Medical Control - - CA Health And Safety

Section § 1798

The law mandates that the medical oversight and direction of emergency medical services (EMS) systems should be handled by the medical director of the local EMS agency, following state standards.

This control must exist within a certified EMS system set up by the local EMS agency.

If a medical director at a base station disagrees with a local EMS agency's policy, they can request a review by sending a statement to the local EMS medical director, who will then organize a panel made up of other base station medical directors to review it. This review process will remain until new state regulations are established.

(a) The medical direction and management of an emergency medical services system shall be under the medical control of the medical director of the local EMS agency. This medical control shall be maintained in accordance with standards for medical control established by the authority.

(b) Medical control shall be within an EMS system which complies with the minimum standards adopted by the authority, and which is established and implemented by the local EMS agency.

(c) In the event a medical director of a base station questions the medical effect of a policy of a local EMS agency, the medical director of the base station shall submit a written statement to the medical director of the local EMS agency requesting a review by a panel of medical directors of other base stations. Upon receipt of the request, the medical director of a local EMS agency shall promptly convene a panel of medical directors of base stations to evaluate the written statement. The panel shall be composed of all the medical directors of the base stations in the region, except that the local EMS medical director may limit the panel to five members.

This subdivision shall remain in effect only until the authority adopts more comprehensive regulations that supersede this subdivision.

emergency medical services medical director local EMS agency medical control base station review panel EMS system standards policy evaluation medical oversight regional medical directors state standards compliance written statement request panel composition limit panel members

(Amended by Stats. 1988, Ch. 1390, Sec. 6.)

Section § 1798.2

This law requires a base hospital to follow the guidelines and procedures set out by the local Emergency Medical Services (EMS) agency. These procedures must be approved by the agency's medical director and are aimed at overseeing the work of emergency medical personnel who provide care before patients reach the hospital.

The base hospital shall implement the policies and procedures established by the local EMS agency and approved by the medical director of the local EMS agency for medical direction of prehospital emergency medical care personnel.

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(Amended by Stats. 1988, Ch. 1390, Sec. 7.)

Section § 1798.3

This law section says that advanced life support workers can get guidance from an alternative station instead of a base hospital if certain conditions are met. First, the alternative station must be approved by the local EMS agency and its medical director when there's no available hospital to provide oversight for the area. Then, the guidance must come from either a trained physician or a mobile intensive care nurse who is authorized by the local EMS medical director to give instructions to emergency medical teams.

Advanced life support and limited advanced life support personnel may receive medical direction from an alternative base station in lieu of a base hospital when the following conditions are met:

(a) The alternative base station has been designated by the local EMS agency and approved by the medical director of the local EMS agency, pursuant to Section 1798.105, to provide medical direction to prehospital personnel because no base hospital is available to provide medical direction for the geographical area assigned.

(b) The medical direction is provided by either of the following:

(1) A physician and surgeon who is trained and qualified to issue advice and instructions to prehospital emergency medical care personnel.

(2) A mobile intensive care nurse who has been authorized by the medical director of the local EMS agency, pursuant to Section 1797.56, as qualified to issue instructions to prehospital emergency medical care personnel.

advanced life support limited advanced life support alternative base station base hospital local EMS agency medical direction prehospital personnel geographical area physician surgeon emergency medical care mobile intensive care nurse medical director Section 1798.105 Section 1797.56

(Added by Stats. 1988, Ch. 1390, Sec. 8.)

Section § 1798.6

This law explains who is in charge during a health care emergency. The most medically qualified licensed or certified health care professional at the scene takes charge. If there's no such person, the most qualified public safety person there steps in. Counties can set up a committee to establish a unified command for emergencies, including key local agencies. Despite this, the primary public safety agency with investigative authority manages the overall scene, ensuring minimal risk to everyone involved, and should consult with medical personnel as needed.

(a) Authority for patient health care management in an emergency shall be vested in that licensed or certified health care professional, which may include any paramedic or other prehospital emergency personnel, at the scene of the emergency who is most medically qualified specific to the provision of rendering emergency medical care. If no licensed or certified health care professional is available, the authority shall be vested in the most appropriate medically qualified representative of public safety agencies who may have responded to the scene of the emergency.

(b) If any county desires to establish a unified command structure for patient management at the scene of an emergency within that county, a committee may be established in that county comprised of representatives of the agency responsible for county emergency medical services, the county sheriff’s department, the California Highway Patrol, public prehospital-care provider agencies serving the county, and public fire, police, and other affected emergency service agencies within the county. The membership and duties of the committee shall be established by an agreement for the joint exercise of powers under Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code.

(c) Notwithstanding subdivision (a), authority for the management of the scene of an emergency shall be vested in the appropriate public safety agency having primary investigative authority. The scene of an emergency shall be managed in a manner designed to minimize the risk of death or health impairment to the patient and to other persons who may be exposed to the risks as a result of the emergency condition, and priority shall be placed upon the interests of those persons exposed to the more serious and immediate risks to life and health. Public safety officials shall consult emergency medical services personnel or other authoritative health care professionals at the scene in the determination of relevant risks.

emergency health care management licensed health care professional prehospital emergency personnel patient management unified command structure county emergency services public safety agencies primary investigative authority risk management in emergencies consultation with medical personnel

(Added by Stats. 1983, Ch. 206, Sec. 2.)

Section § 1798.8

This law ensures that local EMS (Emergency Medical Services) agencies cannot interfere with a public safety agency’s authority regarding 911 calls and emergency response within their area. Local EMS cannot replace or limit the public safety agency's ability to receive and process 911 calls or alter their deployment of resources. Additionally, they cannot reduce emergency response levels, alter resource allocation, or stop public safety agencies from providing mutual aid during emergencies. Even when agencies follow local EMS protocols, it doesn't mean they give up their own authority on how to handle emergencies.

(a) Notwithstanding any provision of this division, medical control by a local EMS agency medical director, or medical direction and management of an emergency medical services system, as described in this chapter, shall not be construed to do any of the following:

(1) Limit, supplant, prohibit, or otherwise alter a public safety agency’s authority to directly receive and process requests for assistance originating within the public safety agency’s territorial jurisdiction through the emergency “911” system established pursuant to Article 6 (commencing with Section 53100) of Chapter 1 of Part 1 of Division 2 of Title 5 of the Government Code. This paragraph does not supersede the local EMS agency’s authority to adopt and implement emergency lifesaving instructions or EMD prearrival instructions.

(2) Authorize or permit a local EMS agency to delegate, assign, or enter into a contract in contravention of subdivision (b) of Section 53110 of the Government Code.

(3) Authorize or permit a local EMS agency to unilaterally reduce a public safety agency’s response mode below that of the EMS transport provider, prevent a public safety response, or alter the deployment of public safety emergency response resources within the public safety agency’s territorial jurisdiction.

(4) Authorize or permit a local EMS agency to prevent a public safety agency from providing mutual aid pursuant to the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code).

(b) A public safety agency’s adherence to the policies, procedures, and protocols adopted by a local EMS agency does not constitute a transfer of any of the public safety agency’s authorities regarding the administration of emergency medical services.

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(Added by Stats. 2019, Ch. 389, Sec. 4. (SB 438) Effective January 1, 2020.)