Paramedic oversight on California radar


By Andrew McIntosh
Sacramento Bee (California)
Copyright 2007 McClatchy Newspapers, Inc.
All Rights Reserved

California must bolster efforts to catch substance-abusing paramedics but also should consider creating a program that offers treatment and support before they commit crimes, state legislators said Monday.

The calls come after a Bee investigation revealed an increase in the number of California paramedics who are abusing drugs or alcohol and, in the worst case, committing crimes and putting patients at risk.

"You shouldn't have to be worried about your first responder being high or picking your pocket when you call for help," said state Sen. Abel Maldonado, R-Santa Maria, a member of the Senate Health Committee.

"It's not tolerable, and it needs to stop," added Assemblyman Alan Nakanishi, R-Lodi, vice chairman of the Assembly Health Committee.

Through a spokesman, Nakanishi said he supports the creation of a diversion program for paramedics, like those available to doctors and nurses in the state.

The Medical Board of California has a program that allows doctors with substance abuse problems to turn themselves in confidentially and get treatment, helping them stay out of court, and in some cases, to continue practicing under strict supervision.

The program costs $1.6 million annually and helps about 350 physicians a year.

It is financed through the fees doctors pay the state to secure their licenses to practice.

Sen. Sheila Kuehl, D-Santa Monica, chairwoman of the Senate Health Committee, said she's willing to consider calls for a paramedic diversion program.

"The notion is appealing," Kuehl said. "The question is funding it. Who will pay?"

The Bee's investigation found that substance-abusing paramedics stole from patients.

Some drove drunk or high. Others were involved in hit-and-runs.

Some even stole morphine from the stocks they carry to ease the pain of their patients, using it themselves and replacing it with salt water to evade detection. Several have been charged, convicted and sentenced to jail.

A recent case saw Joseph Duda, a Tulare paramedic, shave off the eyebrow of a heroin overdose patient as they traveled to a hospital in an ambulance. He then allegedly wrote, "I'm stupid," on the man's hand.

The state suspended Duda's license Jan. 2, citing his alcoholism, and now wants to revoke it.

Yet action came months after Duda showed symptoms of alcoholism and erratic behavior, including domestic violence and shouting profanities on an ambulance radio frequency.

Enforcement efforts by the state Emergency Medical Services Authority, which licenses the state's 16,000 paramedics, have been hampered by a lack of staff and funds.

Through a spokeswoman, Maldonado said he was concerned. "There's no way four people can properly oversee that many. We'll be looking into it," Maldonado said.

EMSA Director Dr. Cesar Aristeiguieta said paramedics need a diversion program.

"Because paramedics can have such a significant impact on the well-being of a patient they care for, we as a society, we as a profession, should be looking after them a little bit better," he said.

The efforts would pay for themselves by increasing state licensing fees, Aristeiguieta added.

Aristeiguieta said jail is the wrong place for paramedics with addictions. "The medical model is much better at helping people."

Paramedics themselves need to discuss any proposal, he said.

"We would need to sit down with the paramedic organizations, with employers, local medical directors and administrators and start to hone down what we want," Aristeiguieta said.

Two former paramedics who lost their licenses after succumbing to addictions said a diversion program would have helped them recover sooner and faster.

Rick Rolston, a former paramedic and EMS manager in Big Bear Lake, was convicted last year of stealing morphine from his fire department safe and using it to treat his chronic pain.

Scott McBride, a former Roseville paramedic firefighter, was charged with drunken driving and was later dismissed after showing up for work intoxicated.

Both men said a diversion might have saved their careers.

The Bee's Andrew McIntosh can be reached at (916) 321-1215 or amcintosh@sacbee.com.

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