinary action against an EMT-I, EMT-II, or EMT-P shall be considered a public record available

to the public, unless otherwise protected from disclosure pursuant to state or federal law.

(e)For purposes of this section, “disciplinary cause” means an act that is substantially related to the qualifications, functions, and duties of an EMT-I, EMT-II, or EMT-P and is evidence of a threat to the public health and safety described in subdivision (c).

§ 1798.201

Amended by Stats. 2021, Ch. 615, Sec. 238. (AB 474) Effective January 1, 2022. Operative January 1, 2023, pursuant to Sec. 463 of Stats. 2021, Ch. 615.

(a)When information comes to the attention of the medical director of the local EMS agency that an EMT-P licenseholder has committed any act or omission that appears to constitute grounds for disciplinary action under this division, the medical director of the local EMS agency may evaluate the information to determine if there is reason to believe that disciplinary action may be necessary.

(b)If the medical director sends a recommendation to the authority for further investigation or discipline of the licenseholder, the recommendation shall include all documentary evidence collected by the medical director in evaluating whether or not to make

that recommendation. The recommendation and accompanying evidence shall be deemed in the nature of an investigative communication and be protected by the provisions listed in Section 7920.505 of the Government Code. In deciding what level of disciplinary action is appropriate in the case, the authority shall consult with the medical director of the local EMS agency.

§ 1798.202

Repealed and added by Stats. 1994, Ch. 709, Sec. 8. Effective January 1, 1995.

(a)The director of the authority or the medical director of the local EMS agency, after consultation with the relevant employer, may temporarily suspend, prior to hearing, any EMT-P license upon a determination that:

(1)the licensee has engaged in acts or omissions that constitute grounds for revocation of the EMT-P license; and (2) permitting the licensee to continue to engage in the licensed activity, or permitting the licensee to continue in the licensed activity without restriction, would present an imminent threat to the public health or safety. When the suspension is initiated by the local EMS agency, subdivision (b) shall apply. When the suspension is initiated by the director of the authority, subdivision (c) shall apply.

(b)The local EMS agency shall notify the licensee that his or her EMT-P license is suspended and shall identify the reasons therefor. Within three working days of the initiation of the suspension by the local EMS agency, the agency shall transmit to the authority, via facsimile transmission or overnight mail, all documentary evidence collected by the local EMS agency relative to the decision to temporarily suspend. Within two working days of receipt of the local EMS agency’s documentary evidence, the director of the authority shall determine the need for the licensure action. Part of that determination shall include an evaluation of the need for continuance of the suspension during the licensure action review process. If the director of the authority determines that the temporary suspension order should not continue, the authority shall immediately notify the licensee that the temporary suspension is lifted. If the director of the authority determines that the temporary suspension order should continue, the authority shall immediately notify the licensee of the decision to continue the temporary suspension and shall, within 15 calendar days of receipt of the EMS agency’s documentary evidence, serve the licensee with a temporary suspension order and accusation pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.

(c)The director of the authority shall initiate a temporary suspension with the filing of a temporary suspension order and accusation pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code and shall notify the director of the local EMS agency, and the relevant employer.

(d)If the licensee files a notice of defense, the hearing shall be held within 30 days of the authority’s receipt of the notice of defense. The temporary suspension order shall be deemed vacated if the authority fails to make a final determination on the merits within 15 days after the administrative law judge renders the proposed decision.

§ 1798.205

Added by Stats. 1987, Ch. 1240, Sec. 18.

Any alleged violations of local EMS agency transfer protocols, guidelines, or agreements shall be evaluated by the local EMS agency. If the local EMS agency has concluded that a violation has occurred, it shall take whatever corrective action it deems appropriate within its jurisdiction, including referrals to the district attorney under Sections 1798.206 and 1798.208 and shall notify the State Department of Health Services if it concludes that any violation of Sections 1317 to 1317.9a, inclusive, has occurred.

§ 1798.206

Amended by Stats. 1987, Ch. 1225, Sec. 17.

Any person who violates this part, the rules and regulations adopted pursuant thereto, or county ordinances adopted pursuant to this part governing patient transfers, is guilty of a misdemeanor. The Attorney General or the district attorney may prosecute any of these misdemeanors which falls within his or her jurisdiction.

§ 1798.207

Added by Stats. 1992, Ch. 215, Sec. 1. Effective January 1, 1993.

(a)It is a misdemeanor for any person to knowingly and willfully engage in conduct that subverts or attempts to subvert any licensing or certification examination, or the administration of any licensing or certification examination, conducted pursuant to this division, including, but not limited to, any of the following:

(1)Conduct that violates the security of the examination material.

(2)Removing from the examination room any examination materials without authorization.

(3)The unauthorized reproduction by any means of any portion of the actual licensing or certification examination.

(4)Aiding by any means the unauthorized reproduction of any portion of the actual licensing or certification examination.

(5)Paying or using professional or paid examination-takers, for the purpose of reconstructing any portion of the licensing or certification examination.

(6)Obtaining or attempting to obtain examination questions or other examination material from examinees or by any other method, except by specific authorization either before, during, or after an examination.

(7)Using or purporting to use any examination questions or materials that were improperly removed or taken from any examination for the purpose of instructing or preparing any applicant for examination.

(8)Selling, distributing, buying, receiving, or having unauthorized possession of any portion of a future, current, or previously administered licensing or certification examination.

(9)Communicating with any other examinee during the administration of a licensing or certification examination.

(10)Copying answers from another examinee or permitting one’s answers to be copied by another examinee.

(11)Having in one’s possession during the administration of the licensing or certification examination any books, equipment, notes written or printed materials, or data of any kind, other than the examination materials distributed, or otherwise authorized to be in one’s possession during the examination.

(12)Impersonating any examinee or having an impersonator take the licensing or certification examination on one’s behalf.

(b)The penalties provided in this section are not exclusive remedies and shall not preclude remedies provided pursuant to any other provision of law.

(c)In addition to any other penalties, a person found guilty of violating this section shall be liable for the actual damages sustained by the agency administering the examination not to exceed ten thousand dollars ($10,000) and the costs of litigation.

§ 1798.208

Amended by Stats. 1987, Ch. 1240, Sec. 19.

Whenever any person who has engaged, or is about to engage, in any act or practice which constitutes, or will constitute, a violation of any provision of this division, the rules and regulations promulgated pursuant thereto, or local EMS agency mandated protocols, guidelines, or transfer agreements, the superior court in and for the county wherein the acts or practices take place or are about to take place may issue an injunction or other appropriate order restraining the conduct on application of the authority, the Attorney General, or the district attorney of the county. The proceedings under this section shall be governed by Chapter 3 (commencing with Section 525) of Title 7 of Part 2 of the Code of Civil Procedure, except that no undertaking shall be required.

§ 1798.209

Added by Stats. 1994, Ch. 709, Sec. 9. Effective January 1, 1995.

The local EMS agency may place on probation, suspend, or revoke the approval under this division of any training program for failure to comply with this division or any rules or regulations adopted pursuant thereto.

§ 1798.210

Amended by Stats. 2021, Ch. 463, Sec. 8. (AB 450) Effective January 1, 2022.

(a)The Paramedic Disciplinary Review Board may impose an administrative fine of up to two thousand five hundred dollars ($2,500) per violation against a licensed paramedic found to have committed any of the actions described by subdivision (c) of Section 1798.200 that did not result in actual harm to a patient. Fines may not be imposed if a paramedic has previously been disciplined by the authority or the board for any other act committed within the immediately preceding five-year period.

(b)The board shall adopt regulations establishing an administrative fine structure, taking into account the nature and gravity of the violation. The

administrative fine shall not be imposed in conjunction with a suspension for the same violation, but may be imposed in conjunction with probation for the same violation except when the conditions of the probation require a paramedic’s personal time or expense for training, clinical observation, or related corrective instruction.

(c)In assessing the fine, the board shall give due consideration to the appropriateness of the amount of the fine with respect to factors that include the gravity of the violation, the good faith of the paramedic, the history of previous violations, any discipline imposed by the paramedic’s employer for the same occurrence of that conduct, as reported pursuant to Section 1799.112, and the totality of the discipline to be imposed. The imposition of the fine shall be subject to the administrative adjudication

provisions set forth in Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.

(d)If a paramedic does not pay the administrative fine imposed by the board and chooses not to renew their license, the board may enforce the order for repayment in any appropriate court. This right of enforcement shall be in addition to any other rights the board may have to require a paramedic to pay costs.

(e)In any action for collection of an administrative fine, proof of the board’s decision shall be conclusive proof of the validity of the order of payment and the terms for payment.

(f)(1) Except as provided in paragraph (2), the authority shall not license or renew the

license of any paramedic who has failed to pay an administrative fine ordered under this section.

(2)The authority may, in its discretion, conditionally license or renew for a maximum of one year the license of any paramedic who demonstrates financial hardship and who enters into a formal agreement with the board to reimburse the board within that one-year period for the unpaid fine.

(g)All funds recovered under this section shall be deposited into the state General Fund.

(h)This section does not preclude the board from imposing an administrative fine in a stipulated settlement.

(i)For purposes of this section, “licensed paramedic” includes a paramedic

whose license has lapsed or has been surrendered.

§ 1798.211

Amended by Stats. 2021, Ch. 463, Sec. 9. (AB 450) Effective January 1, 2022.

When making a decision regarding a disciplinary action pursuant to Section 1798.200 or Section 1798.210, the authority, the board, and, if applicable, the administrative law judge, shall give credit for the time during which the licensee was subject to disciplinary action imposed by the employer and for the time during which the licensee was under immediate suspension imposed by the local EMS agency for the same conduct.