August 2019

Carole provided her EMS Commissioner report, announcing that Dr. Backer has retired. EMSA has formed a Stroke/STEMI technical advisory task force to assist with implementation of the newly enacted regulations. EMSA is now beginning to look at revising the trauma regulations. The scope of practice committee has recommended several additions to the local optional scope, including the use of I-gels, which is part of the plan to help replace the removal of intubation in the prehospital field.
Commissioner Barrow asked how Assembly Bill 1, youth athletics, California Youth Football, integrates with AB 2007 from 2016 and if it will just add on an EMS Component to the law. AB 1 focuses on youth tackle football. EMSA’s concern s the liability protection of the EMTs and paramedics for issuing a return to play or a removal from the game.
Carole provided an update on the ongoing discussion around 1544.

CalChiefs filed three petitions on February 4th on underground regulations dealing with EMS plans and exclusive operating area. EMSA filed a Section 280 Certification in response acknowledging that they would not enforce these guidelines.

There was a presentation at the last Commission meeting on the Centers for Medicare and Medicaid Services (CMS) Innovation Center Emergency Triage, Treatment, and Transport (ET3) Model.

Ambulance Patient Offload Times – EMSA stated that beginning July 1, 2019, all LEMSAs will be required to submit APOT data to EMSA quarterly,

The EMS-T committee met in June. Much of the time was spent on data, collecting it, what to collect, value of the data as well as obstacles to collecting it. More to follow.
BJ Bartleson discussed her presentation at the EMSAAC conference and the ambulance provider who just invoiced a hospital. One of our committee members mentioned an area where a hospital has possibly been billed and paid this to EMS – further research is planned and we’ll find out more. Part of the identified priority items for this committee is emergency services data and story collection. We need good data and transparency.
CHA has updated its Discharge Planning for Homeless Patients guidelines. This toolkit can be downloaded from their website.

Task forces:
Sue is our representative to the State Trauma Regulation Revision workgroup.
EMSA is putting together a Stroke and STEMI technical advisory committee. This group will inform EMSA on the systemization of the recently approved statewide STEMI and Stroke regulations.

National Association of EMS Physicians has formed a California Chapter. There’s some work going on to update Section 1157 of the evidence code to include EMS. Currently EMS is not protected from discovery under 1157. Sometime down the road they are looking for Cal ENA support.

EMDAC – they’ve established a set of standardized quality assurance measures for local optional scope of practice approval that that will be extended to other airway interventions as well, allowing for an unprecedented look at airway management, performance improvement, and data analysis.

EMSAAC – Their legislative committee has been very active, specifically 1544 and 438 (a dispatch bill). EMSAAC has started planning their May 2020 conference, it will be in San Diego.

The EMS Authority, after significant review is now proposing that alternate destination strategies are within its regulatory power. This means that the EMS Authority is clarifying that local EMS operations are legally allowed to transport patients to places other than emergency departments, such as sobering centers or behavioral health facilities.

During round table there was discussion on the move for “planned” power outages during high-wind/high fire risk days. Discussion around how to plan for 3-5 days on generator power.

May 2019

Carole Snyder provide her EMS Commissioner report – the commission last met on 3/19. New Commission chair elected: Jim Dunford. Carole touched on our continued work to maintain the ENA Chair on the commission. The EMS-Trauma Committee last met in March, next meeting is June 5th. In March the challenge of collecting LOS data was discussed, in particular behavioral health patients and how do we define a psych hold. How do we standardize the definition of the metrics? Attendance at the annual California Hospital ED Forum has not increasing significantly and it has been suggested that the date and time of the forum be changed to separate it from the Behavioral Health Symposium. They also expressed interest in pairing with Cal ENA for this ED Forum. EMSA update: the State Trauma Regulation Revisions workgroup has requested an ENA rep. Sue is working with the committee to identify a rep. The paramedic regulations are currently open for revisions. Any comments are due by May 20th. If you have suggested comments to submit as a group please send them to me by May 16 to allow enough time for the board to review prior to submission. The EMSAAC (EMS Administrators Association of California) Conference was held last week, at this same lodge. Some great speakers and topics. The last panel of the day was related to wall times. One panelist administers a large ambulance company and he recently submitted a 2.6 million dollar bill to a hospital in his area – charging for their staff time due to off load delays. It cannot be emphasized enough the importance of the hospitals taking control of collecting accurate turn over of care times. The State is requesting LEMSA’s submit their offload times on July 1 and we expect it will be posted on the publicly facing EMSA website. The National Association of EMS Physician’s group recently started a California Chapter. Two highlights from the summary they provided: They are focusing on advocating over the critical drug shortages. Also they are having a CPR video challenge to get bystander CPR videos to go viral on social media platforms. Everyone is welcome to submit a video, in fact they are encouraging participation. They provided several links related to their blog and podcast, I’ll post the links on the website, on the EMS Committee page. The Emergency Medical Director Association of California or EMDAC, scope of practice committee approval an expanded scope for flight paramedics, including pediatric intubation. Specific criteria must be met for paramedics to practice with this expanded scope. We’ve been talking with leadership of the California Paramedic Foundation. They are focusing on several things but in particular the safety and wellness of EMS providers. There’s an opportunity here for a collaboration. Finally – two LEMSA administrator’s have expressed interest in ENA representation on their Emergency Medical Care Committees. We will follow up with specific chapter leadership.

EMS Commissioner Report

November 2019

Dr. David Duncan was appointed as the new EMSA Director. Paramedic regulations: Alternate destination has been removed from current version of regs. In the latest public comment draft, EMSA removed the proposed alternate destination language found under subsection (a) of from Section 100170 under Article 7 of Chapter 4, Title 22 of the California Code of Regulations (CCR). Throughout the regulatory process, it has become clear to EMSA that further discussion about these details will take more time than initially expected. The changes noticed on September 13 are necessary to allow a new EMS Authority Director the opportunity to work with stakeholders and collaborate on a path forward for both alternate destination and community paramedicine policy. Presently, EMSA’s immediate priority is to proceed with the remaining proposed revisions to Chapter 4 of Title 22 of the CCR, including, but not limited to, modifying paramedic licensure fees and paramedic training program requirements. In order to meet the one-year (1) rulemaking process timeline pursuant to Section 11346.4 of the Government Code, and the Rulemaking Calendar schedule approved during the December 2018 Commission meeting, the EMS Authority is requesting the Commission on Emergency Medical Services to consider the proposed regulatory action for approval at the meeting scheduled for December 4, 2019. Community Paramedicine projects have been extended through November 2020.

This is copied from the minutes “DEPUTY DIRECTOR OF LEGISLATIVE, REGULATORY & EXTERNAL AFFAIRS LIM: The next bill is the AB 1544 and that is Community Paramedicine or Triage to Alternate Destination Act. This bill would authorize the local EMS agency to adopt a community paramedicine or triage to alternate destinations program and provide community paramedicine services, in which we have had pilot programs since 2014. This bill would require EMSA to develop regulations to establish minimum standards. It also would augment the Commission as it stands now in its compilation, among other features of the bill. Again, this bill has had a similar look in last session and that bill was 3115, I believe. I can’t remember but before that it was SB 944. We understand there is a lot of discussion around this bill. Is there any discussion that anyone would like to have? CHAIR DUNFORD: Commissioner Barrow. COMMISSIONER BARROW: This bill is a pretty contentious bill at the Capitol and there are alternative legislators exploring alternatives because they are unhappy with different provisions in this. One of the biggest concerns is the local political and monetary costs associated with this bill in changing EMS system unnecessarily when there is already a collaborative setting at LEMSA to handle CP. I think there is going to be more legislation coming out soon. The administration has made it really clear that they are not really happy that this is the only discussion happening at the Capitol so it will be interesting to see what happens by our September meeting, what the landscape looks like on this. DEPUTY DIRECTOR OF LEGISLATIVE, REGULATORY & EXTERNAL AFFAIRS LIM: Thank you. CHAIR DUNFORD: And Commissioner Snyder. COMMISSIONER SNYDER: Carole Snyder, Emergency Nursing Association. Just to reiterate, this is a sneaky bill that changes the makeup of this commission. It removes the Emergency Nursing Association and it removes the California Paramedic Association, which are not representing anything but the right type of care. And I just want to reiterate that if it was a clean bill ENA may be in support of it; but we are definitely in opposition right now and I would like you guys to take that into consideration. CHAIR DUNFORD: Thank you. Other comments? Commissioner Uner. COMMISSIONER UNER: I would like to second what Carole just said. I think removing emergency nurses and paramedics from this commission is not a good move. CHAIR DUNFORD: Thank you. Others? Commissioner Hinsdale. COMMISSIONER HINSDALE: Echo that, also agree with Carole. Thank you.

June 2019

The Trauma regulations are starting to be revised. EMSA will align with the American College of Surgeon guidelines, their verification process and their quality improvement process as the regs are reviewed and revised. They will concentrate on tracking patients and secondary transfers which may flow over to other specialty transport regulations. Other issues for trauma are how to look at regional issues. Do the current RTCCs accomplish the desired goals? Do we need to re-look at that concept and how can we integrate the concept of some regional evaluation or care into regulations? There are EDs around our state, who are beginning to initiate medically-assisted therapy. In other words, start patients on SUBOXONE, as opioid replacement, through something called the ED-BRIDGE Program. Recently the Scope of Practice Committee has recommended and Dr. Backer approved several additions to Local Optional Scope of Practice. These were either recommended through trial studies that were approved by this Commission such as TXA, or approved through evidence-based literature reviews and these include IV acetaminophen, ketorolac or Toradol which can be given through multiple routes, ketamine. Also approval for paramedics to monitor IV medications during transport to a higher level of care, medications that are initiated at the sending facilities, such as blood, pressors, anticoagulants and antibiotics. Per Dr. Backer-These expansions to Local Optional Scope of Practice provide better patient care, especially for our rural areas and our regional systems of specialty care when it is preferable to transport by paramedic ground ambulance because CCT is not readily available and air ambulance might be too much and too expensive. Dr. Backer announced his retirement from EMSA.

November 2018

Minutes to EMSA commission meeting can be found on the EMSA site: https://emsa.ca.gov/ems_commission_meetings/ Stroke and STEMI regulations were adopted, the full text of the proposed final regulations is posted on the website. Ambulance Patient Offload Time Update Mr. McGinnis stated staff continues to collect and work with data from the Ambulance Patient Offload Time project. 17 LEMSAs have provided information this year compared to 18 last year. Staff is learning more about ways to display this data. In working with the LEMSAs, staff learned that forms and ways data is collected can be difficult at times and is working to improve the process. Mr. McGinnis stated his hope that more submissions and more information will continue to come in and that, as staff learns better ways to visually display the information, it will present a good picture of what is happening in the state. Questions and Discussion Commissioner Dunford asked if there is any trend in favor of showing improvement based on the limited capacity of the current data. Mr. McGinnis stated there is no definitive trend. Dr. Backer noted that the data is only for the first year, 2017. There is variation year by year. Commissioner Dunford stated there are some significant outliers and asked if there is evidence of people trying to fix major problems. Mr. McGinnis stated it is early to say concretely. Action: Commissioner Stone moved to accept the ambulance patient offload time update as presented. Commissioner Burch seconded. . EMS Quality Core Measures Guidelines were approved. Alternate Destination The EMSA received a letter from EMS administrators and medical directors advocating implementing alternate destination by policy rather than seeking it legislatively. Staff will work with EMS administrators and medical directors on best strategies to achieve this. Disaster Medical Medical care support in times of disaster is one of EMSA’s key responsibilities. Medical and mental health care issues in shelters during large-scale evacuations are often underestimated. Individuals who end up in shelters often require a higher level of care because their usual home health care resources are unavailable in general population shelters. There is a need to explore alternative resources and concepts to medical shelters.

March 2018

Minutes to EMSA commission meeting can be found on the EMSA site: https://emsa.ca.gov/ems_commission_meetings/

Core Measures: EMSA has revised the Core Measures program to accommodate the transition to the NEMSIS Version 3.4 standards. EMSA initiated an ad-hoc work group comprised of EMS stakeholders to enhance the existing Core Measure set. This group, which met on November 2nd, 2017, reviewed each of the California Core Measures as well as those developed through the EMS Compass Initiative. The recommendations from the ad-hoc group were discussed and reviewed by the Core Measures Task Force on November 28, 2017. The EMSA commission deferred approval until the June meeting.

Disaster: There will be a 4% cut to HPP funding for the state.

Drug Shortages: EMSA is reporting pain medication shortages and is considering adding Ketamine, IV Tylenol and Nirtous Oxide to the optional scope of practice for paramedics.

Regulations: The following information is an update to the regulation rulemaking calendar approved by the Commission on EMS on December 6, 2017. In accordance with Health and Safety Code Section 1797.107, the Emergency Medical Services Authority is promulgating the following regulations: EMSC Open for public comment until April 30th. STEMI and Stoke regulations passed through finance department.

APOT: Ambulance patient offload times: Ambulance patient offload times (APOT) continue to be submitted quarterly to EMSA. To date, 15 of the 33 LEMSAs have provided at least one Quarter’s worth of APOT information, represented 238 (non-unique) hospitals for 2017 Data. Of those reporting LEMSAs, only 8 LEMSAs provided the full years’ worth of 2017 data. Currently, EMSA is working to develop a repository for this information to enhance the ability for review and analysis. Doing so will help to streamline future submissions of APOT information. Additionally, EMSA revised the APOT reporting spreadsheet to include clearer instructions, formatting enhancements, additional aggregate information, and cost per unit hour. EMSA continues the review of APOT submissions and is working to determine the best ways to visualize the information in a meaningful way. LEMSAs are encouraged to complete and submit APOT information to EMSA each quarter and continue to monitor and analyze APOT data to help identify and implement quality improvement strategies where needed.

The DHV Program has over 23,500 volunteers registered. Over 20,900 of these registered volunteers are in healthcare occupations. All 58 counties have trained DHV System Administrators in their MHOAC Programs. EMSA provides routine training and system drill opportunities for all DHV System Administrators. Over 9,300 of the 23,500 plus DHV registered responders are Medical Reserve Corps (MRC) members. EMSA publishes the “DHV Journal” newsletter for all volunteers on a tri-annual basis. The most recent issue was released on January 29, 2018. The “DHV Journal” is available on the DHV webpage of the EMSA webpage: http://www.emsa.ca.gov/disaster_healthcare_volunteers_journal_page. The DHV website is: https://www.healthcarevolunteers.ca.gov.

Ongoing technical support and clarification is provided to public safety agencies, LEMSA’s and the general public regarding all AED statutes and regulations. EMSA is working on a webpage to provide information regarding AED statutes for clarification. Review and approval of public safety AED programs according to Chapter 1.5 Section 100021 continues.

December 2017

California EMSA met September 13 in San Diego:

Jennifer Lim, EMSA Deputy Director of Policy, Legislative, and External Affairs, spoke about two bills that are inactive at this point but were significant and continue to be on the serious watch list for the two-year session. • AB 263 (Rodriguez) is entitled Emergency Medical Services Workers Rights and Working Conditions. It would require private employers that provide ground emergency medical services to authorize and permit its employees engaged in pre-hospital emergency services a prescribed rest and meal period. It would also require EMSA to publish an annual report containing specified information regarding violent incidents involving EMS providers. • AB 1116 (Grayson) is entitled Peer Support and Crisis Referral Services Act. It would create a Peer Support and Crisis Referral Services Program under the California Office of Emergency Services (Cal OES) with three separate tracks: o Fire service o Correctional officers o Rescue or emergency responders The Commission had some concern about the communication between the peer support member and the employee being confidential and not subject to civil or administrative disclosure.

Data: The Core Measures Report for the 2016 information will be posted soon, as will the report from UC Davis on how the Core Measures program is going. Dr. Backer felt that it is time to take a new look at the Core Measures – especially since all the providers in the state have moved over to the National EMS Information System (NEMSIS) 3.4 which gives more uniform and consistent data across the board. Data problems are now coming from the field entry level; we need to work with providers to not shortcut data entry. As they become facile in working with their ePCRs, they need to know the most important fields and the most important data to enter consistently.

APOT This Commission has shown an interest in ambulance patient offload times and delays (APOT). Because of the statute and our efforts to make standardized reporting, we need to see a statewide picture of APOT. Therefore, we are going to make the argument that we need all of the local EMSAs (LEMSAs) to report this data. An EMS fellow is going to work with us to write a report on the process. The next EMS Commission meeting will be held on December 6. Regards, Carole Snyder, RN.

Statewide Trauma Planning:

  • The Trauma Plan was revised and renamed. This does not require the same levels of approvals a state-approved plan, which had unforeseen challenges.
  • The American College of Surgeons’ Report on the California state-level trauma system review has now been posted on the EMSA website.

APOT

The first data on the ambulance patient offload times has started to arrive. The data confirms that the problem is localized, but it also confirms that the problem can be managed, since some health care systems with similar volumes have resolved the problem. Further data will point out examples of best practices and will also point out which medical centers the local EMS agencies and the California Hospital Association (CHA) need to work with to help improve this problem.

Community Paramedic Pilot Program Update:

The majority of the projects are moving forward with no difficulties.
The Alternate Destination Urgent Care Project has relatively few patients enrolled to date.
The UCLA Project in Santa Monica terminated on June 1st at the request of the fire chief due to the lack of patient enrollment.
The Carlsbad and Orange County urgent care projects are still active but do not have enough enrollees to support meaningful data analysis.
The San Francisco City and County Alternate Destination Sobering Center project is growing and is enrolling over one hundred patients per month.

May 12, 2017
California Crisis care guidelines” EMSA is working with CDPH to acquire funding to develop a crisis care/scarce resources guidance document Disaster Healthcare volunteers has over 22k volunteers registered Epi auto injector training; EMSA began accepting applications for training programs to provide training ad certification for the admin of epi auto injectors to the general public and off duty EMS personnel. They have approved 8 training programs to date. They continue to review and revise paramedic regs-they hope to present the revised regs to the commissions in December. EMT regs-see attached look at website for title 22 language POLST e registry guidelines are out Stroke and Stemi guidelines keep moving forward As of March they weren’t following any legislation-nothing posted on website.
To contact our EMS Commissioner: carole.snyder@pihhealth.org
January 2017
The Commission on Emergency Medical Services met on December 14, 2016 at the Marines Memorial in downtown San Francisco. Community paramedicine project has one year of data: EMSA will not sponsor any legislation for changes. They will be looking for stakeholders going forward. Stroke and Stemi regs have gone out for public comment. EMSA will be working with CDPH regarding deficits in behavior health during disaster. DAG may be brought back to a working committee this year. The POLST guidelines were not yet available but should be out in near future. EMT Regulation revisions went out for public comment. Ambulance Patient Offload Time (APOT) methodology guidelines was moved through the committee. Cal ENA respectfully voted no to these guidelines. LEMSA’s may establish an APOT that exceeds the threshold set forth in the guidelines. CHA rep. BJ Bartleson invitedCalENA to the December meeting to further discuss the APOT guidelines. CalENA will replace the CHA rep during the January meeting.

California State EMS Commission Meet June 20, 2018

Ketamine: Commission passed- Move Ketamine from Trial Study to Local Optional Scope

Community Paramedicine: The Community Paramedicine Project Manager and the Independent Evaluator are funded by the California HealthCare Foundation. Local pilot site providers participate with in-kind contributions and any local grants or reimbursement. Strong progress continues with the Community Paramedicine Projects. The data, as well as the independent evaluator’s public report continues to show these projects have improved patient care as well as having reduced hospital re-admissions and visits to emergency departments. The UCSF’s Healthforce Center issued an update Evaluation Report in February 2018, containing their findings for the first 28 months of the project, (see link below) which in summary states:

“The evaluation found that community paramedics are collaborating successfully with physicians, nurses, behavioral health professionals, and social workers to fill gaps in the health and social services safety net. The evaluation has yielded consistent findings for six of the seven community paramedicine concepts tested. All of the post-discharge, frequent 911 users, tuberculosis, hospice, and alternate destination – mental health projects have been in operation for 21 or more months and have improved patients’ well-being. In most cases, they have yielded savings for payers and other parts of the health care system. Preliminary findings regarding the sixth concept, alternate destination – sobering center, suggest that this project is also benefiting patients and the health care system.” The following links contain the UCSF February 2018 Evaluation Report as well a Research Highlight Document: https://healthforce.ucsf.edu/publications/evaluation-california-s-communityparamedicine-pilot-program

The following is a status update on the additional Pilot Projects:

Local EMS Agency Sponsor Concepts Status
Santa Clara County Santa Clara County EMS Agency Alt Destination Behavioral Health Alt Destination Sobering Center CORE and Site-specific training has been completed, an IRB has been approved for this Pilot Project OSHPD implementation approval is pending.
Sierra Sacramento Valley Dignity Health Post Discharge CORE and Site-specific training and an approved IRB are pending
El Dorado County Cal Tahoe JPA Alt Destination Behavioral Health Post Discharge This project has withdrawn due to lack of JPA Board approval and funding.
Marin County EMS Agency Frequent 911 User CORE and Site-specific Training and an approved IRB are pending, awaiting the outcome of the Legislative process.
City & County of San Francisco San Francisco Fire Department Frequent 911 User Alt Destination Behavioral Health Post Discharge Site-specific Training and an approved updated IRB are pending.
Central California EMS Agency Central California EMS Agency Alt Destination – Behavioral CORE and Site-specifc Training has been completed. Currently awaiting an approved IRB

There are currently two (2) pieces of Legislation making their way through the legislative process which would enable the ability for EMSA and the Local EMS Agencies to approve Community Paramedicine and/or Alternate Destination to Mental Health Facilities or Sobering Centers programs throughout the State of California.

AB 1795 (Gipson) Allows a local emergency medical services agency (LEMSA) to submit, as part of its emergency medical services (EMS) plan, a plan to transport specified patients who meet triage criteria to a behavioral health facility or a sobering center. This bill authorizes a city, county, or city and county to designate, and contract with, a sobering center to receive patients, and would establish sobering center standards. Specifies the training requirements for paramedics to transport individuals to behavioral health facilities. Requires the Emergency Medical Services Authority (EMSA) to adopt guidelines for the triage criteria and assessment procedures by July 1, 2020 and requires EMSA to annually analyze administration of local plans and issue a report. (Sponsored by California Hospital Association (CHA) & Los Angeles County)

SB 944 (Hertzberg)
This Bill is sponsored by the California Professional Firefighters (CPF)
The Bill would enact the Community Paramedicine Act of 2018. This bill would create the statutory authority to transition community paramedicine (CP) from the Health Workforce Pilot Project #173 to a statewide program. The bill would authorize local EMS agencies to develop a community paramedicine program that is consistent with regulations that would be developed by the Emergency Medical Services Authority (EMSA), in consultation with the Community Paramedicine Medical Oversight Committee, which would be formed by this bill. Community paramedicine programs would provide services in one or more of the following five roles: (1) providing short term post discharge follow up; (2) providing directly observed tuberculosis therapy; (3) providing case management services to frequent emergency medical services users; (4) providing hospice services in coordination with hospice nurses to treat patients in their homes; and, (5) providing patients with transport to an alternate destination, which can either be an authorized mental health facility or an authorized sobering center.

Previous Agenda.

Disaster: EMSA is working with CDPH to acquire funding to develop a Crisis Care/Scarce Resources guidance document.
The DHV Program has over 23,700 volunteers registered. There are over 21,000 healthcare occupations filled by registered volunteers. All 58 counties have trained DHV System Administrators in their MHOAC Programs. EMSA provides routine training and system drill opportunities for all DHV System Administrators. Over 9,300 of the 23,700 plus DHV registered responders are Medical Reserve Corps (MRC) members. EMSA trains and supports DHV System Administrators in each of the 36 participating MRC units. DHV System Administrator training, DHV user group webinars, and quarterly DHV drills are ongoing. On, April 4, 2018, EMSA conducted a quarterly DHV drill for System Administrators. On April 11, 2018, EMSA conducted a quarterly DHV User Group webinar.

Patient Movement Plan: EMSA is currently incorporating comments received during the public comment period. The release of the California Statewide Patient Movement Plan will be summer 2018.

Epinephrine Auto-injector Training and Certification: On January 1, 2016 the EMS Authority began accepting applications for training programs to provide training and certification for the administration of epinephrine auto-injectors to the general public and off-duty EMS personnel. EMSA has approved14 training programs and has issued 717 lay rescuer certification cards.

STEMI/Stroke Systems of Care: STEMI and Stroke Regulations EMSA has opened the rulemaking process with the Office of Administrative Law for the Stroke and STEMI regulations. The public was invited to submit written comments on the proposed regulations during the 45-day public comment period from April 6, 2018, through May 21, 2018. At the end of the public comment period, EMSA held a public hearing on May 21, 2018, beginning at 9:00 am and ending at 11:00 am to go over the regulations with any member of the public who had questions. The comments received during the comment periods will be reviewed against the draft regulations and considerations for change will be made. Should substantive changes be indicated, EMSA will engage the working group who helped develop the regulations prior to an additional comment period.

EMS for Children Program:
Regulations: The EMS for Children regulations completed the 45-day public comment period on Friday, April 27, 2018. The public hearing was held on Monday, April 30, 2018. NO members of the public appeared at the hearing to discuss the EMSC regulations draft. Revisions to the draft EMSC regulations are being considered based on the comments received during the first comment period. EMSA is engaging the EMSC TAC to assist us with revision considerations. Upon the completion of the revisions, a second comment period will be held.
Educational Forum: The 21st Annual EMS for Children Educational Forum will be held on Friday,
November 9, 2018 in Fairfield, CA. The venue has changed to the North Bay HealthCare Administration Center. Speakers and vendors/sponsors are being recruited for the forum.
NEDARC Survey:
The EMSC Program survey of California hospitals for Performance Measures EMSC 06 and 07 will be conducted May – August 2018. This survey will pertain to EMSC Interfacility Transfer Guidelines and Agreements of pediatric patients.

Legislative Report: http://www.emsa.ca.gov/current_legislation

Are You Registered?

The California State Emergency Medical Services Authority (EMSA) is always making strides to better prepare our State for disasters. While California does well in disaster situations because of its preparedness and mitigation activities, new resources are frequently added to enhance our response including a statewide volunteer registry for healthcare professionals called Disaster Healthcare Volunteers (DHV).

The Disaster Healthcare Volunteers (DHV) program is California’s solution to the nationwide Emergency System for Advance Registration of Volunteer Healthcare Professionals (ESAR-VHP). It’s a system specifically designed for California and its 58 counties to identify, recruit and mobilize healthcare professionals that are willing to volunteer their services and skill sets to assist locally and regionally in times of need. The registry is strictly voluntary. You can opt to help when you can and decline if you are unable to assist. And whether you’re already committed to a response team (D-MAT, MRC), DHV provides you with another opportunity to help out in case your response team is not deployed.

By registering with Disaster Healthcare Volunteers at www.healthcarevolunteers.ca.gov, you will be joining many of your professional colleagues who have already committed themselves to volunteering when they can to mitigate the negative impact disasters have on a community, including saving the lives of others.

Documents & Information

State EMS AuthorityState of California EMS Authority
Homeland DefenseHomeland Security Levels
Homeland DefenseChemical Decontamination Documents
Homeland DefenseDecontamination Water Containment
Homeland DefenseWhat’s going on with Smallpox Vaccinations in California?
Dept. of Homeland SecurityDepartment of Homeland Security
FEMAFederal Emergency Management Agency
Ready.GovPreparedness Advice from DHS
Disaster Medical Assistance Team – Orange Countywww.dmatca-1.org
American National Red Crosswww.redcross.org
U.S. Fire Administration (DHS/FEMA) Training & Educationwww.training.fema.gov
HazmatState of California: Hazardous Materials Medical Management Protocol (EMSA #231) Managing Hazardous Materials Incidents booklets, free quick reference guide to hazmat can be obtained from: Agency for Toxic Substances and Disease Registry Division of Toxicology Emergency Response and Scientific Assessment Branch (E57) 1600 Clifton Road, N.E. Atlanta, Georgia 30333 Telephone (404)639-6360
Natural HazardsNatural Hazards Center at the University of Colorado, Boulder Their links for GREAT Internet Resources On Hazards and Disasters
Disaster Recovery Training (Free)etraintoday.com/about-us/disaster-recovery
Natural Disasters: Be Informedwww.ready.gov/be-informed
Disaster Recovery Center Locatorwww.fema.gov/disaster-recovery-centers