CA Bill Calls for EMS Licensing Overhaul

Apr. 22--California's 70,000 emergency medical technicians would undergo mandatory criminal background checks and be licensed by the state Emergency Medical Services Authority by 2009 under a sweeping bill introduced last week by Sen. Roy Ashburn.

A direct response to The Bee's investigation of troubled rescuers, SB 254 also calls for a diversion program to help paramedics and EMTs with substance abuse problems get treatment and return to work when recovered.

"The Bee series got the attention of everybody in the (emergency medical services) sector in the state as well as the private ambulance industry, which has embraced statewide EMT licensing and mandatory background checks," Ashburn said.

His legislative move comes as state documents obtained by The Bee show that 289 EMTs have been disciplined and convicted of crimes since 1998 -- including many who never told their employers. Under Ashburn's bill, employers would be notified whenever an EMT is arrested.

Ashburn, a Republican and former county supervisor whose district includes parts of Tulare, Kern, Inyo and San Bernardino counties, urged emergency medical interest groups to put aside turf wars to fix the problems exposed by The Bee. Those problems include loopholes and shortfalls in the system of licensing and state oversight, which put patients at risk.

"A lot of times, we get focused on the system instead of the customer -- the people for whom ambulances roll," Ashburn said.

He said his bill offers state officials tools to ensure that emergency rescuers are all good people with good backgrounds, a solution he suggested should be easy for the Legislature to endorse.

"People also need to be assured that their rescuers, if they have had problems with drugs or alcohol, have sought help and dealt with their problems," Ashburn said. "I don't know why anyone would want to oppose that."

While EMTs offer basic emergency medical care, paramedics have advanced life support skills -- and the conduct of both would be covered by the diversion proposal.

The Bee series reported that paramedics stripped of state licenses after being found guilty of sexual misconduct or patient neglect were returning to jobs as EMTs in ambulances, hospitals and fire departments across California. The culprit consistently was flaws in the patchwork licensing system run by counties, regional emergency medical groups and fire departments.

The only state lacking statewide EMT licensure or mandatory background checks, California also lets people with serious criminal records get or keep EMT credentials. Some of those, The Bee found, turn to the Office of the State Fire Marshal, which doesn't check backgrounds.

Unlike EMTs, paramedics are licensed by the state EMSA. But the 50-person agency has struggled to keep up with the caseload. Ashburn's bill does not address the issue of resources at EMSA, but ambulance industry officials have said that could be addressed through higher licensing fees.

The bill, however, would offer paramedics help with substance abuse problems, which The Bee found were on the rise. Driving drunk. Taking drugs. Stealing. Even pilfering and using the morphine they carry for patients in pain.

Some paramedics said they hesitated to seek help; some complained that no diversion program existed like those offered to doctors and nurses in the state.

A political battle looms, potentially involving both employers and unions, as well as local and state emergency medical service administrators.

California Ambulance Association President David A. Nevins welcomed Ashburn's bill.

"We want to see people qualified to work for us from a skills and training standpoint, but also from a moral standpoint," he said. "We can't be too careful."

Carroll Wills, a spokesman for the California Professional Firefighters, said the union -- which represents EMTs and paramedics -- does not oppose mandatory background checks or a diversion program but has not yet taken a position on the bill.