What’s the REAL Number of EMS License Investigations in California?

by Jennifer Coalson-Perez

Easy enough to find out, right? NO….

A month or so ago, I contacted the California Emergency Medical Services Authority with what I thought was a relatively straightforward request. I wanted to know how many EMT licenses were investigated in California and I wanted that information broken down by the 32 Local EMSAs. My reasoning was that the number of investigations and disciplines reported by EMSA only pertained to Paramedic licenses, not EMTs, so the true number of EMS license investigations in California was very skewed. The CA EMSA investigates about 500 Paramedic Licenses per year. But how many EMT’s were being disciplined? No one knew. I was told to go to each of the 32 LEMSA’s individually with a records request.

I sent this email out to Alameda EMSA to begin with:

“I was hoping that you could help me or help point me in the right direction. Our office works with EMTs and Medics who are dealing with license discipline. I am looking for a list of LOCAL cases for research purposes. I don’t need names, but a rundown of how many issues were investigated by the Alameda EMSA last year, how many of those investigations resulted in discipline and if you have the information, a breakdown of what types of issues were disciplined and how many in each category. While the EMSA’s website has an index of Administrative Law Judge Proposed Decisions on Paramedic Licensure, there is not any information that I can find at the local level with regards to EMTs.”

They said no. The problem with my request (and this is good news for any EMT under investigation) is that Government Code section 6254(f) exempts them from disclosure:

Records of complaints to, or investigations conducted by, or records of intelligence information or security procedures of, the office of the Attorney General and the Department of Justice, the California Emergency Management Agency, and any state or local police agency, or any investigatory or security files compiled by any other state or local police agency, or any investigatory or security files compiled by any other state or local agency for correctional, law enforcement, or licensing purposes.

I kept pushing and finally Alameda County EMSA had the request reviewed by county counsel and they finally agreed to give me the information. I used the fact that Alameda had been cooperative to convince the other 31 EMSA Directors to give me the same info, but amended my request to:

If you could reply with these answers- this will answer my question:

  • Orange      County EMSA investigated__#__ EMT or EMTP licensing issues in 2012
  • Orange      County EMSA formally disciplined __#__ EMTS licenses in 2012

At this point, 11 of the 32 have replied with their numbers. What was more interesting is my request must have been run up the flagpole because I discovered that the EMSA’s Dan Smiley is currently “working on a project” and has asked the Local EMSA Directors the following information:

  • Total      number of complaints opened for investigation, even if the case was      closed,
  • Total      number of certification actions were taken (revocation, suspension,      denial, probation) for the 2012 calendar year?

Smiley has requested that the LEMSA have the information to him by May19th, 2013.

Why is this so important? Why does it matter how many EMT licenses are disciplined in California and how many each LEMSA is conducting? Because license investigations are a Taboo in the EMT and Medic communities. Most of them are the result of off duty, non-work related offenses, like DUIs so no one talks about them. It is important to know that they do happen, and that they happen a lot more than anyone thought – until now.

Based on the data, the 32 LEMSAs of California conduct about 1600 EMT license investigations per year. That excludes the 500 or so Medic license investigations. This means 2100 licenses are being disciplined per year in California- a far cry from the 400+/- one is led to believe take place, according to the EMSA’s website. Considering each of those investigations would cost, on average, about $6000.00 to privately defend, California EMTs and Paramedics are spending a collective $12.6 Million defending themselves every year. That is a staggering number.

Below is the breakdown of the California LEMSA’s Investigation and Discipline:

LEMSA Request   sent Received Investigations Discipline Pending
Alameda X X

55

44

11

Central California X
Coastal Valleys X Waiting

 13

 5

Contra Costa X

9

2

7

El Dorado X
ICEMA X X

56

36

20

Imperial X
Kern X X

26

12

14

Los Angeles X  X

 268

 166

 102

Marin X
Merced X
Monterey X X

16

 5

 11

Mountain Valley X
Napa X
North Coast X X

1

1

Northern California X
Orange X X

68

37

31

Riverside X
Sacramento X Refused
San Benito
San     Diego X

97

46

51

San Francisco X
San Joaquin X
San Luis Obispo X
San     Mateo MSG
Santa Barbara X
Santa Clara X x

58

24

27

Santa Cruz X
Sierra-Sacramento Valley X
Solano X Waiting
Tuolumne X
Ventura 
X

You’ll notice that Sacramento flat out refused to provide the information. Initially the Sacramento EMS Director said they didn’t have the information. After a number of follow-ups, I was tersely told the “information does not exist.” This leads us to believe that they are either not doing hardly any investigations, or they are doing A LOT and don’t want to release the information. I went back to EMSA to find out which entity provided oversight to the Local EMSAs and was shocked to hear “no one.” Steve McGee the Administrative Adviser, Counsel, and EMR of California Emergency Medical Services Authority explained:

“The 32 LEMSA’s are entities of local government and as such are each autonomous – they do not answer to state EMSA oversight, or to any other state agency, or even to each other.  The only statutory requirement they have is to submit an annual EMS system plan to EMSA.”

So in the end, I don’t know which is the more unsettling fact: that over $12 million dollars could be spent each year defending EMS licenses, or that the local disciplining entities have no one to answer to. After having provided license defense for our Firefighters Associations members, it is apparent that some LEMSA’s and their employees basically run amuck, interrogating EMS licensees and not following the law with regards to investigations. And some, like Sacramento, could be doing absolutely nothing at all.  What we do know is EMS licenses are being disciplined, and fortunately for California Firefighters, EMTs and Medics, we also know how to defend them.