EMS

Ensuring a Sustainable EMS System by Promoting Fire-based EMS

CPF has long stood as the champion for Fire-Based EMS in California. Any rulemaking process must acknowledge the long history of the fire service in delivering outstanding EMS services.

The fire service in California is uniquely equipped to handle all levels of disaster response. CPF’s advocacy efforts during several critical rulemaking processes will ensure the fire service is front and center as EMS evolves throughout the state. Recent successes in Sonoma County and San Bernardino, and decisions in Symons v. City of Riverside have further strengthened public fire agencies in the delivery of EMS to our communities.

The latest iteration in developing standards and greater clarity in the EMS system kicked off in June with the Emergency Medical Services Authority’s Policy Advisory Committee (EPAC). The EPAC will meet throughout the remainder of the year. Following those meetings, EMSA will submit draft regulations to the Office of Administrative Law (OAL) to initiate the formal rulemaking process—with draft regulations out for public comment in the fall of 2024, with approval by the State EMS Commission and OAL in the summer of 2025.

CPF continues to be a key stakeholder in the latest efforts to establish minimum standards and clarity within California’s Emergency Medical Services (EMS) System. “Chapter 1: Delivering Equitable and Person Centered Care” regulations, previously known as “Chapter 13”, will initiate the development of regulations to guide the EMS system for generations to come, enhancing clarity and consistency among the 34 Local EMS Agencies (LEMSAs), establishing minimum standards, and ensuring the system is focused on patients and positive clinical outcomes.

The key objectives to be addressed in deliberations over the Chapter 1 regulations will be centered around protecting the statutory rights of cities and fire districts who have been providing services since June 1, 1980, known as Health & Safety Code Section 1797.201 agencies (.201 agencies) and greater transparency in the processes employed by LEMSAs when they contract out for ambulance transport services. Additional issues include improving standards in the EMS Plan submission and evaluation process, the role of EMSA, LEMSA, EMS providers and the appropriate role of the EMS Commission in overseeing California’s EMS System.

Another priority for CPF is accurately defining "medical control" and placing safeguards on LEMSAs who use this concept to intrude on .201 agencies administrative and operational autonomy. Medical control must be focused on clinical patient care policies and not impede a .201 agency’s ability to make operational decisions that serve their communities.

The history of the Chapter 13, and now, Chapter 1 rulemaking process, has been long and we look forward to working collaboratively with system stakeholders.

The ability to establish minimum standards and provide greater clarity to the rules guiding the EMS system is imperative to the sustainability and health of the system. CPF is working to ensure that fire-based EMS providers receive fair opportunities to compete for system delivery options when they are up for a competitive bidding process and that those agencies with grandfathered .201 rights remain in control of their administrative and operational decision-making in the delivery of EMS in California.

When distilled into its core mission, the function and aspiration of the EMS system in California is to deliver rapid, high-quality, lifesaving medical treatment to every citizen, no matter the situation. The system must serve the communities and individuals who support it and who rely on it in their moments of greatest need. CPF feels that those needs are best served by a fire-based EMS system, provided by personnel who have taken an oath and dedicated their lives in public service—not motivated by profits or to further a corporate bottom line.

CPF will continue to engage and inform stakeholders throughout the rulemaking process and the work of the EPAC. For more information, please reach out to EMS/Health & Safety Director Kevin Greene at kgreene@cpf.org or (916) 217-4054.