1797.160. No owner of a publicly or privately owned ambulance shall
permit the operation of the ambulance in emergency service unless
the attendant on duty therein, or, if there is no attendant on duty
therein, the operator, possesses evidence of that specialized
training as is reasonably necessary to ensure that the attendant or
operator is competent to care for sick or injured persons who may be
transported by the ambulance, as set forth in the emergency medical
training and educational standards for ambulance personnel
established by the authority pursuant to this article. This section
shall not be applicable in any state of emergency declared pursuant
to the California Emergencies Services Act (Chapter 7 (commencing
with Section 8550) of Division 1 of Title 2 of the Government Code),
when it is necessary to fully utilize all available ambulances in an
area and it is not possible to have the ambulance operated or
attended by persons with the qualifications required by this section.
1797.170. (a) The authority shall develop and, after approval by
the commission pursuant to Section 1799.50, adopt regulations for the
training and scope of practice for EMT-I certification.
(b) Any individual certified as an EMT-I pursuant to this division
shall be recognized as an EMT-I on a statewide basis, and
recertification shall be based on statewide standards. Effective July
1, 1990, any individual certified as an EMT-I pursuant to this act
shall complete 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 Public Health in consultation with experts in
the field of sudden infant death syndrome.
1797.171. (a) The authority shall develop, and after approval of
the commission pursuant to Section 1799.50, shall adopt, minimum
standards for the training and scope of practice for EMT-II.
(b) An EMT-II shall complete a course of training on the nature of
sudden infant death syndrome in accordance with subdivision (b) of
Section 1797.170.
(c) In rural or remote areas of the state where patient transport
times are particularly long and where local resources are inadequate
to support an EMT-P program for EMS responses, the director may
approve additions to the scope of practice of EMT-IIs serving the
local system, if requested by the medical director of the local EMS
agency, and if the EMT-II has received training equivalent to that of
an EMT-P. The approval of the director, in consultation with a
committee of local EMS medical directors named by the Emergency
Medical Directors Association of California, is required prior to
implementation of any addition to a local optional scope of practice
for EMT-IIs proposed by the medical director of a local EMS agency.
No drug or procedure that is not part of the basic EMT-P scope of
practice, including, but not limited to, any approved local options,
shall be added to any EMT-II scope of practice pursuant to this
subdivision.
Approval of additions to the scope of practices pursuant to this
subdivision may be given only for EMT-II programs in effect on
January 1, 1994.
1797.172. (a) The authority shall develop and, after approval by
the commission pursuant to Section 1799.50, adopt minimum standards
for the training and scope of practice for EMT-P.
(b) The approval of the director, in consultation with a committee
of local EMS medical directors named by the EMS Medical Directors
Association of California, is required prior to implementation of any
addition to a local optional scope of practice for EMT-Ps proposed
by the medical director of a local EMS agency.
(c) Notwithstanding any other provision of law, the authority
shall be the agency solely responsible for licensure and licensure
renewal of EMT-Ps who meet the standards and are not precluded from
licensure because of any of the reasons listed in subdivision (d) of
Section 1798.200. Each application for licensure or licensure renewal
shall require the applicant's social security number in order to
establish the identity of the applicant. The information obtained as
a result of a state and federal level criminal offender record
information search shall be used in accordance with Section 11105 of
the Penal Code, and to determine whether the applicant is subject to
denial of licensure or licensure renewal pursuant to this division.
Submission of fingerprint images to the Department of Justice may not
be required for licensure renewal upon determination by the
authority that fingerprint images have previously been submitted to
the Department of Justice during initial licensure, or a previous
licensure renewal, provided that the license has not lapsed and the
applicant has resided continuously in the state since the initial
licensure.
(d) The authority shall charge fees for the licensure and
licensure renewal of EMT-Ps in an amount sufficient to support the
authority's licensure program at a level that ensures the
qualifications of the individuals licensed to provide quality care.
The basic fee for licensure or licensure renewal of an EMT-P shall
not exceed one hundred twenty-five dollars ($125) until the adoption
of regulations that specify a different amount that does not exceed
the authority's EMT-P licensure, license renewal, and enforcement
programs. The authority shall annually evaluate fees to determine if
the fee is sufficient to fund the actual costs of the authority's
licensure, licensure renewal, and enforcement programs. If the
evaluation shows that the fees are excessive or are insufficient to
fund the actual costs of the authority's EMT-P licensure, licensure
renewal, and enforcement programs, then the fees shall be adjusted
accordingly through the rulemaking process described 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).
Separate additional fees may be charged, at the option of the
authority, for services that are not shared by all applicants for
licensure and licensure renewal, including, but not limited to, any
of the following services:
(1) Initial application for licensure as an EMT-P.
(2) Competency testing, the fee for which shall not exceed thirty
dollars ($30), except that an additional fee may be charged for the
cost of any services that provide enhanced availability of the exam
for the convenience of the EMT-P, such as on-demand electronic
testing.
(3) Fingerprint and criminal record check. The applicant shall, if
applicable according to subdivision (c), submit fingerprint images
and related information for criminal offender record information
searches with the Department of Justice and the Federal Bureau of
Investigation.
(4) Out-of-state training equivalency determination.
(5) Verification of continuing education for a lapse in licensure.
(6) Replacement of a lost licensure card. The fees charged for
individual services shall be set so that the total fees charged to
EMT-Ps shall not exceed the authority's actual total cost for the
EMT-P licensure program.
(e) The authority may provide nonconfidential, nonpersonal
information relating to EMS programs to interested persons upon
request, and may establish and assess fees for the provision of this
information. These fees shall not exceed the costs of providing the
information.
(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 EMT-P 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 Services Personnel 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.
1797.173. The authority shall assure that all training programs for
EMT-I, EMT-II, and EMT-P are located in an approved licensed
hospital or an educational institution operated with written
agreements with an acute care hospital, including a public safety
agency that has been approved by the local emergency medical services
agency to provide training. The authority shall also assure that
each training program has a competency-based curriculum. EMT-I
training and testing for fire service personnel may be offered at
sites approved by the State Board of Fire Services and training for
officers of the California Highway Patrol may be provided at the
California Highway Patrol Academy.
1797.174. In consultation with the commission, the Emergency
Medical Directors Association of California, and other affected
constituencies, the authority shall develop statewide guidelines for
continuing education courses and approval of continuing education
courses for EMT-Ps and for quality improvement systems which monitor
and promote improvement in the quality of care provided by EMT-Ps
throughout the state.
1797.175. The authority shall establish the standards for
continuing education and shall designate the examinations for
certification and recertification of all prehospital personnel.
The authority shall consider including training regarding the
characteristics and method of assessment and treatment of acquired
immune deficiency syndrome (AIDS).
1797.176. The authority shall establish the minimum standards for
the policies and procedures necessary for medical control of the EMS
system.
1797.177. No individual shall hold himself or herself out to be an
EMT-I, EMT-II, EMT-P, or paramedic unless that individual is
currently certified as such by the local EMS agency or other
certifying authority.
1797.178. No person or organization shall provide advanced life
support or limited advanced life support unless that person or
organization is an authorized part of the emergency medical services
system of the local EMS agency or of a pilot program operated
pursuant to the Wedworth-Townsend Paramedic Act, Article 3
(commencing with Section 1480) of Chapter 2.5 of Division 2.
1797.179. Notwithstanding any other provision of law, and to the
extent federal financial participation is available, any city, county
or special district providing paramedic services as set forth in
Section 1797.172, shall reimburse the Health Care Deposit Fund for
the state costs of paying such medical claims. Funds allocated to the
county from the County Health Services Fund pursuant to Part 4.5
(commencing with Section 16700) of Division 9 of the Welfare and
Institutions Code may be utilized by the county or city to make such
reimbursement.
1797.180. No agency, public or private, shall advertise or
disseminate information to the public that the agency provides EMT-II
or EMT-P rescue or ambulance services unless that agency does in
fact provide this service on a continuous 24 hours-per-day basis. If
advertising or information regarding that agency's EMT-II or EMT-P
rescue or ambulance service appears on any vehicle it may only appear
on those vehicles utilized solely to provide that service on a
continuous 24 hours-per-day basis.
1797.181. The authority may, by regulation, prescribe standardized
insignias or emblems for patches which may be affixed to the clothing
of an EMT-I, EMT-II, or EMT-P.
1797.182. All ocean, public beach, and public swimming pool
lifeguards and all firefighters in this state, except those whose
duties are primarily clerical or administrative, shall be trained to
administer first aid and cardiopulmonary resuscitation. The training
shall meet standards prescribed by the authority, and shall be
satisfactorily completed by such persons as soon as practical, but in
no event more than one year after the date of employment.
Satisfactory completion of a refresher course which meets the
standards prescribed by the authority in cardiopulmonary
resuscitation and other first aid shall be required at least every
three years.
The authority may designate a public agency or private nonprofit
agency to provide for each county the training required by this
section. The training shall be provided at no cost to the trainee.
As used in this section, "lifeguard" means any regularly employed
and paid officer, employee, or member of a public aquatic safety
department or marine safety agency of the State of California, a
city, county, city and county, district, or other public or municipal
corporation or political subdivision of this state.
As used in this section, "firefighter" means any regularly
employed and paid officer, employee, or member of a fire department
or fire protection or firefighting agency of the State of California,
a city, county, city and county, district, or other public or
municipal corporation or political subdivision of this state or
member of an emergency reserve unit of a volunteer fire department or
fire protection district.
1797.183. All peace officers described in Section 13518 of the
Penal Code, except those whose duties are primarily clerical or
administrative, shall be trained to administer first aid and
cardiopulmonary resuscitation (CPR). The training shall meet
standards prescribed by the authority, in consultation with the
Commission on Peace Officers Standards and Training, and shall be
satisfactorily completed by those officers as soon as practical, but
in no event more than one year after the date of employment.
Satisfactory completion of either refresher training or appropriate
testing, which meets the standards of the authority, in
cardiopulmonary resuscitation and other first aid, shall be required
at periodic intervals as determined by the authority.
1797.184. The authority shall develop and, after approval by the
commission pursuant to Section 1799.50, adopt all of the following:
(a) Guidelines for disciplinary orders, temporary suspensions, and
conditions of probation for EMT-I and EMT-II certificate holders
that protects the public health and safety.
(b) Regulations for the issuance of EMT-I and EMT-II certificates
by a certifying entity that protects the public health and safety.
(c) Regulations for the recertification of EMT-I and EMT-II
certificate holders that protect the public health and safety.
(d) Regulations for disciplinary processes for EMT-I and EMT-II
applicants and certificate holders that protect the public health and
safety. These disciplinary processes shall be in accordance with
Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of
Title 2 of the Government Code.
1797.185. (a) The authority shall establish criteria for the
statewide recognition of the certification of EMT-P personnel in the
basic scope of practice of those personnel. The criteria shall
include, but need not be limited to, the following:
(1) Standards for training, testing, certification, and revocation
of certification, as required for statewide recognition of
certification. The standards may include designation by the authority
of the specific examinations required for certification, including,
at the option of the authority, an examination provided by the
authority. At the option of the authority, the standards may include
a requirement for registration of prehospital emergency care
personnel with the authority or other entity designated by the
authority.
(2) Conditions for local accreditation of certified EMT-P
personnel which are reasonable in order to maintain medical control
and the integrity of the local EMS system, as determined by the
authority and approved by the commission.
(3) Provisions for local accreditation in approved optional scope
of practice, if any, as allowed by applicable state regulations and
statutes.
(4) Provisions for the establishment and collection of fees by the
appropriate agency, which may be the authority or an entity
designated by the authority to collect fees for the authority, for
testing, certification, accreditation, and registration with the
appropriate state or local agency in the appropriate scope of
practice. 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 Services Personnel Fund within
30 calendar days following the last day of the calendar month in
which the fees were received by the designated entity.
(b) After January 1, 1991, all regulations for EMT-P personnel
adopted by the authority shall, where relevant, include provisions
for statewide recognition of certification or authorization for the
scope of practice of those personnel.
(c) On or before July 1, 1991, the authority shall amend all
relevant regulations for EMT-P personnel to include criteria
developed pursuant to subdivision (c) of Section 1797.7 and
subdivision (b) of Section 1797.172 to insure statewide recognition
of certification for the scope of practice of those personnel.
(d) All future regulations for EMT-P personnel adopted by the
authority shall, where relevant, include provisions for statewide
recognition of certification or authorization for the scope of
practice of those personnel.
1797.186. All persons described in Sections 1797.170, 1797.171,
1797.172, 1797.182, and 1797.183, whether volunteers, partly paid, or
fully paid, shall be entitled to prophylactic medical treatment to
prevent the onset of disease, provided that the person demonstrates
that he or she was exposed, while in the service of the department or
unit, to a contagious disease, as listed in Section 2500 of Title 17
of the California Administrative Code, while performing first aid or
cardiopulmonary resuscitation services to any person.
Medical treatment under this section shall not affect the
provisions of Division 4 (commencing with Section 3200) or Division 5
(commencing with Section 6300) of the Labor Code or the person's
right to make a claim for work-related injuries, at the time the
contagious disease manifests itself.
1797.187. A peace officer as described in Section 830.1,
subdivision (a) of Section 830.2, or subdivision (g) of Section 830.3
of the Penal Code, while in the service of the agency or local
agency which employs him or her, shall be notified by the agency or
local agency if the peace officer is exposed to a known carcinogen,
as defined by the International Agency for Research on Cancer, or as
defined by its director, during the investigation of any place where
any controlled substance, as defined in Section 11007 is suspected of
being manufactured, stored, transferred, or sold, or any toxic waste
spills, accidents, leaks, explosions, or fires.
The Commission on Peace Officers Standards and Training basic
training course, and other training courses as the commission
determines appropriate, shall include, on or before January 1, 1990,
instruction on, but not limited to, the identification and handling
of possible carcinogenic materials and the potential health hazards
associated with these materials, protective equipment, and clothing
available to minimize contamination, handling, and disposing of
materials and measures and procedures that can be adopted to minimize
exposure to possible hazardous materials.
1797.188. (a) As used in this section:
(1) "Prehospital emergency medical care person or personnel" means
any of the following: an authorized registered nurse or mobile
intensive care nurse, emergency medical technician-I, emergency
medical technician-II, emergency medical technician-paramedic,
lifeguard, firefighter, or peace officer, as defined or described by
Sections 1797.56, 1797.80, 1797.82, 1797.84, 1797.182, and 1797.183,
respectively, or a physician and surgeon who provides prehospital
emergency medical care or rescue services.
(2) "Reportable disease or condition" or "a disease or condition
listed as reportable" means those diseases prescribed by Subchapter 1
(commencing with Section 2500) of Chapter 4 of Title 17 of the
California Administrative Code, as may be amended from time to time.
(3) "Exposed" means at risk for contracting the disease, as
defined by regulations of the state department.
(4) "Health facility" means a health facility, as defined in
Section 1250, including a publicly operated facility.
(b) In addition to the communicable disease testing and
notification procedures applicable under Chapter 3.5 (commencing with
Section 120260) of Part 1 of Division 105, all prehospital emergency
medical care personnel, whether volunteers, partly paid, or fully
paid, who have provided emergency medical or rescue services and have
been exposed to a person afflicted with a disease or condition
listed as reportable, which can, as determined by the county health
officer, be transmitted through oral contact or secretions of the
body, including blood, shall be notified that they have been exposed
to the disease and should contact the county health officer if all
the following are satisfied:
(1) The prehospital emergency medical care person, who has
rendered emergency medical or rescue services and has been exposed to
a person afflicted with a reportable disease or condition, provides
the health facility with his or her name and telephone number at the
time the patient is transferred from that prehospital emergency
medical care person to the admitting health facility; or the party
transporting the person afflicted with the reportable disease or
condition provides that health facility with the name and telephone
number of the prehospital emergency medical care person who provided
the emergency medical or rescue services.
(2) The health facility reports the name and telephone number of
the prehospital emergency medical care person to the county health
officer upon determining that the person to whom the prehospital
emergency medical care person provided the emergency medical or
rescue services is diagnosed as being afflicted with a reportable
disease or condition.
(c) The county health officer shall immediately notify the
prehospital emergency medical care person who has provided emergency
medical or rescue services and has been exposed to a person afflicted
with a disease or condition listed as reportable, which can, as
determined by the county health officer, be transmitted through oral
contact or secretions of the body, including blood, upon receiving
the report from a health facility pursuant to paragraph (1) of
subdivision (b). The county health officer shall not disclose the
name of the patient or other identifying characteristics to the
prehospital emergency medical care person.
Nothing in this section shall be construed to authorize the
further disclosure of confidential medical information by the health
facility or any prehospital emergency medical care personnel
described in this section except as otherwise authorized by law.
In the event of the demise of the person afflicted with the
reportable disease or condition, the health facility or county health
officer shall notify the funeral director, charged with removing the
decedent from the health facility, of the reportable disease prior
to the release of the decedent from the health facility to the
funeral director.
Notwithstanding Section 1798.206, violation of this section is not
a misdemeanor.
1797.189. (a) As used in this section:
(1) "Chief medical examiner-coroner" means the chief medical
examiner or the coroner as referred to in subdivision (m) of Section
24000, Section 24010, subdivisions (k), (m), and (n) of Section
24300, subdivisions (k), (m), and (n) of Section 24304, and Sections
27460 to 27530, inclusive, of the Government Code, and Section
102850.
(2) "Prehospital emergency medical care person or personnel" means
any of the following: authorized registered nurse or mobile
intensive care nurse, emergency medical technician-I, emergency
medical technician-II, emergency medical technician-paramedic,
lifeguard, firefighter, or peace officer, as defined or described by
Sections 1797.56, 1797.80, 1797.82, 1797.84, 1797.182, and 1797.183,
respectively, or a physician and surgeon who provides prehospital
emergency medical care or rescue services.
(3) "Reportable disease or condition" or "a disease or condition
listed as reportable" means those diseases specified in Subchapter 1
(commencing with Section 2500) of Chapter 4 of Title 17 of the
California Administrative Code, as may be amended from time to time.
(4) "Exposed" means at risk for contracting a disease, as defined
by regulations of the state department.
(5) "Health facility" means a health facility, as defined in
Section 1250, including a publicly operated facility.
(b) Any prehospital emergency medical care personnel, whether
volunteers, partly paid, or fully paid who have provided emergency
medical or rescue services and have been exposed to a person
afflicted with a disease or condition listed as reportable, that can,
as determined by the county health officer, be transmitted through
oral contact or secretions of the body, including blood, shall be
notified that they have been exposed to the disease and should
contact the county health officer if all of the following conditions
are met:
(1) The prehospital emergency medical care person, who has
rendered emergency medical or rescue services and has been exposed to
a person afflicted with a reportable disease or condition, provides
the chief medical examiner-coroner with his or her name and telephone
number at the time the patient is transferred from that prehospital
medical care person to the chief medical examiner-coroner; or the
party transporting the person afflicted with the reportable disease
or condition provides that chief medical examiner-coroner with the
name and telephone number of the prehospital emergency medical care
person who provided the emergency medical or rescue services.
(2) The chief medical examiner-coroner reports the name and
telephone number of the prehospital emergency medical care person to
the county health officer upon determining that the person to whom
the prehospital emergency medical care person provided the emergency
medical or rescue services is diagnosed as being afflicted with a
reportable disease or condition.
(c) The county health officer shall immediately notify the
prehospital emergency medical care person who has provided emergency
medical or rescue services and has been exposed to a person afflicted
with a disease or condition listed as reportable, that can, as
determined by the county health officer, be transmitted through oral
contact or secretions of the body, including blood, upon receiving
the report from a health facility pursuant to paragraph (1) of
subdivision (b). The county health officer shall not disclose the
name of the patient or other identifying characteristics to the
prehospital emergency medical care person.
Nothing in this section shall be construed to authorize the
further disclosure of confidential medical information by the chief
medical examiner-coroner or any of the prehospital emergency medical
care personnel described in this section except as otherwise
authorized by law.
The chief medical examiner-coroner, or the county health officer
shall notify the funeral director, charged with removing or receiving
the decedent afflicted with a reportable disease or condition from
the chief medical examiner-coroner, of the reportable disease prior
to the release of the decedent from the chief medical
examiner-coroner to the funeral director.
Notwithstanding Section 1798.206, violation of this section is not
a misdemeanor.
1797.190. The authority may establish minimum standards for the
training and use of automatic external defibrillators.
1797.191. (a) The authority shall establish minimum standards for
the training in pediatric first aid, pediatric cardiopulmonary
resuscitation (CPR), and preventive health practices required by
Section 1596.866.
(b) (1) The authority shall establish a process for the ongoing
review and approval of training programs in pediatric first aid,
pediatric CPR, and preventive health practices as specified in
paragraph (2) of subdivision (a) of Section 1596.866 to ensure that
those programs meet the minimum standards established pursuant to
subdivision (a). The authority shall charge fees equal to its costs
incurred for the pediatric first aid and pediatric CPR training
standards program and for the ongoing review and approval of these
programs.
(2) The authority shall establish, in consultation with experts in
pediatric first aid, pediatric CPR, and preventive health practices,
a process to ensure the quality of the training programs, including,
but not limited to, a method for assessing the appropriateness of
the courses and the qualifications of the instructors.
(c) (1) The authority may charge a fee equal to its costs incurred
for the preventive health practices program and for the initial
review and approval and renewal of approval of the program.
(2) If the authority chooses to establish a fee process based on
the use of course completion cards for the preventive health
practices program, the cost shall not exceed seven dollars ($7) per
card for each training participant until January 1, 2001, at which
time the authority may evaluate its administrative costs. After
evaluation of the costs, the authority may establish a new fee scale
for the cards so that revenue does not exceed the costs of the
ongoing review and approval of the preventive health practices
training.
(d) For the purposes of this section, "training programs" means
programs that apply for approval by the authority to provide the
training in pediatric first aid, pediatric CPR, or preventive health
practices as specified in paragraph (2) of subdivision (a) of Section
1596.866. Training programs include all affiliated programs that
also provide any of the authority-approved training required by this
division. "Affiliated programs" means programs that are overseen by
persons or organizations that have an authority-approved training
program in pediatric first aid, pediatric CPR, or preventive health
practices. Affiliated programs also include programs that have
purchased an authority-approved training program in pediatric first
aid, pediatric CPR, or preventive health practices. Training programs
and their affiliated programs shall comply with this division and
with the regulations adopted by the authority pertaining to training
programs in pediatric first aid, pediatric CPR, or preventive health
practices.
(e) The director of the authority may, in accordance with
regulations adopted by the authority, deny, suspend, or revoke any
approval issued under this division or may place any approved program
on probation, upon the finding by the director of the authority of
an imminent threat to the public health and safety as evidenced by
the occurrence of any of the actions listed in subdivision (f).
(f) 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, probation, or revocation of a program's approval
or application for approval pursuant to this division.
(1) Fraud.
(2) Incompetence.
(3) The commission of any fraudulent, dishonest, or corrupt act
that is substantially related to the qualifications, functions, and
duties of training program directors and instructors.
(4) Conviction of any crime that is substantially related to the
qualifications, functions, and duties of training program directors
and instructors. The record of conviction or a certified copy of the
record shall be conclusive evidence of the conviction.
(5) Violating or attempting to violate, directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
this division or the regulations promulgated by the authority
pertaining to the review and approval of training programs in
pediatric first aid, pediatric CPR, and preventive health practices
as specified in paragraph (2) of subdivision (a) of Section 1596.866.
(g) In order to ensure that adequate qualified training programs
are available to provide training in the preventive health practices
course to all persons who are required to have that training, the
authority may, after approval of the Commission on Emergency Medical
Services pursuant to Section 1799.50, establish temporary standards
for training programs for use until permanent standards are adopted
pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of
Division 3 of Title 2 of the Government Code.
(h) Persons who, prior to the date on which the amendments to this
section enacted in 1998 become operative, have completed a course or
courses in preventive health practices as specified in subparagraph
(C) of paragraph (2) of subdivision (a) of Section 1596.866, and have
a certificate of completion card for a course or courses in
preventive health practices, or certified copies of transcripts that
identify the number of hours and the specific course or courses taken
for training in preventive health practices shall be deemed to have
met the requirement for training in preventive health practices.
1797.192. On or before July 1, 1991, the authority shall adopt
standards for a standard statewide scope of practice which shall be
utilized for the training and certification testing of EMT-P
personnel for certification as EMT-P's. Local EMS systems shall not
be required to utilize the entire standard scope of practice. Testing
of EMT-P personnel for local accreditation to practice shall only
include local operational policies and procedures, and drug, device,
or treatment procedures being utilized within that local EMS system
pursuant to Sections 1797.172 and 1797.221.
1797.193. (a) By July 1, 1992, existing firefighters in this state
shall complete a course on the nature of sudden infant death syndrome
taught by experts in the field of sudden infant death syndrome. All
persons who become firefighters after January 1, 1990, shall complete
a course on this topic as part of their basic training as
firefighters. The course shall include information on the community
resources available to assist families who have lost children to
sudden infant death syndrome.
(b) For purposes of this section, the term "firefighter" has the
same meaning as that specified in Section 1797.182.
(c) When the instruction and training are provided by a local
agency, a fee shall be charged sufficient to defray the entire cost
of the instruction and training.
1797.194. The purpose of this section is to provide for the state
licensure of EMT-P personnel. Notwithstanding any provision of law,
including, but not limited to, Sections 1797.208 and 1797.214, all of
the following applies to EMT-P personnel:
(a) Any reference to EMT-P certification pursuant to this division
shall be equivalent to EMT-P licensure pursuant to this division,
including, but not limited to, any provision in this division
relating to the assessment of fees.
(b) The statewide examination designated by the authority for
licensure of EMT-P personnel and the licensure issued by the
authority shall be the single sufficient examination and licensure
required for practice as an EMT-P.
(c) EMT-P licenses shall be renewed every two years upon
submission to the authority of proof of satisfactory completion of
continuing education or other educational requirements established by
regulations of the authority, upon approval by the commission. If
the evaluation and recommendations of the authority required pursuant
to Section 8 of Chapter 997 of the Statutes of 1993, so concludes,
the renewal of EMT-P licenses shall, in addition to continuing
education requirements, be contingent upon reexamination at 10-year
intervals to ensure competency.
(d) Every EMT-P licensee may be disciplined by the authority for
violations of this division. The proceedings under this subdivision
shall be conducted in accordance with Chapter 5 (commencing with
Section 11500) of Part 1 of Division 3 of Title 2 of the Government
Code, and the authority shall have all the powers granted therein for
this purpose.
(e) Nothing in this section shall be construed to extend the scope
of practice of an EMT-P beyond prehospital settings, as defined by
regulations of the authority.
(f) Nothing in this section shall be construed to alter or
interfere with the local EMS agency's ability to locally accredit
licensed EMT-Ps.
(g) Nothing in this section shall be construed to hinder the
ability of the medical director of the local EMS agency to maintain
medical control within the local EMS system in accordance with this
division, including, but not limited to, Chapter 5 (commencing with
Section 1798).
1797.195. (a) Notwithstanding any other provision of law to the
contrary, an EMT-I, EMT-II, or EMT-P may provide emergency medical
care pursuant to this section in the emergency department of a
hospital that meets the definition of small and rural hospital
pursuant to Section 1188.855, except that in the case of a hospital
meeting the definition contained in Section 1188.855 the population
of the incorporated place or census designated place where the
hospital is located shall not have increased to more than 20,000
since 1980, and all of the following conditions are met:
(1) The EMT-I, EMT-II, or EMT-P is on duty as a prehospital
emergency medical care provider.
(2) The EMT-I, EMT-II, or EMT-P shall function under direct
supervision as defined in hospital protocols that have been issued
pursuant to paragraph (3), and only where the physician and surgeon
or the registered nurse determines that the emergency department is
faced with a patient crisis, and that the services of the EMT-I,
EMT-II, or EMT-P are necessary to temporarily meet the health care
needs of the patients in the emergency department.
(3) The utilization of an EMT-I, EMT-II, or EMT-P in the emergency
department is done pursuant to hospital protocols that have been
developed by the hospital's nursing staff, the physician and surgeon
medical director of the emergency department, and the administration
of the hospital, with the approval of the medical staff, and that
shall include at least all of the following:
(A) A requirement that the EMT-I, EMT-II, or EMT-P successfully
complete a hospital training program on the protocols and procedures
of the hospital emergency department. The program shall include, but
not be limited to, features of the protocols for which the EMT-I,
EMT-II, or EMT-P has not previously received training and a
postprogram evaluation.
(B) A requirement that the EMT-I, EMT-II, or EMT-P annually
demonstrates and documents to the hospital competency in the
emergency department procedures.
(C) The emergency medical care to be provided in the emergency
department by the EMT-I, EMT-II, or EMT-P shall be set forth or
referenced in the protocols and shall be limited to that which is
otherwise authorized by their certification or licensure as defined
in statute or regulation. The protocols shall not include patient
assessment in this setting, except when the assessment is directly
related to the specific task the EMT-I, EMT-II, and EMT-P is
performing.
(D) A process for continuity of patient care when the EMT-I,
EMT-II, or EMT-P is called to an off-site emergency situation.
(E) Procedures for the supervision of the EMT-I, EMT-II, or EMT-P.
(4) The protocols for utilization of an EMT-I, EMT-II, or EMT-P in
the emergency department are developed in consultation with the
medical director of the local EMS agency and the emergency medical
care committee, if a committee has been formed.
(5) A written contract shall be in effect relative to the services
provided pursuant to this section, between the ambulance company and
the hospital, where the EMT-I, EMT-II, or EMT-P is employed by an
ambulance company that is not owned by the hospital.
(b) When services of emergency personnel are called upon pursuant
to this section, responsibility for the medical direction of the
EMT-I, EMT-II, or EMT-P rests with the hospital, pursuant to the
hospital protocols as set forth in paragraph (3) of subdivision (a).
(c) Although this section authorizes the provision of services in
an emergency department of certain small and rural hospitals, nothing
in this section is intended to expand or restrict the types of
services or care to be provided by EMT-I, EMT-II, or EMT-P pursuant
to this article.
1797.196. (a) For purposes of this section, "AED" or "defibrillator"
means an automated or automatic external defibrillator.
(b) In order to ensure public safety, any person or entity that
acquires an AED is not liable for any civil damages resulting from
any acts or omissions in the rendering of the emergency care under
subdivision (b) of Section 1714.21 of the Civil Code, if that person
or entity does all of the following:
(1) Complies with all regulations governing the placement of an
AED.
(2) Ensures all of the following:
(A) That the AED is maintained and regularly tested according to
the operation and maintenance guidelines set forth by the
manufacturer, the American Heart Association, and the American Red
Cross, and according to any applicable rules and regulations set
forth by the governmental authority under the federal Food and Drug
Administration and any other applicable state and federal authority.
(B) That the AED is checked for readiness after each use and at
least once every 30 days if the AED has not been used in the
preceding 30 days. Records of these checks shall be maintained.
(C) That any person who renders emergency care or treatment on a
person in cardiac arrest by using an AED activates the emergency
medical services system as soon as possible, and reports any use of
the AED to the licensed physician and to the local EMS agency.
(D) For every AED unit acquired up to five units, no less than one
employee per AED unit shall complete a training course in
cardiopulmonary resuscitation and AED use that complies with the
regulations adopted by the Emergency Medical Service Authority and
the standards of the American Heart Association or the American Red
Cross. After the first five AED units are acquired, for each
additional five AED units acquired, one employee shall be trained
beginning with the first AED unit acquired. Acquirers of AED units
shall have trained employees who should be available to respond to an
emergency that may involve the use of an AED unit during normal
operating hours.
(E) That there is a written plan that describes the procedures to
be followed in the event of an emergency that may involve the use of
an AED, to ensure compliance with the requirements of this section.
The written plan shall include, but not be limited to, immediate
notification of 911 and trained office personnel at the start of AED
procedures.
(3) When an AED is placed in a building, building owners shall
ensure that tenants annually receive a brochure, approved as to
content and style by the American Heart Association or American Red
Cross, which describes the proper use of an AED, and also ensure that
similar information is posted next to any installed AED.
(4) When an AED is placed in a building, no less than once a year,
building owners shall notify their tenants as to the location of AED
units in the building.
(5) When an AED is placed in a public or private K-12 school, the
principal shall ensure that the school administrators and staff
annually receive a brochure, approved as to contents and style by the
American Heart Association or the American Red Cross, that describes
the proper use of an AED. The principal shall also ensure that
similar information is posted next to every AED. The principal shall,
at least annually, notify school employees as to the location of all
AED units on the campus. The principal shall designate the trained
employees who shall be available to respond to an emergency that may
involve the use of an AED during normal operating hours. As used in
this paragraph, "normal operating hours" means during the hours of
classroom instruction and any school-sponsored activity occurring on
school grounds.
(c) Any person or entity that supplies an AED shall do all of the
following:
(1) Notify an agent of the local EMS agency of the existence,
location, and type of AED acquired.
(2) Provide to the acquirer of the AED all information governing
the use, installation, operation, training, and maintenance of the
AED.
(d) A violation of this provision is not subject to penalties
pursuant to Section 1798.206.
(e) The protections specified in this section do not apply in the
case of personal injury or wrongful death that results from the gross
negligence or willful or wanton misconduct of the person who renders
emergency care or treatment by the use of an AED.
(f) Nothing in this section or Section 1714.21 may be construed to
require a building owner or a building manager to acquire and have
installed an AED in any building.
(g) This section shall remain in effect only until January 1,
2013, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2013, deletes or extends
that date.
1797.196. (a) For purposes of this section, "AED" or "defibrillator"
means an automated or automatic external defibrillator.
(b) In order to ensure public safety, any person who acquires an
AED shall do all of the following:
(1) Comply with all regulations governing the training, use, and
placement of an AED.
(2) Notify an agent of the local EMS agency of the existence,
location, and type of AED acquired.
(3) Ensure all of the following:
(A) That expected AED users complete a training course in
cardiopulmonary resuscitation and AED use that complies with
regulations adopted by the Emergency Medical Services (EMS) Authority
and the standards of the American Heart Association or the American
Red Cross.
(B) That the defibrillator is maintained and regularly tested
according to the operation and maintenance guidelines set forth by
the manufacturer, the American Heart Association, and the American
Red Cross, and according to any applicable rules and regulations set
forth by the governmental authority under the federal Food and Drug
Administration and any other applicable state and federal authority.
(C) That the AED is checked for readiness after each use and at
least once every 30 days if the AED has not been used in the
preceding 30 days. Records of these periodic checks shall be
maintained.
(D) That any person who renders emergency care or treatment on a
person in cardiac arrest by using an AED activates the emergency
medical services system as soon as possible, and reports any use of
the AED to the licensed physician and to the local EMS agency.
(E) That there is involvement of a licensed physician in
developing a program to ensure compliance with regulations and
requirements for training, notification, and maintenance.
(c) A violation of this provision is not subject to penalties
pursuant to Section 1798.206.
(d) This section shall become operative on January 1, 2013.
1797.197. The authority shall establish training and standards for
all prehospital emergency care personnel, as defined pursuant to
paragraph (2) of subdivision (a) of Section 1797.189, regarding the
characteristics and method of assessment and treatment of
anaphylactic reactions and the use epinephrine. The authority shall
promulgate regulations regarding these matters for use by all
prehospital emergency care personnel.
1797.160. No owner of a publicly or privately owned ambulance shall
permit the operation of the ambulance in emergency service unless
the attendant on duty therein, or, if there is no attendant on duty
therein, the operator, possesses evidence of that specialized
training as is reasonably necessary to ensure that the attendant or
operator is competent to care for sick or injured persons who may be
transported by the ambulance, as set forth in the emergency medical
training and educational standards for ambulance personnel
established by the authority pursuant to this article. This section
shall not be applicable in any state of emergency declared pursuant
to the California Emergencies Services Act (Chapter 7 (commencing
with Section 8550) of Division 1 of Title 2 of the Government Code),
when it is necessary to fully utilize all available ambulances in an
area and it is not possible to have the ambulance operated or
attended by persons with the qualifications required by this section.
1797.170. (a) The authority shall develop and, after approval by
the commission pursuant to Section 1799.50, adopt regulations for the
training and scope of practice for EMT-I certification.
(b) Any individual certified as an EMT-I pursuant to this division
shall be recognized as an EMT-I on a statewide basis, and
recertification shall be based on statewide standards. Effective July
1, 1990, any individual certified as an EMT-I pursuant to this act
shall complete 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 Public Health in consultation with experts in
the field of sudden infant death syndrome.
1797.171. (a) The authority shall develop, and after approval of
the commission pursuant to Section 1799.50, shall adopt, minimum
standards for the training and scope of practice for EMT-II.
(b) An EMT-II shall complete a course of training on the nature of
sudden infant death syndrome in accordance with subdivision (b) of
Section 1797.170.
(c) In rural or remote areas of the state where patient transport
times are particularly long and where local resources are inadequate
to support an EMT-P program for EMS responses, the director may
approve additions to the scope of practice of EMT-IIs serving the
local system, if requested by the medical director of the local EMS
agency, and if the EMT-II has received training equivalent to that of
an EMT-P. The approval of the director, in consultation with a
committee of local EMS medical directors named by the Emergency
Medical Directors Association of California, is required prior to
implementation of any addition to a local optional scope of practice
for EMT-IIs proposed by the medical director of a local EMS agency.
No drug or procedure that is not part of the basic EMT-P scope of
practice, including, but not limited to, any approved local options,
shall be added to any EMT-II scope of practice pursuant to this
subdivision.
Approval of additions to the scope of practices pursuant to this
subdivision may be given only for EMT-II programs in effect on
January 1, 1994.
1797.172. (a) The authority shall develop and, after approval by
the commission pursuant to Section 1799.50, adopt minimum standards
for the training and scope of practice for EMT-P.
(b) The approval of the director, in consultation with a committee
of local EMS medical directors named by the EMS Medical Directors
Association of California, is required prior to implementation of any
addition to a local optional scope of practice for EMT-Ps proposed
by the medical director of a local EMS agency.
(c) Notwithstanding any other provision of law, the authority
shall be the agency solely responsible for licensure and licensure
renewal of EMT-Ps who meet the standards and are not precluded from
licensure because of any of the reasons listed in subdivision (d) of
Section 1798.200. Each application for licensure or licensure renewal
shall require the applicant's social security number in order to
establish the identity of the applicant. The information obtained as
a result of a state and federal level criminal offender record
information search shall be used in accordance with Section 11105 of
the Penal Code, and to determine whether the applicant is subject to
denial of licensure or licensure renewal pursuant to this division.
Submission of fingerprint images to the Department of Justice may not
be required for licensure renewal upon determination by the
authority that fingerprint images have previously been submitted to
the Department of Justice during initial licensure, or a previous
licensure renewal, provided that the license has not lapsed and the
applicant has resided continuously in the state since the initial
licensure.
(d) The authority shall charge fees for the licensure and
licensure renewal of EMT-Ps in an amount sufficient to support the
authority's licensure program at a level that ensures the
qualifications of the individuals licensed to provide quality care.
The basic fee for licensure or licensure renewal of an EMT-P shall
not exceed one hundred twenty-five dollars ($125) until the adoption
of regulations that specify a different amount that does not exceed
the authority's EMT-P licensure, license renewal, and enforcement
programs. The authority shall annually evaluate fees to determine if
the fee is sufficient to fund the actual costs of the authority's
licensure, licensure renewal, and enforcement programs. If the
evaluation shows that the fees are excessive or are insufficient to
fund the actual costs of the authority's EMT-P licensure, licensure
renewal, and enforcement programs, then the fees shall be adjusted
accordingly through the rulemaking process described 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).
Separate additional fees may be charged, at the option of the
authority, for services that are not shared by all applicants for
licensure and licensure renewal, including, but not limited to, any
of the following services:
(1) Initial application for licensure as an EMT-P.
(2) Competency testing, the fee for which shall not exceed thirty
dollars ($30), except that an additional fee may be charged for the
cost of any services that provide enhanced availability of the exam
for the convenience of the EMT-P, such as on-demand electronic
testing.
(3) Fingerprint and criminal record check. The applicant shall, if
applicable according to subdivision (c), submit fingerprint images
and related information for criminal offender record information
searches with the Department of Justice and the Federal Bureau of
Investigation.
(4) Out-of-state training equivalency determination.
(5) Verification of continuing education for a lapse in licensure.
(6) Replacement of a lost licensure card. The fees charged for
individual services shall be set so that the total fees charged to
EMT-Ps shall not exceed the authority's actual total cost for the
EMT-P licensure program.
(e) The authority may provide nonconfidential, nonpersonal
information relating to EMS programs to interested persons upon
request, and may establish and assess fees for the provision of this
information. These fees shall not exceed the costs of providing the
information.
(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 EMT-P 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 Services Personnel 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.
1797.173. The authority shall assure that all training programs for
EMT-I, EMT-II, and EMT-P are located in an approved licensed
hospital or an educational institution operated with written
agreements with an acute care hospital, including a public safety
agency that has been approved by the local emergency medical services
agency to provide training. The authority shall also assure that
each training program has a competency-based curriculum. EMT-I
training and testing for fire service personnel may be offered at
sites approved by the State Board of Fire Services and training for
officers of the California Highway Patrol may be provided at the
California Highway Patrol Academy.
1797.174. In consultation with the commission, the Emergency
Medical Directors Association of California, and other affected
constituencies, the authority shall develop statewide guidelines for
continuing education courses and approval of continuing education
courses for EMT-Ps and for quality improvement systems which monitor
and promote improvement in the quality of care provided by EMT-Ps
throughout the state.
1797.175. The authority shall establish the standards for
continuing education and shall designate the examinations for
certification and recertification of all prehospital personnel.
The authority shall consider including training regarding the
characteristics and method of assessment and treatment of acquired
immune deficiency syndrome (AIDS).
1797.176. The authority shall establish the minimum standards for
the policies and procedures necessary for medical control of the EMS
system.
1797.177. No individual shall hold himself or herself out to be an
EMT-I, EMT-II, EMT-P, or paramedic unless that individual is
currently certified as such by the local EMS agency or other
certifying authority.
1797.178. No person or organization shall provide advanced life
support or limited advanced life support unless that person or
organization is an authorized part of the emergency medical services
system of the local EMS agency or of a pilot program operated
pursuant to the Wedworth-Townsend Paramedic Act, Article 3
(commencing with Section 1480) of Chapter 2.5 of Division 2.
1797.179. Notwithstanding any other provision of law, and to the
extent federal financial participation is available, any city, county
or special district providing paramedic services as set forth in
Section 1797.172, shall reimburse the Health Care Deposit Fund for
the state costs of paying such medical claims. Funds allocated to the
county from the County Health Services Fund pursuant to Part 4.5
(commencing with Section 16700) of Division 9 of the Welfare and
Institutions Code may be utilized by the county or city to make such
reimbursement.
1797.180. No agency, public or private, shall advertise or
disseminate information to the public that the agency provides EMT-II
or EMT-P rescue or ambulance services unless that agency does in
fact provide this service on a continuous 24 hours-per-day basis. If
advertising or information regarding that agency's EMT-II or EMT-P
rescue or ambulance service appears on any vehicle it may only appear
on those vehicles utilized solely to provide that service on a
continuous 24 hours-per-day basis.
1797.181. The authority may, by regulation, prescribe standardized
insignias or emblems for patches which may be affixed to the clothing
of an EMT-I, EMT-II, or EMT-P.
1797.182. All ocean, public beach, and public swimming pool
lifeguards and all firefighters in this state, except those whose
duties are primarily clerical or administrative, shall be trained to
administer first aid and cardiopulmonary resuscitation. The training
shall meet standards prescribed by the authority, and shall be
satisfactorily completed by such persons as soon as practical, but in
no event more than one year after the date of employment.
Satisfactory completion of a refresher course which meets the
standards prescribed by the authority in cardiopulmonary
resuscitation and other first aid shall be required at least every
three years.
The authority may designate a public agency or private nonprofit
agency to provide for each county the training required by this
section. The training shall be provided at no cost to the trainee.
As used in this section, "lifeguard" means any regularly employed
and paid officer, employee, or member of a public aquatic safety
department or marine safety agency of the State of California, a
city, county, city and county, district, or other public or municipal
corporation or political subdivision of this state.
As used in this section, "firefighter" means any regularly
employed and paid officer, employee, or member of a fire department
or fire protection or firefighting agency of the State of California,
a city, county, city and county, district, or other public or
municipal corporation or political subdivision of this state or
member of an emergency reserve unit of a volunteer fire department or
fire protection district.
1797.183. All peace officers described in Section 13518 of the
Penal Code, except those whose duties are primarily clerical or
administrative, shall be trained to administer first aid and
cardiopulmonary resuscitation (CPR). The training shall meet
standards prescribed by the authority, in consultation with the
Commission on Peace Officers Standards and Training, and shall be
satisfactorily completed by those officers as soon as practical, but
in no event more than one year after the date of employment.
Satisfactory completion of either refresher training or appropriate
testing, which meets the standards of the authority, in
cardiopulmonary resuscitation and other first aid, shall be required
at periodic intervals as determined by the authority.
1797.184. The authority shall develop and, after approval by the
commission pursuant to Section 1799.50, adopt all of the following:
(a) Guidelines for disciplinary orders, temporary suspensions, and
conditions of probation for EMT-I and EMT-II certificate holders
that protects the public health and safety.
(b) Regulations for the issuance of EMT-I and EMT-II certificates
by a certifying entity that protects the public health and safety.
(c) Regulations for the recertification of EMT-I and EMT-II
certificate holders that protect the public health and safety.
(d) Regulations for disciplinary processes for EMT-I and EMT-II
applicants and certificate holders that protect the public health and
safety. These disciplinary processes shall be in accordance with
Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of
Title 2 of the Government Code.
1797.185. (a) The authority shall establish criteria for the
statewide recognition of the certification of EMT-P personnel in the
basic scope of practice of those personnel. The criteria shall
include, but need not be limited to, the following:
(1) Standards for training, testing, certification, and revocation
of certification, as required for statewide recognition of
certification. The standards may include designation by the authority
of the specific examinations required for certification, including,
at the option of the authority, an examination provided by the
authority. At the option of the authority, the standards may include
a requirement for registration of prehospital emergency care
personnel with the authority or other entity designated by the
authority.
(2) Conditions for local accreditation of certified EMT-P
personnel which are reasonable in order to maintain medical control
and the integrity of the local EMS system, as determined by the
authority and approved by the commission.
(3) Provisions for local accreditation in approved optional scope
of practice, if any, as allowed by applicable state regulations and
statutes.
(4) Provisions for the establishment and collection of fees by the
appropriate agency, which may be the authority or an entity
designated by the authority to collect fees for the authority, for
testing, certification, accreditation, and registration with the
appropriate state or local agency in the appropriate scope of
practice. 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 Services Personnel Fund within
30 calendar days following the last day of the calendar month in
which the fees were received by the designated entity.
(b) After January 1, 1991, all regulations for EMT-P personnel
adopted by the authority shall, where relevant, include provisions
for statewide recognition of certification or authorization for the
scope of practice of those personnel.
(c) On or before July 1, 1991, the authority shall amend all
relevant regulations for EMT-P personnel to include criteria
developed pursuant to subdivision (c) of Section 1797.7 and
subdivision (b) of Section 1797.172 to insure statewide recognition
of certification for the scope of practice of those personnel.
(d) All future regulations for EMT-P personnel adopted by the
authority shall, where relevant, include provisions for statewide
recognition of certification or authorization for the scope of
practice of those personnel.
1797.186. All persons described in Sections 1797.170, 1797.171,
1797.172, 1797.182, and 1797.183, whether volunteers, partly paid, or
fully paid, shall be entitled to prophylactic medical treatment to
prevent the onset of disease, provided that the person demonstrates
that he or she was exposed, while in the service of the department or
unit, to a contagious disease, as listed in Section 2500 of Title 17
of the California Administrative Code, while performing first aid or
cardiopulmonary resuscitation services to any person.
Medical treatment under this section shall not affect the
provisions of Division 4 (commencing with Section 3200) or Division 5
(commencing with Section 6300) of the Labor Code or the person's
right to make a claim for work-related injuries, at the time the
contagious disease manifests itself.
1797.187. A peace officer as described in Section 830.1,
subdivision (a) of Section 830.2, or subdivision (g) of Section 830.3
of the Penal Code, while in the service of the agency or local
agency which employs him or her, shall be notified by the agency or
local agency if the peace officer is exposed to a known carcinogen,
as defined by the International Agency for Research on Cancer, or as
defined by its director, during the investigation of any place where
any controlled substance, as defined in Section 11007 is suspected of
being manufactured, stored, transferred, or sold, or any toxic waste
spills, accidents, leaks, explosions, or fires.
The Commission on Peace Officers Standards and Training basic
training course, and other training courses as the commission
determines appropriate, shall include, on or before January 1, 1990,
instruction on, but not limited to, the identification and handling
of possible carcinogenic materials and the potential health hazards
associated with these materials, protective equipment, and clothing
available to minimize contamination, handling, and disposing of
materials and measures and procedures that can be adopted to minimize
exposure to possible hazardous materials.
1797.188. (a) As used in this section:
(1) "Prehospital emergency medical care person or personnel" means
any of the following: an authorized registered nurse or mobile
intensive care nurse, emergency medical technician-I, emergency
medical technician-II, emergency medical technician-paramedic,
lifeguard, firefighter, or peace officer, as defined or described by
Sections 1797.56, 1797.80, 1797.82, 1797.84, 1797.182, and 1797.183,
respectively, or a physician and surgeon who provides prehospital
emergency medical care or rescue services.
(2) "Reportable disease or condition" or "a disease or condition
listed as reportable" means those diseases prescribed by Subchapter 1
(commencing with Section 2500) of Chapter 4 of Title 17 of the
California Administrative Code, as may be amended from time to time.
(3) "Exposed" means at risk for contracting the disease, as
defined by regulations of the state department.
(4) "Health facility" means a health facility, as defined in
Section 1250, including a publicly operated facility.
(b) In addition to the communicable disease testing and
notification procedures applicable under Chapter 3.5 (commencing with
Section 120260) of Part 1 of Division 105, all prehospital emergency
medical care personnel, whether volunteers, partly paid, or fully
paid, who have provided emergency medical or rescue services and have
been exposed to a person afflicted with a disease or condition
listed as reportable, which can, as determined by the county health
officer, be transmitted through oral contact or secretions of the
body, including blood, shall be notified that they have been exposed
to the disease and should contact the county health officer if all
the following are satisfied:
(1) The prehospital emergency medical care person, who has
rendered emergency medical or rescue services and has been exposed to
a person afflicted with a reportable disease or condition, provides
the health facility with his or her name and telephone number at the
time the patient is transferred from that prehospital emergency
medical care person to the admitting health facility; or the party
transporting the person afflicted with the reportable disease or
condition provides that health facility with the name and telephone
number of the prehospital emergency medical care person who provided
the emergency medical or rescue services.
(2) The health facility reports the name and telephone number of
the prehospital emergency medical care person to the county health
officer upon determining that the person to whom the prehospital
emergency medical care person provided the emergency medical or
rescue services is diagnosed as being afflicted with a reportable
disease or condition.
(c) The county health officer shall immediately notify the
prehospital emergency medical care person who has provided emergency
medical or rescue services and has been exposed to a person afflicted
with a disease or condition listed as reportable, which can, as
determined by the county health officer, be transmitted through oral
contact or secretions of the body, including blood, upon receiving
the report from a health facility pursuant to paragraph (1) of
subdivision (b). The county health officer shall not disclose the
name of the patient or other identifying characteristics to the
prehospital emergency medical care person.
Nothing in this section shall be construed to authorize the
further disclosure of confidential medical information by the health
facility or any prehospital emergency medical care personnel
described in this section except as otherwise authorized by law.
In the event of the demise of the person afflicted with the
reportable disease or condition, the health facility or county health
officer shall notify the funeral director, charged with removing the
decedent from the health facility, of the reportable disease prior
to the release of the decedent from the health facility to the
funeral director.
Notwithstanding Section 1798.206, violation of this section is not
a misdemeanor.
1797.189. (a) As used in this section:
(1) "Chief medical examiner-coroner" means the chief medical
examiner or the coroner as referred to in subdivision (m) of Section
24000, Section 24010, subdivisions (k), (m), and (n) of Section
24300, subdivisions (k), (m), and (n) of Section 24304, and Sections
27460 to 27530, inclusive, of the Government Code, and Section
102850.
(2) "Prehospital emergency medical care person or personnel" means
any of the following: authorized registered nurse or mobile
intensive care nurse, emergency medical technician-I, emergency
medical technician-II, emergency medical technician-paramedic,
lifeguard, firefighter, or peace officer, as defined or described by
Sections 1797.56, 1797.80, 1797.82, 1797.84, 1797.182, and 1797.183,
respectively, or a physician and surgeon who provides prehospital
emergency medical care or rescue services.
(3) "Reportable disease or condition" or "a disease or condition
listed as reportable" means those diseases specified in Subchapter 1
(commencing with Section 2500) of Chapter 4 of Title 17 of the
California Administrative Code, as may be amended from time to time.
(4) "Exposed" means at risk for contracting a disease, as defined
by regulations of the state department.
(5) "Health facility" means a health facility, as defined in
Section 1250, including a publicly operated facility.
(b) Any prehospital emergency medical care personnel, whether
volunteers, partly paid, or fully paid who have provided emergency
medical or rescue services and have been exposed to a person
afflicted with a disease or condition listed as reportable, that can,
as determined by the county health officer, be transmitted through
oral contact or secretions of the body, including blood, shall be
notified that they have been exposed to the disease and should
contact the county health officer if all of the following conditions
are met:
(1) The prehospital emergency medical care person, who has
rendered emergency medical or rescue services and has been exposed to
a person afflicted with a reportable disease or condition, provides
the chief medical examiner-coroner with his or her name and telephone
number at the time the patient is transferred from that prehospital
medical care person to the chief medical examiner-coroner; or the
party transporting the person afflicted with the reportable disease
or condition provides that chief medical examiner-coroner with the
name and telephone number of the prehospital emergency medical care
person who provided the emergency medical or rescue services.
(2) The chief medical examiner-coroner reports the name and
telephone number of the prehospital emergency medical care person to
the county health officer upon determining that the person to whom
the prehospital emergency medical care person provided the emergency
medical or rescue services is diagnosed as being afflicted with a
reportable disease or condition.
(c) The county health officer shall immediately notify the
prehospital emergency medical care person who has provided emergency
medical or rescue services and has been exposed to a person afflicted
with a disease or condition listed as reportable, that can, as
determined by the county health officer, be transmitted through oral
contact or secretions of the body, including blood, upon receiving
the report from a health facility pursuant to paragraph (1) of
subdivision (b). The county health officer shall not disclose the
name of the patient or other identifying characteristics to the
prehospital emergency medical care person.
Nothing in this section shall be construed to authorize the
further disclosure of confidential medical information by the chief
medical examiner-coroner or any of the prehospital emergency medical
care personnel described in this section except as otherwise
authorized by law.
The chief medical examiner-coroner, or the county health officer
shall notify the funeral director, charged with removing or receiving
the decedent afflicted with a reportable disease or condition from
the chief medical examiner-coroner, of the reportable disease prior
to the release of the decedent from the chief medical
examiner-coroner to the funeral director.
Notwithstanding Section 1798.206, violation of this section is not
a misdemeanor.
1797.190. The authority may establish minimum standards for the
training and use of automatic external defibrillators.
1797.191. (a) The authority shall establish minimum standards for
the training in pediatric first aid, pediatric cardiopulmonary
resuscitation (CPR), and preventive health practices required by
Section 1596.866.
(b) (1) The authority shall establish a process for the ongoing
review and approval of training programs in pediatric first aid,
pediatric CPR, and preventive health practices as specified in
paragraph (2) of subdivision (a) of Section 1596.866 to ensure that
those programs meet the minimum standards established pursuant to
subdivision (a). The authority shall charge fees equal to its costs
incurred for the pediatric first aid and pediatric CPR training
standards program and for the ongoing review and approval of these
programs.
(2) The authority shall establish, in consultation with experts in
pediatric first aid, pediatric CPR, and preventive health practices,
a process to ensure the quality of the training programs, including,
but not limited to, a method for assessing the appropriateness of
the courses and the qualifications of the instructors.
(c) (1) The authority may charge a fee equal to its costs incurred
for the preventive health practices program and for the initial
review and approval and renewal of approval of the program.
(2) If the authority chooses to establish a fee process based on
the use of course completion cards for the preventive health
practices program, the cost shall not exceed seven dollars ($7) per
card for each training participant until January 1, 2001, at which
time the authority may evaluate its administrative costs. After
evaluation of the costs, the authority may establish a new fee scale
for the cards so that revenue does not exceed the costs of the
ongoing review and approval of the preventive health practices
training.
(d) For the purposes of this section, "training programs" means
programs that apply for approval by the authority to provide the
training in pediatric first aid, pediatric CPR, or preventive health
practices as specified in paragraph (2) of subdivision (a) of Section
1596.866. Training programs include all affiliated programs that
also provide any of the authority-approved training required by this
division. "Affiliated programs" means programs that are overseen by
persons or organizations that have an authority-approved training
program in pediatric first aid, pediatric CPR, or preventive health
practices. Affiliated programs also include programs that have
purchased an authority-approved training program in pediatric first
aid, pediatric CPR, or preventive health practices. Training programs
and their affiliated programs shall comply with this division and
with the regulations adopted by the authority pertaining to training
programs in pediatric first aid, pediatric CPR, or preventive health
practices.
(e) The director of the authority may, in accordance with
regulations adopted by the authority, deny, suspend, or revoke any
approval issued under this division or may place any approved program
on probation, upon the finding by the director of the authority of
an imminent threat to the public health and safety as evidenced by
the occurrence of any of the actions listed in subdivision (f).
(f) 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, probation, or revocation of a program's approval
or application for approval pursuant to this division.
(1) Fraud.
(2) Incompetence.
(3) The commission of any fraudulent, dishonest, or corrupt act
that is substantially related to the qualifications, functions, and
duties of training program directors and instructors.
(4) Conviction of any crime that is substantially related to the
qualifications, functions, and duties of training program directors
and instructors. The record of conviction or a certified copy of the
record shall be conclusive evidence of the conviction.
(5) Violating or attempting to violate, directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
this division or the regulations promulgated by the authority
pertaining to the review and approval of training programs in
pediatric first aid, pediatric CPR, and preventive health practices
as specified in paragraph (2) of subdivision (a) of Section 1596.866.
(g) In order to ensure that adequate qualified training programs
are available to provide training in the preventive health practices
course to all persons who are required to have that training, the
authority may, after approval of the Commission on Emergency Medical
Services pursuant to Section 1799.50, establish temporary standards
for training programs for use until permanent standards are adopted
pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of
Division 3 of Title 2 of the Government Code.
(h) Persons who, prior to the date on which the amendments to this
section enacted in 1998 become operative, have completed a course or
courses in preventive health practices as specified in subparagraph
(C) of paragraph (2) of subdivision (a) of Section 1596.866, and have
a certificate of completion card for a course or courses in
preventive health practices, or certified copies of transcripts that
identify the number of hours and the specific course or courses taken
for training in preventive health practices shall be deemed to have
met the requirement for training in preventive health practices.
1797.192. On or before July 1, 1991, the authority shall adopt
standards for a standard statewide scope of practice which shall be
utilized for the training and certification testing of EMT-P
personnel for certification as EMT-P's. Local EMS systems shall not
be required to utilize the entire standard scope of practice. Testing
of EMT-P personnel for local accreditation to practice shall only
include local operational policies and procedures, and drug, device,
or treatment procedures being utilized within that local EMS system
pursuant to Sections 1797.172 and 1797.221.
1797.193. (a) By July 1, 1992, existing firefighters in this state
shall complete a course on the nature of sudden infant death syndrome
taught by experts in the field of sudden infant death syndrome. All
persons who become firefighters after January 1, 1990, shall complete
a course on this topic as part of their basic training as
firefighters. The course shall include information on the community
resources available to assist families who have lost children to
sudden infant death syndrome.
(b) For purposes of this section, the term "firefighter" has the
same meaning as that specified in Section 1797.182.
(c) When the instruction and training are provided by a local
agency, a fee shall be charged sufficient to defray the entire cost
of the instruction and training.
1797.194. The purpose of this section is to provide for the state
licensure of EMT-P personnel. Notwithstanding any provision of law,
including, but not limited to, Sections 1797.208 and 1797.214, all of
the following applies to EMT-P personnel:
(a) Any reference to EMT-P certification pursuant to this division
shall be equivalent to EMT-P licensure pursuant to this division,
including, but not limited to, any provision in this division
relating to the assessment of fees.
(b) The statewide examination designated by the authority for
licensure of EMT-P personnel and the licensure issued by the
authority shall be the single sufficient examination and licensure
required for practice as an EMT-P.
(c) EMT-P licenses shall be renewed every two years upon
submission to the authority of proof of satisfactory completion of
continuing education or other educational requirements established by
regulations of the authority, upon approval by the commission. If
the evaluation and recommendations of the authority required pursuant
to Section 8 of Chapter 997 of the Statutes of 1993, so concludes,
the renewal of EMT-P licenses shall, in addition to continuing
education requirements, be contingent upon reexamination at 10-year
intervals to ensure competency.
(d) Every EMT-P licensee may be disciplined by the authority for
violations of this division. The proceedings under this subdivision
shall be conducted in accordance with Chapter 5 (commencing with
Section 11500) of Part 1 of Division 3 of Title 2 of the Government
Code, and the authority shall have all the powers granted therein for
this purpose.
(e) Nothing in this section shall be construed to extend the scope
of practice of an EMT-P beyond prehospital settings, as defined by
regulations of the authority.
(f) Nothing in this section shall be construed to alter or
interfere with the local EMS agency's ability to locally accredit
licensed EMT-Ps.
(g) Nothing in this section shall be construed to hinder the
ability of the medical director of the local EMS agency to maintain
medical control within the local EMS system in accordance with this
division, including, but not limited to, Chapter 5 (commencing with
Section 1798).
1797.195. (a) Notwithstanding any other provision of law to the
contrary, an EMT-I, EMT-II, or EMT-P may provide emergency medical
care pursuant to this section in the emergency department of a
hospital that meets the definition of small and rural hospital
pursuant to Section 1188.855, except that in the case of a hospital
meeting the definition contained in Section 1188.855 the population
of the incorporated place or census designated place where the
hospital is located shall not have increased to more than 20,000
since 1980, and all of the following conditions are met:
(1) The EMT-I, EMT-II, or EMT-P is on duty as a prehospital
emergency medical care provider.
(2) The EMT-I, EMT-II, or EMT-P shall function under direct
supervision as defined in hospital protocols that have been issued
pursuant to paragraph (3), and only where the physician and surgeon
or the registered nurse determines that the emergency department is
faced with a patient crisis, and that the services of the EMT-I,
EMT-II, or EMT-P are necessary to temporarily meet the health care
needs of the patients in the emergency department.
(3) The utilization of an EMT-I, EMT-II, or EMT-P in the emergency
department is done pursuant to hospital protocols that have been
developed by the hospital's nursing staff, the physician and surgeon
medical director of the emergency department, and the administration
of the hospital, with the approval of the medical staff, and that
shall include at least all of the following:
(A) A requirement that the EMT-I, EMT-II, or EMT-P successfully
complete a hospital training program on the protocols and procedures
of the hospital emergency department. The program shall include, but
not be limited to, features of the protocols for which the EMT-I,
EMT-II, or EMT-P has not previously received training and a
postprogram evaluation.
(B) A requirement that the EMT-I, EMT-II, or EMT-P annually
demonstrates and documents to the hospital competency in the
emergency department procedures.
(C) The emergency medical care to be provided in the emergency
department by the EMT-I, EMT-II, or EMT-P shall be set forth or
referenced in the protocols and shall be limited to that which is
otherwise authorized by their certification or licensure as defined
in statute or regulation. The protocols shall not include patient
assessment in this setting, except when the assessment is directly
related to the specific task the EMT-I, EMT-II, and EMT-P is
performing.
(D) A process for continuity of patient care when the EMT-I,
EMT-II, or EMT-P is called to an off-site emergency situation.
(E) Procedures for the supervision of the EMT-I, EMT-II, or EMT-P.
(4) The protocols for utilization of an EMT-I, EMT-II, or EMT-P in
the emergency department are developed in consultation with the
medical director of the local EMS agency and the emergency medical
care committee, if a committee has been formed.
(5) A written contract shall be in effect relative to the services
provided pursuant to this section, between the ambulance company and
the hospital, where the EMT-I, EMT-II, or EMT-P is employed by an
ambulance company that is not owned by the hospital.
(b) When services of emergency personnel are called upon pursuant
to this section, responsibility for the medical direction of the
EMT-I, EMT-II, or EMT-P rests with the hospital, pursuant to the
hospital protocols as set forth in paragraph (3) of subdivision (a).
(c) Although this section authorizes the provision of services in
an emergency department of certain small and rural hospitals, nothing
in this section is intended to expand or restrict the types of
services or care to be provided by EMT-I, EMT-II, or EMT-P pursuant
to this article.
1797.196. (a) For purposes of this section, "AED" or "defibrillator"
means an automated or automatic external defibrillator.
(b) In order to ensure public safety, any person or entity that
acquires an AED is not liable for any civil damages resulting from
any acts or omissions in the rendering of the emergency care under
subdivision (b) of Section 1714.21 of the Civil Code, if that person
or entity does all of the following:
(1) Complies with all regulations governing the placement of an
AED.
(2) Ensures all of the following:
(A) That the AED is maintained and regularly tested according to
the operation and maintenance guidelines set forth by the
manufacturer, the American Heart Association, and the American Red
Cross, and according to any applicable rules and regulations set
forth by the governmental authority under the federal Food and Drug
Administration and any other applicable state and federal authority.
(B) That the AED is checked for readiness after each use and at
least once every 30 days if the AED has not been used in the
preceding 30 days. Records of these checks shall be maintained.
(C) That any person who renders emergency care or treatment on a
person in cardiac arrest by using an AED activates the emergency
medical services system as soon as possible, and reports any use of
the AED to the licensed physician and to the local EMS agency.
(D) For every AED unit acquired up to five units, no less than one
employee per AED unit shall complete a training course in
cardiopulmonary resuscitation and AED use that complies with the
regulations adopted by the Emergency Medical Service Authority and
the standards of the American Heart Association or the American Red
Cross. After the first five AED units are acquired, for each
additional five AED units acquired, one employee shall be trained
beginning with the first AED unit acquired. Acquirers of AED units
shall have trained employees who should be available to respond to an
emergency that may involve the use of an AED unit during normal
operating hours.
(E) That there is a written plan that describes the procedures to
be followed in the event of an emergency that may involve the use of
an AED, to ensure compliance with the requirements of this section.
The written plan shall include, but not be limited to, immediate
notification of 911 and trained office personnel at the start of AED
procedures.
(3) When an AED is placed in a building, building owners shall
ensure that tenants annually receive a brochure, approved as to
content and style by the American Heart Association or American Red
Cross, which describes the proper use of an AED, and also ensure that
similar information is posted next to any installed AED.
(4) When an AED is placed in a building, no less than once a year,
building owners shall notify their tenants as to the location of AED
units in the building.
(5) When an AED is placed in a public or private K-12 school, the
principal shall ensure that the school administrators and staff
annually receive a brochure, approved as to contents and style by the
American Heart Association or the American Red Cross, that describes
the proper use of an AED. The principal shall also ensure that
similar information is posted next to every AED. The principal shall,
at least annually, notify school employees as to the location of all
AED units on the campus. The principal shall designate the trained
employees who shall be available to respond to an emergency that may
involve the use of an AED during normal operating hours. As used in
this paragraph, "normal operating hours" means during the hours of
classroom instruction and any school-sponsored activity occurring on
school grounds.
(c) Any person or entity that supplies an AED shall do all of the
following:
(1) Notify an agent of the local EMS agency of the existence,
location, and type of AED acquired.
(2) Provide to the acquirer of the AED all information governing
the use, installation, operation, training, and maintenance of the
AED.
(d) A violation of this provision is not subject to penalties
pursuant to Section 1798.206.
(e) The protections specified in this section do not apply in the
case of personal injury or wrongful death that results from the gross
negligence or willful or wanton misconduct of the person who renders
emergency care or treatment by the use of an AED.
(f) Nothing in this section or Section 1714.21 may be construed to
require a building owner or a building manager to acquire and have
installed an AED in any building.
(g) This section shall remain in effect only until January 1,
2013, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2013, deletes or extends
that date.
1797.196. (a) For purposes of this section, "AED" or "defibrillator"
means an automated or automatic external defibrillator.
(b) In order to ensure public safety, any person who acquires an
AED shall do all of the following:
(1) Comply with all regulations governing the training, use, and
placement of an AED.
(2) Notify an agent of the local EMS agency of the existence,
location, and type of AED acquired.
(3) Ensure all of the following:
(A) That expected AED users complete a training course in
cardiopulmonary resuscitation and AED use that complies with
regulations adopted by the Emergency Medical Services (EMS) Authority
and the standards of the American Heart Association or the American
Red Cross.
(B) That the defibrillator is maintained and regularly tested
according to the operation and maintenance guidelines set forth by
the manufacturer, the American Heart Association, and the American
Red Cross, and according to any applicable rules and regulations set
forth by the governmental authority under the federal Food and Drug
Administration and any other applicable state and federal authority.
(C) That the AED is checked for readiness after each use and at
least once every 30 days if the AED has not been used in the
preceding 30 days. Records of these periodic checks shall be
maintained.
(D) That any person who renders emergency care or treatment on a
person in cardiac arrest by using an AED activates the emergency
medical services system as soon as possible, and reports any use of
the AED to the licensed physician and to the local EMS agency.
(E) That there is involvement of a licensed physician in
developing a program to ensure compliance with regulations and
requirements for training, notification, and maintenance.
(c) A violation of this provision is not subject to penalties
pursuant to Section 1798.206.
(d) This section shall become operative on January 1, 2013.
1797.197. The authority shall establish training and standards for
all prehospital emergency care personnel, as defined pursuant to
paragraph (2) of subdivision (a) of Section 1797.189, regarding the
characteristics and method of assessment and treatment of
anaphylactic reactions and the use epinephrine. The authority shall
promulgate regulations regarding these matters for use by all
prehospital emergency care personnel.
1797.160. No owner of a publicly or privately owned ambulance shall
permit the operation of the ambulance in emergency service unless
the attendant on duty therein, or, if there is no attendant on duty
therein, the operator, possesses evidence of that specialized
training as is reasonably necessary to ensure that the attendant or
operator is competent to care for sick or injured persons who may be
transported by the ambulance, as set forth in the emergency medical
training and educational standards for ambulance personnel
established by the authority pursuant to this article. This section
shall not be applicable in any state of emergency declared pursuant
to the California Emergencies Services Act (Chapter 7 (commencing
with Section 8550) of Division 1 of Title 2 of the Government Code),
when it is necessary to fully utilize all available ambulances in an
area and it is not possible to have the ambulance operated or
attended by persons with the qualifications required by this section.
1797.170. (a) The authority shall develop and, after approval by
the commission pursuant to Section 1799.50, adopt regulations for the
training and scope of practice for EMT-I certification.
(b) Any individual certified as an EMT-I pursuant to this division
shall be recognized as an EMT-I on a statewide basis, and
recertification shall be based on statewide standards. Effective July
1, 1990, any individual certified as an EMT-I pursuant to this act
shall complete 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 Public Health in consultation with experts in
the field of sudden infant death syndrome.
1797.171. (a) The authority shall develop, and after approval of
the commission pursuant to Section 1799.50, shall adopt, minimum
standards for the training and scope of practice for EMT-II.
(b) An EMT-II shall complete a course of training on the nature of
sudden infant death syndrome in accordance with subdivision (b) of
Section 1797.170.
(c) In rural or remote areas of the state where patient transport
times are particularly long and where local resources are inadequate
to support an EMT-P program for EMS responses, the director may
approve additions to the scope of practice of EMT-IIs serving the
local system, if requested by the medical director of the local EMS
agency, and if the EMT-II has received training equivalent to that of
an EMT-P. The approval of the director, in consultation with a
committee of local EMS medical directors named by the Emergency
Medical Directors Association of California, is required prior to
implementation of any addition to a local optional scope of practice
for EMT-IIs proposed by the medical director of a local EMS agency.
No drug or procedure that is not part of the basic EMT-P scope of
practice, including, but not limited to, any approved local options,
shall be added to any EMT-II scope of practice pursuant to this
subdivision.
Approval of additions to the scope of practices pursuant to this
subdivision may be given only for EMT-II programs in effect on
January 1, 1994.
1797.172. (a) The authority shall develop and, after approval by
the commission pursuant to Section 1799.50, adopt minimum standards
for the training and scope of practice for EMT-P.
(b) The approval of the director, in consultation with a committee
of local EMS medical directors named by the EMS Medical Directors
Association of California, is required prior to implementation of any
addition to a local optional scope of practice for EMT-Ps proposed
by the medical director of a local EMS agency.
(c) Notwithstanding any other provision of law, the authority
shall be the agency solely responsible for licensure and licensure
renewal of EMT-Ps who meet the standards and are not precluded from
licensure because of any of the reasons listed in subdivision (d) of
Section 1798.200. Each application for licensure or licensure renewal
shall require the applicant's social security number in order to
establish the identity of the applicant. The information obtained as
a result of a state and federal level criminal offender record
information search shall be used in accordance with Section 11105 of
the Penal Code, and to determine whether the applicant is subject to
denial of licensure or licensure renewal pursuant to this division.
Submission of fingerprint images to the Department of Justice may not
be required for licensure renewal upon determination by the
authority that fingerprint images have previously been submitted to
the Department of Justice during initial licensure, or a previous
licensure renewal, provided that the license has not lapsed and the
applicant has resided continuously in the state since the initial
licensure.
(d) The authority shall charge fees for the licensure and
licensure renewal of EMT-Ps in an amount sufficient to support the
authority's licensure program at a level that ensures the
qualifications of the individuals licensed to provide quality care.
The basic fee for licensure or licensure renewal of an EMT-P shall
not exceed one hundred twenty-five dollars ($125) until the adoption
of regulations that specify a different amount that does not exceed
the authority's EMT-P licensure, license renewal, and enforcement
programs. The authority shall annually evaluate fees to determine if
the fee is sufficient to fund the actual costs of the authority's
licensure, licensure renewal, and enforcement programs. If the
evaluation shows that the fees are excessive or are insufficient to
fund the actual costs of the authority's EMT-P licensure, licensure
renewal, and enforcement programs, then the fees shall be adjusted
accordingly through the rulemaking process described 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).
Separate additional fees may be charged, at the option of the
authority, for services that are not shared by all applicants for
licensure and licensure renewal, including, but not limited to, any
of the following services:
(1) Initial application for licensure as an EMT-P.
(2) Competency testing, the fee for which shall not exceed thirty
dollars ($30), except that an additional fee may be charged for the
cost of any services that provide enhanced availability of the exam
for the convenience of the EMT-P, such as on-demand electronic
testing.
(3) Fingerprint and criminal record check. The applicant shall, if
applicable according to subdivision (c), submit fingerprint images
and related information for criminal offender record information
searches with the Department of Justice and the Federal Bureau of
Investigation.
(4) Out-of-state training equivalency determination.
(5) Verification of continuing education for a lapse in licensure.
(6) Replacement of a lost licensure card. The fees charged for
individual services shall be set so that the total fees charged to
EMT-Ps shall not exceed the authority's actual total cost for the
EMT-P licensure program.
(e) The authority may provide nonconfidential, nonpersonal
information relating to EMS programs to interested persons upon
request, and may establish and assess fees for the provision of this
information. These fees shall not exceed the costs of providing the
information.
(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 EMT-P 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 Services Personnel 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.
1797.173. The authority shall assure that all training programs for
EMT-I, EMT-II, and EMT-P are located in an approved licensed
hospital or an educational institution operated with written
agreements with an acute care hospital, including a public safety
agency that has been approved by the local emergency medical services
agency to provide training. The authority shall also assure that
each training program has a competency-based curriculum. EMT-I
training and testing for fire service personnel may be offered at
sites approved by the State Board of Fire Services and training for
officers of the California Highway Patrol may be provided at the
California Highway Patrol Academy.
1797.174. In consultation with the commission, the Emergency
Medical Directors Association of California, and other affected
constituencies, the authority shall develop statewide guidelines for
continuing education courses and approval of continuing education
courses for EMT-Ps and for quality improvement systems which monitor
and promote improvement in the quality of care provided by EMT-Ps
throughout the state.
1797.175. The authority shall establish the standards for
continuing education and shall designate the examinations for
certification and recertification of all prehospital personnel.
The authority shall consider including training regarding the
characteristics and method of assessment and treatment of acquired
immune deficiency syndrome (AIDS).
1797.176. The authority shall establish the minimum standards for
the policies and procedures necessary for medical control of the EMS
system.
1797.177. No individual shall hold himself or herself out to be an
EMT-I, EMT-II, EMT-P, or paramedic unless that individual is
currently certified as such by the local EMS agency or other
certifying authority.
1797.178. No person or organization shall provide advanced life
support or limited advanced life support unless that person or
organization is an authorized part of the emergency medical services
system of the local EMS agency or of a pilot program operated
pursuant to the Wedworth-Townsend Paramedic Act, Article 3
(commencing with Section 1480) of Chapter 2.5 of Division 2.
1797.179. Notwithstanding any other provision of law, and to the
extent federal financial participation is available, any city, county
or special district providing paramedic services as set forth in
Section 1797.172, shall reimburse the Health Care Deposit Fund for
the state costs of paying such medical claims. Funds allocated to the
county from the County Health Services Fund pursuant to Part 4.5
(commencing with Section 16700) of Division 9 of the Welfare and
Institutions Code may be utilized by the county or city to make such
reimbursement.
1797.180. No agency, public or private, shall advertise or
disseminate information to the public that the agency provides EMT-II
or EMT-P rescue or ambulance services unless that agency does in
fact provide this service on a continuous 24 hours-per-day basis. If
advertising or information regarding that agency's EMT-II or EMT-P
rescue or ambulance service appears on any vehicle it may only appear
on those vehicles utilized solely to provide that service on a
continuous 24 hours-per-day basis.
1797.181. The authority may, by regulation, prescribe standardized
insignias or emblems for patches which may be affixed to the clothing
of an EMT-I, EMT-II, or EMT-P.
1797.182. All ocean, public beach, and public swimming pool
lifeguards and all firefighters in this state, except those whose
duties are primarily clerical or administrative, shall be trained to
administer first aid and cardiopulmonary resuscitation. The training
shall meet standards prescribed by the authority, and shall be
satisfactorily completed by such persons as soon as practical, but in
no event more than one year after the date of employment.
Satisfactory completion of a refresher course which meets the
standards prescribed by the authority in cardiopulmonary
resuscitation and other first aid shall be required at least every
three years.
The authority may designate a public agency or private nonprofit
agency to provide for each county the training required by this
section. The training shall be provided at no cost to the trainee.
As used in this section, "lifeguard" means any regularly employed
and paid officer, employee, or member of a public aquatic safety
department or marine safety agency of the State of California, a
city, county, city and county, district, or other public or municipal
corporation or political subdivision of this state.
As used in this section, "firefighter" means any regularly
employed and paid officer, employee, or member of a fire department
or fire protection or firefighting agency of the State of California,
a city, county, city and county, district, or other public or
municipal corporation or political subdivision of this state or
member of an emergency reserve unit of a volunteer fire department or
fire protection district.
1797.183. All peace officers described in Section 13518 of the
Penal Code, except those whose duties are primarily clerical or
administrative, shall be trained to administer first aid and
cardiopulmonary resuscitation (CPR). The training shall meet
standards prescribed by the authority, in consultation with the
Commission on Peace Officers Standards and Training, and shall be
satisfactorily completed by those officers as soon as practical, but
in no event more than one year after the date of employment.
Satisfactory completion of either refresher training or appropriate
testing, which meets the standards of the authority, in
cardiopulmonary resuscitation and other first aid, shall be required
at periodic intervals as determined by the authority.
1797.184. The authority shall develop and, after approval by the
commission pursuant to Section 1799.50, adopt all of the following:
(a) Guidelines for disciplinary orders, temporary suspensions, and
conditions of probation for EMT-I and EMT-II certificate holders
that protects the public health and safety.
(b) Regulations for the issuance of EMT-I and EMT-II certificates
by a certifying entity that protects the public health and safety.
(c) Regulations for the recertification of EMT-I and EMT-II
certificate holders that protect the public health and safety.
(d) Regulations for disciplinary processes for EMT-I and EMT-II
applicants and certificate holders that protect the public health and
safety. These disciplinary processes shall be in accordance with
Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of
Title 2 of the Government Code.
1797.185. (a) The authority shall establish criteria for the
statewide recognition of the certification of EMT-P personnel in the
basic scope of practice of those personnel. The criteria shall
include, but need not be limited to, the following:
(1) Standards for training, testing, certification, and revocation
of certification, as required for statewide recognition of
certification. The standards may include designation by the authority
of the specific examinations required for certification, including,
at the option of the authority, an examination provided by the
authority. At the option of the authority, the standards may include
a requirement for registration of prehospital emergency care
personnel with the authority or other entity designated by the
authority.
(2) Conditions for local accreditation of certified EMT-P
personnel which are reasonable in order to maintain medical control
and the integrity of the local EMS system, as determined by the
authority and approved by the commission.
(3) Provisions for local accreditation in approved optional scope
of practice, if any, as allowed by applicable state regulations and
statutes.
(4) Provisions for the establishment and collection of fees by the
appropriate agency, which may be the authority or an entity
designated by the authority to collect fees for the authority, for
testing, certification, accreditation, and registration with the
appropriate state or local agency in the appropriate scope of
practice. 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 Services Personnel Fund within
30 calendar days following the last day of the calendar month in
which the fees were received by the designated entity.
(b) After January 1, 1991, all regulations for EMT-P personnel
adopted by the authority shall, where relevant, include provisions
for statewide recognition of certification or authorization for the
scope of practice of those personnel.
(c) On or before July 1, 1991, the authority shall amend all
relevant regulations for EMT-P personnel to include criteria
developed pursuant to subdivision (c) of Section 1797.7 and
subdivision (b) of Section 1797.172 to insure statewide recognition
of certification for the scope of practice of those personnel.
(d) All future regulations for EMT-P personnel adopted by the
authority shall, where relevant, include provisions for statewide
recognition of certification or authorization for the scope of
practice of those personnel.
1797.186. All persons described in Sections 1797.170, 1797.171,
1797.172, 1797.182, and 1797.183, whether volunteers, partly paid, or
fully paid, shall be entitled to prophylactic medical treatment to
prevent the onset of disease, provided that the person demonstrates
that he or she was exposed, while in the service of the department or
unit, to a contagious disease, as listed in Section 2500 of Title 17
of the California Administrative Code, while performing first aid or
cardiopulmonary resuscitation services to any person.
Medical treatment under this section shall not affect the
provisions of Division 4 (commencing with Section 3200) or Division 5
(commencing with Section 6300) of the Labor Code or the person's
right to make a claim for work-related injuries, at the time the
contagious disease manifests itself.
1797.187. A peace officer as described in Section 830.1,
subdivision (a) of Section 830.2, or subdivision (g) of Section 830.3
of the Penal Code, while in the service of the agency or local
agency which employs him or her, shall be notified by the agency or
local agency if the peace officer is exposed to a known carcinogen,
as defined by the International Agency for Research on Cancer, or as
defined by its director, during the investigation of any place where
any controlled substance, as defined in Section 11007 is suspected of
being manufactured, stored, transferred, or sold, or any toxic waste
spills, accidents, leaks, explosions, or fires.
The Commission on Peace Officers Standards and Training basic
training course, and other training courses as the commission
determines appropriate, shall include, on or before January 1, 1990,
instruction on, but not limited to, the identification and handling
of possible carcinogenic materials and the potential health hazards
associated with these materials, protective equipment, and clothing
available to minimize contamination, handling, and disposing of
materials and measures and procedures that can be adopted to minimize
exposure to possible hazardous materials.
1797.188. (a) As used in this section:
(1) "Prehospital emergency medical care person or personnel" means
any of the following: an authorized registered nurse or mobile
intensive care nurse, emergency medical technician-I, emergency
medical technician-II, emergency medical technician-paramedic,
lifeguard, firefighter, or peace officer, as defined or described by
Sections 1797.56, 1797.80, 1797.82, 1797.84, 1797.182, and 1797.183,
respectively, or a physician and surgeon who provides prehospital
emergency medical care or rescue services.
(2) "Reportable disease or condition" or "a disease or condition
listed as reportable" means those diseases prescribed by Subchapter 1
(commencing with Section 2500) of Chapter 4 of Title 17 of the
California Administrative Code, as may be amended from time to time.
(3) "Exposed" means at risk for contracting the disease, as
defined by regulations of the state department.
(4) "Health facility" means a health facility, as defined in
Section 1250, including a publicly operated facility.
(b) In addition to the communicable disease testing and
notification procedures applicable under Chapter 3.5 (commencing with
Section 120260) of Part 1 of Division 105, all prehospital emergency
medical care personnel, whether volunteers, partly paid, or fully
paid, who have provided emergency medical or rescue services and have
been exposed to a person afflicted with a disease or condition
listed as reportable, which can, as determined by the county health
officer, be transmitted through oral contact or secretions of the
body, including blood, shall be notified that they have been exposed
to the disease and should contact the county health officer if all
the following are satisfied:
(1) The prehospital emergency medical care person, who has
rendered emergency medical or rescue services and has been exposed to
a person afflicted with a reportable disease or condition, provides
the health facility with his or her name and telephone number at the
time the patient is transferred from that prehospital emergency
medical care person to the admitting health facility; or the party
transporting the person afflicted with the reportable disease or
condition provides that health facility with the name and telephone
number of the prehospital emergency medical care person who provided
the emergency medical or rescue services.
(2) The health facility reports the name and telephone number of
the prehospital emergency medical care person to the county health
officer upon determining that the person to whom the prehospital
emergency medical care person provided the emergency medical or
rescue services is diagnosed as being afflicted with a reportable
disease or condition.
(c) The county health officer shall immediately notify the
prehospital emergency medical care person who has provided emergency
medical or rescue services and has been exposed to a person afflicted
with a disease or condition listed as reportable, which can, as
determined by the county health officer, be transmitted through oral
contact or secretions of the body, including blood, upon receiving
the report from a health facility pursuant to paragraph (1) of
subdivision (b). The county health officer shall not disclose the
name of the patient or other identifying characteristics to the
prehospital emergency medical care person.
Nothing in this section shall be construed to authorize the
further disclosure of confidential medical information by the health
facility or any prehospital emergency medical care personnel
described in this section except as otherwise authorized by law.
In the event of the demise of the person afflicted with the
reportable disease or condition, the health facility or county health
officer shall notify the funeral director, charged with removing the
decedent from the health facility, of the reportable disease prior
to the release of the decedent from the health facility to the
funeral director.
Notwithstanding Section 1798.206, violation of this section is not
a misdemeanor.
1797.189. (a) As used in this section:
(1) "Chief medical examiner-coroner" means the chief medical
examiner or the coroner as referred to in subdivision (m) of Section
24000, Section 24010, subdivisions (k), (m), and (n) of Section
24300, subdivisions (k), (m), and (n) of Section 24304, and Sections
27460 to 27530, inclusive, of the Government Code, and Section
102850.
(2) "Prehospital emergency medical care person or personnel" means
any of the following: authorized registered nurse or mobile
intensive care nurse, emergency medical technician-I, emergency
medical technician-II, emergency medical technician-paramedic,
lifeguard, firefighter, or peace officer, as defined or described by
Sections 1797.56, 1797.80, 1797.82, 1797.84, 1797.182, and 1797.183,
respectively, or a physician and surgeon who provides prehospital
emergency medical care or rescue services.
(3) "Reportable disease or condition" or "a disease or condition
listed as reportable" means those diseases specified in Subchapter 1
(commencing with Section 2500) of Chapter 4 of Title 17 of the
California Administrative Code, as may be amended from time to time.
(4) "Exposed" means at risk for contracting a disease, as defined
by regulations of the state department.
(5) "Health facility" means a health facility, as defined in
Section 1250, including a publicly operated facility.
(b) Any prehospital emergency medical care personnel, whether
volunteers, partly paid, or fully paid who have provided emergency
medical or rescue services and have been exposed to a person
afflicted with a disease or condition listed as reportable, that can,
as determined by the county health officer, be transmitted through
oral contact or secretions of the body, including blood, shall be
notified that they have been exposed to the disease and should
contact the county health officer if all of the following conditions
are met:
(1) The prehospital emergency medical care person, who has
rendered emergency medical or rescue services and has been exposed to
a person afflicted with a reportable disease or condition, provides
the chief medical examiner-coroner with his or her name and telephone
number at the time the patient is transferred from that prehospital
medical care person to the chief medical examiner-coroner; or the
party transporting the person afflicted with the reportable disease
or condition provides that chief medical examiner-coroner with the
name and telephone number of the prehospital emergency medical care
person who provided the emergency medical or rescue services.
(2) The chief medical examiner-coroner reports the name and
telephone number of the prehospital emergency medical care person to
the county health officer upon determining that the person to whom
the prehospital emergency medical care person provided the emergency
medical or rescue services is diagnosed as being afflicted with a
reportable disease or condition.
(c) The county health officer shall immediately notify the
prehospital emergency medical care person who has provided emergency
medical or rescue services and has been exposed to a person afflicted
with a disease or condition listed as reportable, that can, as
determined by the county health officer, be transmitted through oral
contact or secretions of the body, including blood, upon receiving
the report from a health facility pursuant to paragraph (1) of
subdivision (b). The county health officer shall not disclose the
name of the patient or other identifying characteristics to the
prehospital emergency medical care person.
Nothing in this section shall be construed to authorize the
further disclosure of confidential medical information by the chief
medical examiner-coroner or any of the prehospital emergency medical
care personnel described in this section except as otherwise
authorized by law.
The chief medical examiner-coroner, or the county health officer
shall notify the funeral director, charged with removing or receiving
the decedent afflicted with a reportable disease or condition from
the chief medical examiner-coroner, of the reportable disease prior
to the release of the decedent from the chief medical
examiner-coroner to the funeral director.
Notwithstanding Section 1798.206, violation of this section is not
a misdemeanor.
1797.190. The authority may establish minimum standards for the
training and use of automatic external defibrillators.
1797.191. (a) The authority shall establish minimum standards for
the training in pediatric first aid, pediatric cardiopulmonary
resuscitation (CPR), and preventive health practices required by
Section 1596.866.
(b) (1) The authority shall establish a process for the ongoing
review and approval of training programs in pediatric first aid,
pediatric CPR, and preventive health practices as specified in
paragraph (2) of subdivision (a) of Section 1596.866 to ensure that
those programs meet the minimum standards established pursuant to
subdivision (a). The authority shall charge fees equal to its costs
incurred for the pediatric first aid and pediatric CPR training
standards program and for the ongoing review and approval of these
programs.
(2) The authority shall establish, in consultation with experts in
pediatric first aid, pediatric CPR, and preventive health practices,
a process to ensure the quality of the training programs, including,
but not limited to, a method for assessing the appropriateness of
the courses and the qualifications of the instructors.
(c) (1) The authority may charge a fee equal to its costs incurred
for the preventive health practices program and for the initial
review and approval and renewal of approval of the program.
(2) If the authority chooses to establish a fee process based on
the use of course completion cards for the preventive health
practices program, the cost shall not exceed seven dollars ($7) per
card for each training participant until January 1, 2001, at which
time the authority may evaluate its administrative costs. After
evaluation of the costs, the authority may establish a new fee scale
for the cards so that revenue does not exceed the costs of the
ongoing review and approval of the preventive health practices
training.
(d) For the purposes of this section, "training programs" means
programs that apply for approval by the authority to provide the
training in pediatric first aid, pediatric CPR, or preventive health
practices as specified in paragraph (2) of subdivision (a) of Section
1596.866. Training programs include all affiliated programs that
also provide any of the authority-approved training required by this
division. "Affiliated programs" means programs that are overseen by
persons or organizations that have an authority-approved training
program in pediatric first aid, pediatric CPR, or preventive health
practices. Affiliated programs also include programs that have
purchased an authority-approved training program in pediatric first
aid, pediatric CPR, or preventive health practices. Training programs
and their affiliated programs shall comply with this division and
with the regulations adopted by the authority pertaining to training
programs in pediatric first aid, pediatric CPR, or preventive health
practices.
(e) The director of the authority may, in accordance with
regulations adopted by the authority, deny, suspend, or revoke any
approval issued under this division or may place any approved program
on probation, upon the finding by the director of the authority of
an imminent threat to the public health and safety as evidenced by
the occurrence of any of the actions listed in subdivision (f).
(f) 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, probation, or revocation of a program's approval
or application for approval pursuant to this division.
(1) Fraud.
(2) Incompetence.
(3) The commission of any fraudulent, dishonest, or corrupt act
that is substantially related to the qualifications, functions, and
duties of training program directors and instructors.
(4) Conviction of any crime that is substantially related to the
qualifications, functions, and duties of training program directors
and instructors. The record of conviction or a certified copy of the
record shall be conclusive evidence of the conviction.
(5) Violating or attempting to violate, directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
this division or the regulations promulgated by the authority
pertaining to the review and approval of training programs in
pediatric first aid, pediatric CPR, and preventive health practices
as specified in paragraph (2) of subdivision (a) of Section 1596.866.
(g) In order to ensure that adequate qualified training programs
are available to provide training in the preventive health practices
course to all persons who are required to have that training, the
authority may, after approval of the Commission on Emergency Medical
Services pursuant to Section 1799.50, establish temporary standards
for training programs for use until permanent standards are adopted
pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of
Division 3 of Title 2 of the Government Code.
(h) Persons who, prior to the date on which the amendments to this
section enacted in 1998 become operative, have completed a course or
courses in preventive health practices as specified in subparagraph
(C) of paragraph (2) of subdivision (a) of Section 1596.866, and have
a certificate of completion card for a course or courses in
preventive health practices, or certified copies of transcripts that
identify the number of hours and the specific course or courses taken
for training in preventive health practices shall be deemed to have
met the requirement for training in preventive health practices.
1797.192. On or before July 1, 1991, the authority shall adopt
standards for a standard statewide scope of practice which shall be
utilized for the training and certification testing of EMT-P
personnel for certification as EMT-P's. Local EMS systems shall not
be required to utilize the entire standard scope of practice. Testing
of EMT-P personnel for local accreditation to practice shall only
include local operational policies and procedures, and drug, device,
or treatment procedures being utilized within that local EMS system
pursuant to Sections 1797.172 and 1797.221.
1797.193. (a) By July 1, 1992, existing firefighters in this state
shall complete a course on the nature of sudden infant death syndrome
taught by experts in the field of sudden infant death syndrome. All
persons who become firefighters after January 1, 1990, shall complete
a course on this topic as part of their basic training as
firefighters. The course shall include information on the community
resources available to assist families who have lost children to
sudden infant death syndrome.
(b) For purposes of this section, the term "firefighter" has the
same meaning as that specified in Section 1797.182.
(c) When the instruction and training are provided by a local
agency, a fee shall be charged sufficient to defray the entire cost
of the instruction and training.
1797.194. The purpose of this section is to provide for the state
licensure of EMT-P personnel. Notwithstanding any provision of law,
including, but not limited to, Sections 1797.208 and 1797.214, all of
the following applies to EMT-P personnel:
(a) Any reference to EMT-P certification pursuant to this division
shall be equivalent to EMT-P licensure pursuant to this division,
including, but not limited to, any provision in this division
relating to the assessment of fees.
(b) The statewide examination designated by the authority for
licensure of EMT-P personnel and the licensure issued by the
authority shall be the single sufficient examination and licensure
required for practice as an EMT-P.
(c) EMT-P licenses shall be renewed every two years upon
submission to the authority of proof of satisfactory completion of
continuing education or other educational requirements established by
regulations of the authority, upon approval by the commission. If
the evaluation and recommendations of the authority required pursuant
to Section 8 of Chapter 997 of the Statutes of 1993, so concludes,
the renewal of EMT-P licenses shall, in addition to continuing
education requirements, be contingent upon reexamination at 10-year
intervals to ensure competency.
(d) Every EMT-P licensee may be disciplined by the authority for
violations of this division. The proceedings under this subdivision
shall be conducted in accordance with Chapter 5 (commencing with
Section 11500) of Part 1 of Division 3 of Title 2 of the Government
Code, and the authority shall have all the powers granted therein for
this purpose.
(e) Nothing in this section shall be construed to extend the scope
of practice of an EMT-P beyond prehospital settings, as defined by
regulations of the authority.
(f) Nothing in this section shall be construed to alter or
interfere with the local EMS agency's ability to locally accredit
licensed EMT-Ps.
(g) Nothing in this section shall be construed to hinder the
ability of the medical director of the local EMS agency to maintain
medical control within the local EMS system in accordance with this
division, including, but not limited to, Chapter 5 (commencing with
Section 1798).
1797.195. (a) Notwithstanding any other provision of law to the
contrary, an EMT-I, EMT-II, or EMT-P may provide emergency medical
care pursuant to this section in the emergency department of a
hospital that meets the definition of small and rural hospital
pursuant to Section 1188.855, except that in the case of a hospital
meeting the definition contained in Section 1188.855 the population
of the incorporated place or census designated place where the
hospital is located shall not have increased to more than 20,000
since 1980, and all of the following conditions are met:
(1) The EMT-I, EMT-II, or EMT-P is on duty as a prehospital
emergency medical care provider.
(2) The EMT-I, EMT-II, or EMT-P shall function under direct
supervision as defined in hospital protocols that have been issued
pursuant to paragraph (3), and only where the physician and surgeon
or the registered nurse determines that the emergency department is
faced with a patient crisis, and that the services of the EMT-I,
EMT-II, or EMT-P are necessary to temporarily meet the health care
needs of the patients in the emergency department.
(3) The utilization of an EMT-I, EMT-II, or EMT-P in the emergency
department is done pursuant to hospital protocols that have been
developed by the hospital's nursing staff, the physician and surgeon
medical director of the emergency department, and the administration
of the hospital, with the approval of the medical staff, and that
shall include at least all of the following:
(A) A requirement that the EMT-I, EMT-II, or EMT-P successfully
complete a hospital training program on the protocols and procedures
of the hospital emergency department. The program shall include, but
not be limited to, features of the protocols for which the EMT-I,
EMT-II, or EMT-P has not previously received training and a
postprogram evaluation.
(B) A requirement that the EMT-I, EMT-II, or EMT-P annually
demonstrates and documents to the hospital competency in the
emergency department procedures.
(C) The emergency medical care to be provided in the emergency
department by the EMT-I, EMT-II, or EMT-P shall be set forth or
referenced in the protocols and shall be limited to that which is
otherwise authorized by their certification or licensure as defined
in statute or regulation. The protocols shall not include patient
assessment in this setting, except when the assessment is directly
related to the specific task the EMT-I, EMT-II, and EMT-P is
performing.
(D) A process for continuity of patient care when the EMT-I,
EMT-II, or EMT-P is called to an off-site emergency situation.
(E) Procedures for the supervision of the EMT-I, EMT-II, or EMT-P.
(4) The protocols for utilization of an EMT-I, EMT-II, or EMT-P in
the emergency department are developed in consultation with the
medical director of the local EMS agency and the emergency medical
care committee, if a committee has been formed.
(5) A written contract shall be in effect relative to the services
provided pursuant to this section, between the ambulance company and
the hospital, where the EMT-I, EMT-II, or EMT-P is employed by an
ambulance company that is not owned by the hospital.
(b) When services of emergency personnel are called upon pursuant
to this section, responsibility for the medical direction of the
EMT-I, EMT-II, or EMT-P rests with the hospital, pursuant to the
hospital protocols as set forth in paragraph (3) of subdivision (a).
(c) Although this section authorizes the provision of services in
an emergency department of certain small and rural hospitals, nothing
in this section is intended to expand or restrict the types of
services or care to be provided by EMT-I, EMT-II, or EMT-P pursuant
to this article.
1797.196. (a) For purposes of this section, "AED" or "defibrillator"
means an automated or automatic external defibrillator.
(b) In order to ensure public safety, any person or entity that
acquires an AED is not liable for any civil damages resulting from
any acts or omissions in the rendering of the emergency care under
subdivision (b) of Section 1714.21 of the Civil Code, if that person
or entity does all of the following:
(1) Complies with all regulations governing the placement of an
AED.
(2) Ensures all of the following:
(A) That the AED is maintained and regularly tested according to
the operation and maintenance guidelines set forth by the
manufacturer, the American Heart Association, and the American Red
Cross, and according to any applicable rules and regulations set
forth by the governmental authority under the federal Food and Drug
Administration and any other applicable state and federal authority.
(B) That the AED is checked for readiness after each use and at
least once every 30 days if the AED has not been used in the
preceding 30 days. Records of these checks shall be maintained.
(C) That any person who renders emergency care or treatment on a
person in cardiac arrest by using an AED activates the emergency
medical services system as soon as possible, and reports any use of
the AED to the licensed physician and to the local EMS agency.
(D) For every AED unit acquired up to five units, no less than one
employee per AED unit shall complete a training course in
cardiopulmonary resuscitation and AED use that complies with the
regulations adopted by the Emergency Medical Service Authority and
the standards of the American Heart Association or the American Red
Cross. After the first five AED units are acquired, for each
additional five AED units acquired, one employee shall be trained
beginning with the first AED unit acquired. Acquirers of AED units
shall have trained employees who should be available to respond to an
emergency that may involve the use of an AED unit during normal
operating hours.
(E) That there is a written plan that describes the procedures to
be followed in the event of an emergency that may involve the use of
an AED, to ensure compliance with the requirements of this section.
The written plan shall include, but not be limited to, immediate
notification of 911 and trained office personnel at the start of AED
procedures.
(3) When an AED is placed in a building, building owners shall
ensure that tenants annually receive a brochure, approved as to
content and style by the American Heart Association or American Red
Cross, which describes the proper use of an AED, and also ensure that
similar information is posted next to any installed AED.
(4) When an AED is placed in a building, no less than once a year,
building owners shall notify their tenants as to the location of AED
units in the building.
(5) When an AED is placed in a public or private K-12 school, the
principal shall ensure that the school administrators and staff
annually receive a brochure, approved as to contents and style by the
American Heart Association or the American Red Cross, that describes
the proper use of an AED. The principal shall also ensure that
similar information is posted next to every AED. The principal shall,
at least annually, notify school employees as to the location of all
AED units on the campus. The principal shall designate the trained
employees who shall be available to respond to an emergency that may
involve the use of an AED during normal operating hours. As used in
this paragraph, "normal operating hours" means during the hours of
classroom instruction and any school-sponsored activity occurring on
school grounds.
(c) Any person or entity that supplies an AED shall do all of the
following:
(1) Notify an agent of the local EMS agency of the existence,
location, and type of AED acquired.
(2) Provide to the acquirer of the AED all information governing
the use, installation, operation, training, and maintenance of the
AED.
(d) A violation of this provision is not subject to penalties
pursuant to Section 1798.206.
(e) The protections specified in this section do not apply in the
case of personal injury or wrongful death that results from the gross
negligence or willful or wanton misconduct of the person who renders
emergency care or treatment by the use of an AED.
(f) Nothing in this section or Section 1714.21 may be construed to
require a building owner or a building manager to acquire and have
installed an AED in any building.
(g) This section shall remain in effect only until January 1,
2013, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2013, deletes or extends
that date.
1797.196. (a) For purposes of this section, "AED" or "defibrillator"
means an automated or automatic external defibrillator.
(b) In order to ensure public safety, any person who acquires an
AED shall do all of the following:
(1) Comply with all regulations governing the training, use, and
placement of an AED.
(2) Notify an agent of the local EMS agency of the existence,
location, and type of AED acquired.
(3) Ensure all of the following:
(A) That expected AED users complete a training course in
cardiopulmonary resuscitation and AED use that complies with
regulations adopted by the Emergency Medical Services (EMS) Authority
and the standards of the American Heart Association or the American
Red Cross.
(B) That the defibrillator is maintained and regularly tested
according to the operation and maintenance guidelines set forth by
the manufacturer, the American Heart Association, and the American
Red Cross, and according to any applicable rules and regulations set
forth by the governmental authority under the federal Food and Drug
Administration and any other applicable state and federal authority.
(C) That the AED is checked for readiness after each use and at
least once every 30 days if the AED has not been used in the
preceding 30 days. Records of these periodic checks shall be
maintained.
(D) That any person who renders emergency care or treatment on a
person in cardiac arrest by using an AED activates the emergency
medical services system as soon as possible, and reports any use of
the AED to the licensed physician and to the local EMS agency.
(E) That there is involvement of a licensed physician in
developing a program to ensure compliance with regulations and
requirements for training, notification, and maintenance.
(c) A violation of this provision is not subject to penalties
pursuant to Section 1798.206.
(d) This section shall become operative on January 1, 2013.
1797.197. The authority shall establish training and standards for
all prehospital emergency care personnel, as defined pursuant to
paragraph (2) of subdivision (a) of Section 1797.189, regarding the
characteristics and method of assessment and treatment of
anaphylactic reactions and the use epinephrine. The authority shall
promulgate regulations regarding these matters for use by all
prehospital emergency care personnel.
