EMT 2010 Project Commission on EMS March 25, 2009

1. EMT 2010 Project Commission on EMS March 25, 2009 1

2. EMT 2010 Sean Trask Manager Personnel Standards Unit Sean.trask@emsa.ca.gov

3. AB 2917 Expert Writing Group Central Registry Background Checks Investigations /Discipline/APA LEMSA ALJ Reimbursement function Required fees Implementation time line EMT 2010 Discussion Points:

4. AMR CPF EMSAAC EMDAC CAA Cal Fire & SFM CRPA CFCA CHP Parks and Recreation Public Member EMSA Agency / Governor’s Office AB 2917Author – TorricoConsensus Bill

5. AB 2917 Provisions • Picked up where SB 941 left off. • EMSA to create a central registry. • Require criminal background checks on EMT-Is and EMT-IIs. • Allow employers to conduct investigations that may lead to certification action.

6. AB 2917 Provisions • EMSA to: • Revise several chapters of regulations • Create guidelines for model disciplinary orders. • EMSA to create the ALJ reimbursement fund. • LEMSA medical directors retain authority for certification action. • LEMSA must follow APA for appeals to certification action.

7. AB 2917 Provisions • EMSA to collect fees from certifying entities for: • The central registry • LEMSA ALJ reimbursement • Separate fees not shared by all applicants (currently DOJ fees). • EMSA may set paramedic licensure fee in regulations.

8. AB 2917 Provisions • EMSA may establish penalties for • Failure to report certification status changes. • July 1, 2010 Deadline

9. Four Phases of Project • Regulation Revisions • Administrative Phase • Funding Start Up costs • Establish 3 new functions • New staff • IT Project – Central Registry • Roll Out

10. Regulation Revisions Strategy: • Convene Expert Writing Group • Pre-public Comment Period • Convene Task Force • Public Comment Period • EMS Commission Approval

11. Expert Writing Group • Representatives from: • CAA • EMDAC • EMSAAC • CPF • CFCA • EMSA

12. Expert Writing Group • Purpose was to assist EMSA in translating the AB 2917 requirements into relevant regulations. • Met from October 3, 2008 to December 12, 2008.

13. Expert Writing Group • Small, manageable writing group. • Representatives were involved in AB 2917 Task Force who were familiar with provisions of AB 2917. • Short timeline.

14. Expert Writing Group • Revisions were made to: • EMT-I Regulations • EMT-II Regulations • Paramedic Regulations • EMT-I and EMT-II Disciplinary Regulations • EMT-I and EMT-II Model Disciplinary Orders

15. Expert Writing Group • New Chapter of Regulations was introduced • Central Registry

16. Central Registry • All certifying entities will use • EMT certificates will be printed from central registry • Information available to certifying entities and the public

17. Proposed Central Registry Process

18. Background Checks • Beginning 7-1-2010, all EMTs will be required to have completed criminal background checks • “Grandfathering” Provision • Dual Reporting – EMSA & Certifying Entity • Re-Live Scan Provision

19. Background Checks • “Grandfathering” • Individuals with state level DOJ prior to 7-1-2010 for employment or EMT certification. • Employer or certifying entity must receive subsequent arrest reports to qualify for “grandfathering”. • Must certify to EMSA individual was DOJ’d, subsequent arrest notification in place, and individual is not precluded from EMT certification (no shall denies).

20. Background Checks • Preclusions From Certification: • Has committed any sexually related offense specified under Section 290 of the Penal Code. • Has been convicted of murder, attempted murder, or murder for hire. • Has been convicted of two (2) or more felonies. • Is on parole or probation for any felony.

21. Background Checks • Beginning 7-1-2010, all EMT-Is, AEMTs, & EMT-IIs not “grandfathered” shall be Live Scanned at the time of recertification. • EMTs “grandfathered” prior to 7-1-2010 will not need to be Live Scanned after 7-1-2010, except: • EMTs previously “grandfathered” who switch employers or certifying entities will need to get a new Live Scan. • No Longer Interested.

22. Background Checks • Individual who switches certifying entities that has a subsequent arrest may be requested to be re-Live Scanned by the LEMSA as part of their investigation.

23. Background Checks • FBI Criminal Offender Record Information (CORIs) • Only governmental agencies will receive FBI CORIs. • Need governing board resolution on file to accept FBI criminal background information. • Important timeframe to get board resolutions. • EMSA has sample resolution language from DOJ.

24. Background Checks

25. Investigation/Discipline Process • Employer may conduct investigation • Timelines • LEMSA retains certification action authority • Appeals to certification action follow APA • Certification action honored statewide for 12 months

26. Investigation / Discipline Process

27. LEMSA ALJ Reimbursement • LEMSAs with actual ALJ costs eligible for reimbursement from EMSA • Projected $300,000 available • Reimbursements made once / year • Amount reimbursed depends on amount in fund.

28. Fees • Fees • EMT-I • Advanced EMT • EMT-II • Paramedic

29. Fees • EMT-I, Advanced EMT, & EMT-II • $75 for new certification • $22 for Central Registry • $15 for LEMSA ALJ Reimbursement • $38 for DOJ-CORI function • $37 for certification renewal • $22 for Central Registry • $15 for LEMSA ALJ Reimbursement

30. Fees • Fees will be submitted to EMSA from each certifying entity. • Fees listed are in addition to: • Local certification fees. • Live scan fees

31. Fees • EMT-I and EMT-II Fee Calculation Assumptions • Revenues begin July 1, 2010 • Estimated 60,000 EMT-Is certified in CA, half will recertify each year. • 5,000 new EMT-Is per year • 10% attrition in EMT-I renewals

32. Fees • EMT-I, AEMT, & EMT-II fees support: • 3 new functions @ EMSA – Central Registry, DOJ/ CORI, LEMSA-ALJ Reimbursement. • 7 new staff members (1 manager, 1 specialist, 2 programmers, 2 program technicians, 1 special investigator) • IT Project

33. Fees • Central Registry • Estimated central registry start-up costs are $1.5 million for hardware and software procurement processes, data center costs, customization, and two new staff programmers.

34. Fees IT Project • Feasibility Study Report • Bid preparation • Vendor selection • Independent project oversight consultant • Loading and testing of software • Implementing program • Training users • Ongoing support and modifications

35. Fees • LEMSA – ALJ Reimbursement • Fee is based on an estimated 50 hearings/year at an average cost of $6,000 plus program costs.

36. Paramedic Fees

37. Paramedic Fees • Fees have not been adjusted since being set in statute in1994. • New fees will take effect 7-1-2010. • Fund is currently operating at a $257,000 deficit per year. • Largest portion of the fund supports the enforcement unit.

38. Next Steps • Pre-Public Comment • Convene Task Force • Public Comment Period(s) • General Fund Loan • Hire New Staff • IT Project • Regulation Revisions • Education and Roll Out of Central Registry • Implementation

39. Timeline

40. EMT 2010 Questions?