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

2 EMT 2010 Sean Trask Manager Personnel Standards Unit

3 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

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

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 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 Central Registry EMSA surveying all certifying entities to determine: –Numbers of EMTs certified –Type of software used to certify EMTs –ORI Number for DOJ –Contact information for certifying authorities for future correspondence.

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

20 Background Checks “Grandfathering” –Individuals with state level DOJ prior to 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).

21 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.

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

23 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.

24 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.

25 Background Checks

26 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

27 Investigation / Discipline Process

28 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.

29 Fees –EMT-I –Advanced EMT –EMT-II –Paramedic

30 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

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

32 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

33 Fees EMT-I, AEMT, & EMT-II fees support: –3 new 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

34 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.

35 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

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

37 Paramedic Fees CurrentProposed Base licensing fee$125$195 Initial In-state application50 Initial Out of State Application100 Late Renewal (<30 days before expiration or past expiration) 50 State License Match System55

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

39 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

40 Timeline

41 EMT 2010 Questions?