By Andrew McIntosh
Sacramento Bee (California)
Copyright 2007 McClatchy Newspapers, Inc.
All Rights Reserved
Saying patient safety is paramount, California’s private ambulance operators are calling on legislators to adopt a statewide licensing system and mandatory background checks for all emergency medical technicians along with a new program to help substance-abusing EMTs and paramedics.
California Ambulance Association President David A. Nivens said The Bee’s recent investigation uncovering flaws in the state’s fragmented emergency medical services system should prompt a concerted statewide response.
“California has always been ahead of the rest of the country in providing emergency medical services,” Nivens said. “Now, it’s behind in not having statewide licensing and requiring mandatory background checks.”
“There’s a problem, and our people must not stick their heads in the sand,” Nivens added. “We provide a public safety service and the public has to trust us. “
The Roseville-based industry group for California’s largest private ambulance companies made the call for statewide licensure, mandatory background checks and a diversion program following its annual legislative summit in Sacramento last week.
The Bee reported in February that paramedics stripped of state licenses for sexual misconduct and patient neglect have been able to slip back into rescue jobs as emergency medical technicians in ambulances, hospitals and fire departments.
Nivens said he wasn’t surprised because “having the EMT licensing done by 61 different county, regional and public safety agencies just isn’t going to work.”
People with serious criminal records are getting and keeping EMT credentials, The Bee found, putting them in contact with vulnerable patients. Some of them obtained their certifications through the Office of the State Fire Marshal, which does not do background checks on applicants.
The Bee also reported an increase in substance abuse among paramedics who also commit crimes, including cases in which paramedics stole money from patients or morphine from their employers, abused patients and committed fraud ranging from forgery to hiding criminal pasts.
Nivens said that even though the volume of such cases appears to be small, the problems must be addressed to retain the public’s trust.
“We are different and we must act differently,” he said.
All EMTs should undergo Department of Justice criminal background checks, Nivens said. Ambulance operators also favor a “wrap-around” provision, in which Justice officials would notify an employer whenever an EMT employee is arrested, on or off duty.
The association’s support for statewide licensure of EMTs is conditional on increased funding for the agency that would be in charge, the Emergency Medical Services Authority. Those funds could be paid through higher licensing fees, Nivens said, noting that EMT certification currently costs between $30 and $50.
American Medical Response, the largest ambulance company in the United States, parted ways with the California Ambulance Association last year. But AMR also supports statewide licensing, mandatory background checks for EMTs and the creation of a diversion program, according to spokesman Jason Sorrick.
“The most important thing for us is consistency so that every EMT and paramedic is going through the same background checks,” Sorrick said.
Sen. Abel Maldonado, R-Santa Maria, has reserved a spot for an emergency medical services bill during this legislative session, saying that vulnerable patients shouldn’t have to worry about rescuers stealing their money or medicines when they call for help.
Maldonado spokeswoman Amy Thoma said the senator plans to meet this month with representatives of the emergency medical world, including the state authority, ambulance companies and fire departments, to draft legislation that would strengthen regulation and licensing of EMTs and launch a substance abuse diversion program.
The California Professional Firefighters, a powerful union group whose ranks include firefighter EMTs and paramedics, has indicated willingness to discuss mandatory background checks and statewide licensing of EMTs. But its leaders have concerns about giving a state agency powers to license and discipline those EMTs already subject to fire department discipline.
“Any discussion would have to recognize the vital role that local public agencies have in certifying EMTs and paramedics, and local accountability that currently exists needs to be strongly maintained,” said spokesman Carroll Wills.
In addition, Wills said his group believes that administrative problems at the state authority could hamper its ability to handle the added workload of statewide licensure of EMTs.
Such concerns have led the firefighters’ group to push for its own Assembly legislation, AB 220, called the Firefighters Bill of Rights. It aims to offer additional disciplinary rights and protections to firefighter EMTs and paramedics statewide.
However, Nivens said ambulance owners oppose AB 220 because it sets different disciplinary standards for fire department EMTs and paramedics than for those working outside of fire departments. That, he said, would further fragment an already patchwork system.
The Bee’s Andrew McIntosh can be reached at (916) 321-1215 or amcintosh@sacbee.com.