emt 2010 project commission on ems march 25, 2009 emt 2010 project commission on ems march 25, 2009...
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EMT 2010 Project
Commission on EMS
March 25, 2009
EMT 2010 Project
Commission on EMS
March 25, 2009
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EMT 2010 Discussion Points:
EMT 2010 Discussion Points:
• AB 2917
• Expert Writing Group
• Central Registry
• Background Checks
• Investigations /Discipline/APA
• LEMSA ALJ Reimbursement function
• Required fees
• Implementation time line
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AB 2917Author – TorricoConsensus Bill
AB 2917Author – TorricoConsensus Bill
– AMR– CPF– EMSAAC– EMDAC– CAA– Cal Fire & SFM– CRPA
– CFCA– CHP– Parks and
Recreation– Public Member– EMSA– Agency /
Governor’s Office
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AB 2917 ProvisionsAB 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.
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AB 2917 ProvisionsAB 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.
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AB 2917 ProvisionsAB 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.
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AB 2917 ProvisionsAB 2917 Provisions
• EMSA may establish penalties for – Failure to report certification status
changes.
• July 1, 2010 Deadline
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Four Phases of ProjectFour Phases of Project
• Regulation Revisions• Administrative Phase
– Funding Start Up costs– Establish 3 new functions– New staff
• IT Project – Central Registry• Roll Out
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Regulation RevisionsRegulation RevisionsStrategy:• Convene Expert Writing Group• Pre-public Comment Period• Convene Task Force• Public Comment Period• EMS Commission Approval
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Expert Writing Group Expert Writing Group
• Representatives from:– CAA– EMDAC– EMSAAC– CPF– CFCA– EMSA
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Expert Writing GroupExpert 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.
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Expert Writing GroupExpert Writing Group
• Small, manageable writing group.
• Representatives were involved in AB 2917 Task Force who were familiar with provisions of AB 2917.
• Short timeline.
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Expert Writing GroupExpert 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
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Expert Writing GroupExpert Writing Group
• New Chapter of Regulations was introduced
– Central Registry
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Central RegistryCentral Registry
• All certifying entities will use• EMT certificates will be printed
from central registry• Information available to
certifying entities and the public
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Proposed Central Registry Process
Proposed Central Registry Process
Statewide DBSQL Server
Paramedic License or
EMT Certificate
Mailed to Paramedic or EMT
Store Application
(Image)
Photo
ParamedicOn-Line Self Licensing
(Proposed)
ApplicationServer
Central Registry
Data Entry
Update Central Registry on Certification Status
Report Course Completion(Capability)
Verify Test ScoresReport CE Hours(Capability)
Dept of Justice
- Background Check- RAP Back
Verify Background Check if not required by Employer
Renewal Notice Mailed or e-mailed
to EMT
68 Certifying Entities CE Providers Training Programs National RegistryLocal EMS Agency
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Background ChecksBackground 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
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Background ChecksBackground 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).
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Background ChecksBackground 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.
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Background Checks 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.
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Background ChecksBackground 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.
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Background ChecksBackground 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.
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Background ChecksBackground ChecksDOJ / FBI Live Scan Process
EM
T A
pplic
atio
ns B
egin
ning
7-
1-20
10C
hang
es C
ertif
ying
Ent
ity a
fter
7-1-
2010
DO
J’d
Prio
r to
7-1-
2010
“Gra
ndfa
ther
ed”
Previous Certifying
Entity Notifies DOJ No Longer
Interested For This Individual
Verification to Central Registry
of DOJ Date and Not
Precluded From Certification
Previously “grandfathered” leaves employer
or certifying entity.
LEMSA Commences Investigation
CORI Results
Continue to EMSA
Only
Subsequent Arrest Notification
Included?Yes
“Grandfathered”New Live Scan Not Required
EMSA Notified of Subsequent
Arrest
No
New EMT Application
EMT Renewal Not “Grandfathered”
Live Scan Required Results to
Certifying Entity and EMSA
Or
Changes Certifying Entity
EMSA Notifies LEMSA
Individual No Longer Has Certificate of Clearance
State level DOJ for employer or
certifying entity prior to
7-1-2010
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Investigation/Discipline Process
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
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Investigation / Discipline Process
Investigation / Discipline Process
Complaint Received @ LEMSA
Individual Employed by EMS Provider (Fire
Department or Ambulance Company
Licensed by CHP)
Refer to Employer For Investigation within 3 Days of
Receipt of Complaint
Employer Investigates Complaint
LEMSA Investigates
Employer Shares Disciplinary Plan and Investigatory Findings With LEMSA Within 3 Days of Completion
LEMSA Determines if
Certification Action is Warranted
LEMSA Concurs With Disciplinary Plan?
LEMSA Updates Certification Status in
Central Registry
LEMSA Takes Certification Action and
Offers Due Process
LEMSA May or May Not Take Certification Action
and / or Offer Due Process
Certification Action Warranted?
LEMSA Takes Certification Action and
Offers Due Process
LEMSA Updates Certification Status in
Central Registry
NoYes
Yes
No
Yes
Discipline Warranted?
Yes
Employer Creates Disciplinary Plan
Employer Notifies LEMSA of Investigatory
Findings
No
No
Yes
No
Case Closed
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LEMSA ALJ ReimbursementLEMSA 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.
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FeesFees
• Fees– EMT-I– Advanced EMT – EMT-II – Paramedic
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FeesFees
• 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
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FeesFees
• Fees will be submitted to EMSA from each certifying entity.
• Fees listed are in addition to:– Local certification fees.– Live scan fees
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FeesFees
• 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
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FeesFees
• 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
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FeesFees• 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.
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FeesFeesIT 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
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FeesFees• LEMSA – ALJ Reimbursement
– Fee is based on an estimated 50 hearings/year at an average cost of $6,000 plus program costs.
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Paramedic FeesParamedic Fees
Paramedic Fees Current Proposed
Base licensing fee $125 $195
Initial In-state application 50 50
Initial Out of State Application
100 100
Late Renewal (<30 days before expiration or past expiration)
50 50
State License Match System 5 5
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Paramedic FeesParamedic 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.
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Next StepsNext 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
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TimelineTimeline
9/25/2008 8/24/2010
10/1/2008 1/1/2009 4/1/2009 7/1/2009 10/1/2009 1/1/2010 4/1/2010 7/1/2010
15-day Public Comment
3/25/2009Commission Meeting
9/25/2008AB 2917 Chaptered
7/1/2010Implement CORI Program
10/3/2008 - 12/12/2008Expert Writing Group
8/23/2010Implement LEMSA ALJ Program
1/30/2009SFL: IT Project
11/2/2009BCP: PTs & Investigator
7/1/2010EMT 2010 Effective
12/3/2008Commission Meeting
3/31/2010Regulations Become Effective
7/1/2009Hire HPS & HPM
4/7/2009Convene Task Force
1/26/2009 - 3/27/2009Pre-Public Comment
9/29/2009Commission Meeting
7/1/2009 - 7/1/2010IT Procurement, Testing, Training, Implementation
6/24/2009Commission Meeting
9/6/2009 - 9/21/2009
12/1/2008BCP: HPM & HPS
6/12/2009 - 7/27/2009Public Comment
3/31/2010Commission Meeting
12/2/2009Commission Meeting
6/24/2010Commission Meeting
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EMT 2010EMT 2010
Questions?