the next meeting of the emcc is on - riverside county...
TRANSCRIPT
P.O Box 7600 Riverside, CA 92513-7600
EMCC Members Per Board of Supervisors Resolution No. 2001-358: PMAC Physician Representative 1.a. Stephen Patterson, MD Hospital Association Representative (ex-officio) 1.b. Christian Bivona-Tellez Riverside County Medical Association 1.c. Kenneth Nickson, MD Riverside County Ambulance Association 1.d. Peter Hubbard Riverside County Fire Chiefs’ Association 1.e. David Waltemeyer Coachella Valley Association of Governments 1.f. Mike Marlow Western Riverside Council of Governments 1.g. Grant Yates Riv Co Law Enforcement Agency Admin Assoc 1.h. Tom McCreary PMAC Prehospital Representative 1.i. Jim Price Riverside Co Fire Dept Rep (ex-officio) 1.j. Phil Rawlings Supervisorial District One 1.k. Gloria Huerta Supervisorial District Two 1.k. Stan Grube Supervisorial District Three 1.k. Mike Norris Supervisorial District Four 1.k. Bary Freet Supervisorial District Five 1.k. Kent McCurdy
The next meeting of the EMCC is on:
Wednesday, April 6, 2011 9:00AM – 10:30AM
Riverside County Regional Medical Center
26520 Cactus Avenue, Moreno Valley Rooms A1017 and A1019
951/358-5029
1. CALL TO ORDER Chairman Stan Grube
2. ROUNDTABLE INTRODUCTIONS (3 Minutes) Stan Grube
3. RECOGNITION OF BLAKE GOETZ—Stan Grube
4. APPROVAL OF MINUTES January 5, 2011 Minutes (Attachment A)
5. EMS AGENCY REPORT (40 Minutes) 5.1 ED Wait Times—Trevor Douville (Attachment B) 5.2 Receiving Center Policy—Bruce Barton (Attachment C) 5.3 AMR Contract Term Mod Request—Bruce Barton (Handout) 5.4 EMS Plan Update—Brian MacGavin (Attachment D) 5.5 Board of Supervisors Report—Brian MacGavin (Attach E)
6. OTHER REPORTS (15 Minutes)
6.1 PMAC—Steve Patterson, MD / Jim Price 6.2 5150 Regional Taskforce—Christina Bivona-Tellez 6.3 PHEPR Branch—Kim Saruwatari
7. NEW BUSINESS (20 Minutes)
7.1 EMCC Membership—Brian MacGavin 8. Open Discussion / Public Comment (10 Minutes) 9. Next Meeting / Adjournment (1 Minute) July 6, 2011
P.O Box 7600 Riverside, CA 92513-7600
NOTICE: Items on the agenda: Any member of the public may address this meeting of the Emergency Medical Care Committee or any items appearing on the agenda by raising their hand to be recognized by the Chair or acting Committee Chairperson. If a member of the public desires to speak, they must do this before or anytime during discussion of the item. All comments are to be directed to the Emergency Medical Care Committee and shall not consist of any personal attacks. Members of the public are expected to maintain a professional, courteous decorum during their comments. A three-minute limitation shall apply to each member of the public, unless the Chair extends such time. No member of the public shall be permitted to “share” his/her three minutes with any other member of the public. Items not on the agenda: Any member of the public may address this meeting of the Emergency Medical Care Committee on any item that does not appear on the agenda, but is of interest to the general public and is an item upon which the Committee may act. All comments are to be directed to the Emergency Medical Care Committee and shall not consist of any personal attacks. Members of the public are expected to maintain a professional, courteous decorum during their comments. A three-minute limitation shall apply to each member of the public who wishes to address the Committee on a matter not on the agenda. No member of the public shall be permitted to “share” his/her three minutes with any other member of the public. (Usually, any items received under this heading are referred to the staff for further study, research, completion, and/or future Committee action.) It is the responsibility of the members of the committee to disseminate information from EMCC meetings to the organizations they represent. Any questions regarding meeting or agenda items may be addressed to Brian MacGavin, Assistant EMS Director, Riverside County EMS Agency at (951) 358-5029. Next meeting: Wednesday, April 6, 2011, 9:00 AM - 10:30 AM, Riverside County Regional Medical Center. EMCC agendas with attachments are available online at www.rivcoems.org The County of Riverside does not discriminate on the basis of disability in admission to, access to, or operations of its programs, services or activities. It is committed to ensuring that its programs, services, and activities are fully accessible to and usable by people with disabilities. If you have a disability and need assistance, contact Brian MacGavin at (951) 358-5029.
EMCC Minutes Attachment A January 5, 2011 Page 1 of 6 Members Organization Represented Term Dates
Gloria Huerta (Absent) District 1 (Bob Buster) 7/1/08 - 6/30/11
Stan Grube (Present) District 2 (John Tavaglione) 7/1/08 - 6/30/11
Michael Norris (Absent) District 3 (Jeff Stone) 7/1/08 - 6/30/11
Bary Freet (Absent) District 4 (John Benoit) 7/1/08 - 6/30/11
Kent McCurdy (Present) District 5 (Marion Ashley) 7/1/09 - 6/30/12
Stephen Patterson, MD (Absent) Prehospital Medical Advisory Committee (PMAC)
7/1/09 - 6/30/12
Mike Marlow (Present) Coachella Valley Association of Governments
7/1/10 - 6/30/13
Grant Yates (Absent) Western Riverside Council of Governments
7/1/10 - 6/30/13
Jim Price (Present) Prehospital Medical Advisory Committee (PMAC)
7/1/10- 6/30/13
Tom McCreary (Absent) Riverside County Law Enforcement Agency Administrators Association
7/1/10 - 6/30/13
Peter Hubbard (Present) Riverside County Ambulance Association
7/1/10 - 6/30/13
Kenneth Nickson, MD (Present) Riverside County Medical Association
7/1/09 – 6/30/12
David Waltemeyer (Present) Riverside County Fire Chiefs’ Association
7/1/09 – 6/30/12
Christina Bivona-Tellez (Present) Hospital Association of Southern California
Ex-officio
Phil Rawlings (Present) Riverside County Fire Department Ex-officio
Attendance Organization Represented
Bruce Barton Director, EMS Agency
Humberto Ochoa, MD Medical Director, EMS Agency
Brian MacGavin Assistant Director, EMS Agency
James Lee EMS Specialist, EMS Agency
Karen Petrilla EMS Specialist, EMS Agency
EMCC Minutes Attachment A January 5, 2011 Page 2 of 6 Georgia Herbaugh Secretary I, EMS Agency
Laura Wallin EMS Specialist, EMS Agency
Scott Moffatt EMS Specialist, EMS Agency
Trevor Douville EMS Specialist, EMS Agency
Kevin Powell Cal Fire
Norm Walker Idyllwild Fire Department
Kay Schulz RCRMC
Chuck Dovey Pacific Ambulance
Kay Schulz Riverside County Regional Medical Center
Holly Kendall Symons Ambulance
Jonathon Dyreyes Kaiser Riverside
Burch Wright Pacific Ambulance
EMCC Minutes Attachment A January 5, 2011 Page 3 of 6
TOPIC
DISCUSSION ACTION
1. Call To Order Chairman Stan Grube called the meeting to order at 9:00 AM.
2. Roundtable Introductions Chairman Stan Grube held roundtable introductions.
3. Approval of Minutes Approval of minutes of October 6, 2010 minutes without changes.
4. EMS AGENCY (REMSA) REPORT
4.1 Ambulance ED Wait Times Trevor Douville
Ambulances ED wait times have been worse than they ever have been.
The Chair requested a meeting to take place within 30‐days with Bruce Barton, Brian MacGavin, Dr. Nickson, Christina Bivona‐Tellez, Jim Price and David Waltemeyer to discuss a receiving center policy that will address ED wait times for ambulances.
4.2 Base hospital Agreements Laura Wallin
The Board of Supervisors approved of the base hospital agreements on December 14, 2010. Palo Verde Hospital’s base hospital status remains on suspension. Another audit will be performed once Palo Verde Hospital’s base hospital status has been reinstated.
No action, information only.
4.3 EMS Communications Trevor Douville
REMSA’s communication center was completed last year. We have been granted Urban Areas Security Initiative (UASI) funds to enhance and replace the UHF communications equipment at Box Springs. REMSA recommends looking into restoring the Hospital
No action, information only.
EMCC Minutes Attachment A January 5, 2011 Page 4 of 6
Emergency Administrative Radio (HEAR) system.
4.4 EMS Data System – Scott Moffatt
Corona Fire Department and Pechanga Fire Department have been using Sansio data collection system with no problems. We anticipate that Riverside County Fire Department, March Fire Department, Murrieta Fire Department, Cathedral City Fire Department, Mission Ambulance and CRA (LEXXIOM Medical Services) will be using Sansio.
No action, information only.
4.5 STEMI – Laura Wallin A letter was sent to all STEMI Receiving Center Directors requesting their stance on REMSA requiring ALS Providers and STEMI Receiving Centers to implement a 12‐lead ECG transmission program.
No action, information only.
4.6 Trauma – Cindi Stoll No report was given. ‐‐‐ 4.7 EMS Credentialing –
Karen Petrilla As of July 1, 2010, all EMT certifications transitioned to the State system. EMTs still apply at local EMS Agency offices and all EMT that have never been fingerprinted will need to upon renewal.
No action, information only.
5. OTHER REPORTS 5.1 PMAC – Steve Patterson The HEMS CQI group
reviewed cases from August through December. On January 4, 2011 the committee met about completing the Helicopter Transport Policy for submission to PMAC.
No action, information only.
EMCC Minutes Attachment A January 5, 2011 Page 5 of 6
Riverside Community Hospital had their Helispot grand opening in December.
5.2 5150 Regional Taskforce‐ Christina Bivona‐Tellez
No reports were given. An update on the 5150 study will be presented at the next EMCC meeting.
5.3 PHEPR Branch – Kim Saruwatari
No reports were given. ‐‐‐
5.4 EMS Plan Update – Brian MacGavin
The EMS Plan update should be done annually. An on‐line forum could be established to address the update. If any EMCC member is interested in participating with the update contact Brian MacGavin.
A report will be given at the next EMCC meeting.
6. NEW BUSINESS 6.1 AMR Contract Term Modification Request – Bruce Barton
In October 2010 AMR submitted a request to review the terms of their agreement with the county. The current contract term is until June 2012. AMR is asking for a five year extension with automatic renewals inline with compliance performance. It was suggested that a report be given on AMR’s performance.
REMSA will provide a report on AMR’s performance at the next EMCC meeting.
6.2 Receiving Center Policy – Bruce Barton
A subcommittee has been established to address reviewing the draft Receiving Center Policy. This has been covered under agenda item 4.1.
No action, information only.
6.3 LLUMC Murrieta – Laura Wallin
Loma Linda University Medical Center Murrieta will be opening in March 2011.
No action, information only.
6.4 Report to the Board of Supervisors Brian MacGavin
A draft annual report was circulated at the EMCC meeting. Members are encouraged to make
Comments should be sent to Brian MacGavin in preparation for submission to the Board of Supervisors.
EMCC Minutes Attachment A January 5, 2011 Page 6 of 6
comments. 7. OPEN DISCUSSION AND
PUBLIC COMMENT
PHEPR Branch has a grant to cover costs for ReddiNet satellite upgrades countywide.
No action, information only.
AMR purchased Blythe Ambulance Service on January 1, 2011. There will be no decrease in services.
No action, information only.
Hospital Association and Healthcare providers in the Inland Empire are seeking a Board of Supervisor’s resolution on attaining a data vendor for the Inland Empire Health Information Exchange.
No action, information only.
Phil Rawlings is now the Interim EMS Bureau Chief for Riverside County Fire Department ‐ Cal Fire.
No action, information only.
Blake Goetz has retired and David Waltemeyer will be replacing him as Riverside County Fire Chief’s Association Representative to EMCC.
EMCC will give a certificate of recognition to Blake Goetz.
There was a request that meeting minutes be sent out two weeks after the EMCC meetings so that EMCC members can share them with their constituent groups. There were concerns about sharing draft minutes that have not been approved by EMCC.
The EMS Agency will attempt to get the draft EMCC minutes out sooner.
8. Next Meeting / Adjournment
April 6, 2011
Attachment B 04/06/11 ‐ EMCC Ambulance ED Wait Time Charts
Prepared By. TDouville Riverside County EMS Agency
Attachment B 04/06/11 ‐ EMCC Ambulance ED Wait Time Charts
Prepared By. TDouville Riverside County EMS Agency
Riverside County ‐ Ambulance ED Wait Hours
Hospital Sep‐10 Oct‐10 Nov‐10 Dec‐10 Jan‐11 Feb‐11 RCH 481:36:06 433:09:33 401:13:31 473:40:33 504:11:10 171:20:57 Kaiser 12:11:30 21:34:33 23:03:38 19:48:00 38:48:01 32:47:17 Parkview 140:30:07 124:28:32 205:45:09 130:02:01 165:43:20 149:47:49 RCRMC 32:59:36 30:36:19 38:30:46 43:16:50 48:12:03 47:22:12 Corona 127:11:12 169:06:19 143:32:10 175:15:54 236:35:16 169:51:13 Moreno Valley 28:03:05 25:59:35 20:18:47 17:28:46 31:40:50 34:17:32 Menifee 57:06:05 43:43:48 71:02:02 61:16:44 98:53:33 90:04:11 Inland Valley 122:50:06 206:29:20 184:40:17 192:36:34 245:42:15 240:49:39 Rancho Springs 133:46:31 146:52:11 109:40:27 121:14:15 159:34:19 175:00:47 Hemet 73:46:03 46:19:39 47:30:27 60:45:02 115:18:38 102:40:50 San Gorgonio 10:18:25 14:54:17 16:32:48 15:40:28 18:47:43 22:20:58 Eisenhower 1:52:33 1:11:15 2:44:55 0:41:23 2:57:29 5:44:47 Desert 10:59:40 8:54:42 10:54:52 8:06:33 7:51:40 19:11:31 JFK 4:31:08 6:19:24 4:32:18 2:56:15 7:02:01 9:16:36 Monthly Total 1237:42:07 1279:39:27 1280:02:07 1322:49:18 1681:18:18 1270:36:19
EMS PLAN Report Attachment D
Date: March 24, 2011
To: Emergency Medical Care Committee (EMCC)
From: Brian MacGavin, EMS Agency Assistant Director
Subject: REMSA’s EMS Plan Assessment Summary Report
Recommended Action: Receive information and direct the subcommittee to develop further or make additional recommendations
Discussion:
REMSA has completed a preliminary assessment of the EMS Plan for presentation to the EMCC. This assessment identifies and updates REMSA’s status in meeting established objectives in the EMS plan. Additionally, it indicates responses to standards that possibly need modification or increased focus. Standards in the plan not requiring any action have not been included in this assessment.
For standards: 1.01, 1.02, 1.06, 1.17, 1.18, 1.23, 1.25, 1.26, 1.27, 2.01, 2.02, 2.03, 2.11, 2.13, 2.16, 3.05, 3.06, 4.08, 4.14, 4.15 and 4.18 the objectives have been met.
REMSA is making progress on standards: 1.07, 1.11, 1.13, 1.24, 2.08, 2.10, 3.01, 3.02, 3.10, 5.01, 6.03, 6.05, 6.09 and 6.11.
Objectives for standards: 1.10, 1.12, 2.04, 2.05, 2.06, 3.03. 3.08, 3.09, 4.05, 4.07, 4.10, 4.12, 4.13, 4.16, 5.10, 5.11, 6.04, 6.06, 8.01, 8.02, 8.04 8.05 and 8.10 may require a change in focus or additional planning by REMSA.
Atta
chm
ent D
Pa
ge 1
of 2
2
EM
S PL
AN
ASS
ESS
ME
NT
SU
MM
AR
Y R
EPO
RT
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
1.01
LE
MSA
Str
uctu
re
Stan
dard
: Eac
h LE
MSA
shal
l hav
e a
form
al
orga
niza
tiona
l stru
ctur
e w
hich
incl
udes
bot
h ag
ency
staf
f and
non
-age
ncy
reso
urce
s and
w
hich
incl
udes
app
ropr
iate
tech
nica
l and
clin
ical
ex
perti
se.
Y
Y
Del
inea
ted
in E
MS
Polic
y M
anua
l.
Cre
dent
ialin
g sp
ecia
list h
ired.
Shor
t O
bjec
tive
met
.
1.02
LE
MSA
Mis
sion
St
anda
rd: E
ach
LEM
SA sh
all p
lan,
impl
emen
t, an
d ev
alua
te th
e EM
S sy
stem
. Th
e ag
ency
shal
l us
e its
qua
lity
assu
ranc
e/qu
ality
impr
ovem
ent
and
eval
uatio
n pr
oces
ses t
o id
entif
y ne
eded
sy
stem
cha
nges
.
Y
Y
EMS
Polic
y M
anua
l sp
ecifi
es Q
A/Q
I cr
iteria
.
CQ
I Coo
rdin
ator
is
mak
ing
prog
ress
in
revi
ewin
g &
ap
prov
ing
CQ
I pl
ans.
Long
O
bjec
tive
met
.
1.06
Ann
ual P
lan
Upd
ate
Stan
dard
: Eac
h LE
MSA
shal
l dev
elop
an
annu
al
upda
te to
its E
MS
syst
em p
lan
and
shal
l sub
mit
it to
the
EMS
Aut
horit
y. T
he u
pdat
e sh
all:
a) Id
entif
y pr
ogre
ss m
ade
in p
lan
impl
emen
tatio
n.
b) C
hang
es to
the
plan
ned
syst
em d
esig
n.
N
Y
Upd
ates
hav
e be
en se
nt
to th
e St
ate.
Upd
ates
do
ne in
200
0, 2
005
and
2010
.
Subm
it an
nual
up
date
s. Lo
ng
Obj
ectiv
e be
ing
met
.
1.07
Tra
uma
Plan
ning
: St
anda
rd: T
he L
EMSA
shal
l pla
n fo
r tra
uma
care
an
d sh
all d
eter
min
e th
e op
timal
syst
em d
esig
n fo
r tra
uma
care
in it
s jur
isdi
ctio
n.
Y
Y
C
ount
y Tr
aum
a Pl
an.
TAC
mee
ts q
uarte
rly to
re
view
cas
es &
syst
em
dem
ands
. Tra
uma
cent
ers a
re h
eld
to A
CS
stan
dard
s
Ref
ine
Trau
ma
Plan
&
supp
ort R
TCC
go
als.
Long
Tr
aum
a Pl
an u
pdat
e is
pla
nned
for t
his
year
.
Atta
chm
ent D
Pa
ge 2
of 2
2
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
1.09
Inve
ntor
y of
Res
ourc
es
Stan
dard
: Eac
h LE
MSA
shal
l dev
elop
a d
etai
led
inve
ntor
y of
EM
S re
sour
ces (
e.g.
, per
sonn
el,
vehi
cles
, and
faci
litie
s) w
ithin
its a
rea
and,
at
leas
t ann
ually
, sha
ll up
date
this
inve
ntor
y
Y
N
Upd
ates
are
per
form
ed
thou
gh o
ur a
nnua
l am
bula
nce
perm
it pr
oces
s and
thro
ugh
the
P &
P m
anua
l.
Bia
nnua
l sur
vey.
O
bjec
tive
not m
et.
Long
R
EMSA
nee
ds to
dev
elop
a
proc
ess t
o en
sure
tim
ely
upda
tes o
f fa
cilit
y sp
ecia
l car
e ca
pabi
litie
s an
d a
plan
for r
apid
dep
loym
ent
durin
g la
rge
MC
Is.
1.10
Spe
cial
Pop
ulat
ions
St
anda
rd: E
ach
LEM
SA sh
all i
dent
ify p
opul
atio
n gr
oups
serv
ed b
y th
e EM
S sy
stem
whi
ch re
quire
sp
ecia
lized
serv
ices
(e.g
. eld
erly
, han
dica
pped
, ch
ildre
n, n
on-E
nglis
h sp
eake
rs).
R
ecom
men
ded
Gui
delin
es:
Each
LEM
SA
shou
ld d
evel
op se
rvic
es, a
s app
ropr
iate
, for
sp
ecia
l pop
ulat
ion
grou
ps se
rved
by
the
EMS
syst
em w
hich
requ
ire sp
ecia
lized
serv
ices
(e.g
., el
derly
, han
dica
pped
, chi
ldre
n, n
on-E
nglis
h sp
eake
rs).
Y
N
EMSC
pro
ject
, C
urta
iling
Abu
se
Rel
ated
to th
e El
derly
(C
AR
E), C
hild
Dea
th
Rev
iew
, Dom
estic
V
iole
nce
and
Elde
rly
Abu
se D
eath
Rev
iew
, ou
treac
h pr
ogra
m to
th
e de
af c
omm
unity
, dr
owni
ng su
rvei
llanc
e pr
ogra
m.
Dev
elop
add
ition
al
train
ing
prog
ram
s fo
cuse
d on
ger
iatri
c ha
ndic
appe
d an
d no
n-En
glis
h sp
eaki
ng
popu
latio
ns.
Obj
ectiv
e no
t met
.
Long
R
EMSA
nee
ds to
form
ulat
e a
plan
to
addr
ess t
his o
bjec
tive.
1.11
Sys
tem
Par
ticip
ants
St
anda
rd: E
ach
LEM
SA sh
all i
dent
ify o
ptim
al
role
s and
resp
onsi
bilit
ies o
f sys
tem
par
ticip
ants
. R
ecom
men
ded
Gui
delin
e: E
ach
LEM
SA sh
ould
en
sure
that
syst
em p
artic
ipan
ts c
onfo
rm w
ith
assi
gned
EM
S sy
stem
role
s and
resp
onsi
bilit
ies
thro
ugh
mec
hani
sms s
uch
as w
ritte
n ag
reem
ents
, fa
cilit
y de
sign
atio
ns, a
nd e
xclu
sive
ope
ratin
g ar
eas.
Y
N
EMS
Polic
y M
anua
l; Pr
ovid
er a
gree
men
ts.
Bas
e H
ospi
tal a
udits
an
d ag
reem
ents
hav
e be
en re
new
ed.
Agr
eem
ents
with
all
EMS
prov
ider
s. O
bjec
tive
not m
et.
Long
N
eed
to fi
nish
agr
eem
ents
with
all
EMS
parti
cipa
nts:
ALS
tran
spor
ting,
A
LS fi
rst r
espo
nder
s, re
ceiv
ing
hosp
itals
, and
air
prov
ider
s.
1.12
Rev
iew
& M
onito
ring
St
anda
rd: E
ach
LEM
SA sh
all p
rovi
de fo
r rev
iew
an
d m
onito
ring
of E
MS
syst
em o
pera
tions
.
Y
N
Site
vis
its; a
udits
; tra
uma
regi
stry
; CQ
I re
view
s; H
elic
opte
r EM
S (H
EMS)
CQ
I, pe
rfor
man
ce-b
ased
co
ntra
ct re
view
s.
Obj
ectiv
e no
t met
. Lo
ngN
eed
data
syst
em; i
nclu
de fi
rst
resp
onde
rs a
nd P
SAPs
for f
eedb
ack
and
revi
ews.
Atta
chm
ent D
Pa
ge 3
of 2
2
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
1.13
Coo
rdin
atio
n St
anda
rd: E
ach
LEM
SA sh
all c
oord
inat
e EM
S sy
stem
ope
ratio
ns.
Y
N
EMS
plan
ning
ac
tiviti
es P
roto
cols
, po
licie
s and
pr
oced
ures
; Rev
iew
of
com
plia
nce.
Obj
ectiv
e no
t met
.
Long
REM
SA is
wor
king
on
plan
for b
ette
r si
tuat
iona
l aw
aren
ess a
nd c
oord
inat
ion
of E
MS
syst
em o
pera
tions
for l
arge
M
CIs
.
1.17
Med
ical
Dir
ectio
n St
anda
rd: E
ach
LEM
SA sh
all p
lan
for m
edic
al
dire
ctio
n w
ithin
the
EMS
syst
em. T
he p
lan
shal
l id
entif
y th
e op
timal
num
ber a
nd ro
les o
f bas
e ho
spita
ls a
nd a
ltern
ativ
e ba
se st
atio
ns a
nd th
e ro
les,
resp
onsi
bilit
ies,
and
rela
tions
hips
of
preh
ospi
tal a
nd h
ospi
tal p
rovi
ders
.
Y
Y
P &
P M
anua
l and
B
ase
Hos
pita
l ag
reem
ents
. N
ew B
ase
hosp
ital
polic
y.
EMS
Med
ical
Dire
ctor
- m
embe
r of P
MA
C.
REM
SA h
as
desi
gnat
ed a
ho
spita
l lia
ison
Po
sitio
n.
Shor
t O
bjec
tive
met
.
1.18
QA
/QI
Stan
dard
: Eac
h LE
MSA
shal
l est
ablis
h a
qual
ity
assu
ranc
e/qu
ality
impr
ovem
ent p
rogr
am. T
his
may
incl
ude
use
of p
rovi
der b
ased
pro
gram
s w
hich
are
app
rove
d by
the
LEM
SA a
nd w
hich
ar
e co
ordi
nate
d w
ith o
ther
syst
em p
artic
ipan
ts.
Rec
omm
ende
d G
uide
lines
: Pre
hosp
ital c
are
prov
ider
s sho
uld
be e
ncou
rage
d to
est
ablis
h in
-ho
use
proc
edur
es w
hich
iden
tify
met
hods
of
impr
ovin
g th
e qu
ality
of c
are
prov
ided
.
Y
Y
REM
SA h
as
esta
blis
hed
CQ
I TA
G.
Am
bula
nce
perm
it pr
oces
s req
uire
s CQ
I pr
ogra
ms f
or
ambu
lanc
e pr
ovid
ers.
HEM
S C
QI.
CQ
I TA
G h
as
deve
lope
d a
stan
dard
CQ
I te
mpl
ate.
The
y ar
e cu
rren
tly w
orki
ng
on P
erfo
rman
ce
Stan
dard
s.
Shor
t O
bjec
tive
met
.
1.23
Inte
rfac
ility
Tra
nsfe
r St
anda
rd: T
he L
EMSA
Dire
ctor
shal
l est
ablis
h po
licie
s and
pro
toco
ls fo
r sco
pe o
f pra
ctic
e of
pr
ehos
pita
l med
ical
per
sonn
el d
urin
g in
ter-
faci
lity
trans
fers
.
Y
Y
EMS
Polic
y M
anua
l. C
ontin
uatio
n of
trau
ma
care
pol
icy
The
IFT
grou
p ha
s be
en fo
rmed
to
upda
te IF
T po
licie
s.
Shor
t O
bjec
tive
met
.
Atta
chm
ent D
Pa
ge 4
of 2
2
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
1.24
AL
S Sy
stem
s St
anda
rd: A
dvan
ced
life
supp
ort s
ervi
ces s
hall
be
prov
ided
onl
y as
an
appr
oved
par
t of a
loca
l EM
S sy
stem
and
all
ALS
pro
vide
rs sh
all h
ave
writ
ten
agre
emen
ts w
ith th
e LE
MSA
. R
ecom
men
ded
Gui
delin
e: E
ach
LEM
SA, b
ased
on
stat
e ap
prov
al, s
houl
d, w
hen
appr
opria
te,
deve
lop
excl
usiv
e op
erat
ing
area
s for
ALS
pr
ovid
ers.
N
N
Am
bula
nce
Ord
inan
ce
756,
A
LS S
yste
m S
tand
ards
an
d th
e am
bula
nce
perm
it pr
oces
s. Ex
clus
ive
Ope
ratin
g A
reas
est
ablis
hed
in
1994
EM
S Pl
an a
nd
auth
oriz
ed b
y A
mbu
lanc
e O
rdin
ance
.
REM
SA h
as
atte
mpt
ed to
es
tabl
ish
a no
n-ex
clus
ive
agre
emen
t w
ith C
athe
dral
City
Fi
re D
epar
tmen
t. O
bjec
tive
not m
et.
Shor
t R
EMSA
may
hav
e to
seek
reso
lutio
n th
roug
h C
ount
y C
ouns
el.
1.25
On-
Lin
e M
edic
al D
irec
tion
Stan
dard
: Eac
h EM
S sy
stem
shal
l hav
e on
-line
m
edic
al d
irect
ion,
pro
vide
d by
a b
ase
hosp
ital
(or a
ltern
ativ
e ba
se st
atio
n) p
hysi
cian
or
auth
oriz
ed re
gist
ered
nur
se/m
obile
inte
nsiv
e ca
re
nurs
e.
Rec
omm
ende
d G
uide
line:
Eac
h EM
S sy
stem
sh
ould
dev
elop
a m
edic
al c
ontro
l pla
n w
hich
de
term
ines
: a)
the
base
hos
pita
l con
figur
atio
n fo
r the
syst
em;
b) th
e pr
oces
s for
sele
ctin
g ba
se h
ospi
tals
, in
clud
ing
a pr
oces
s for
des
igna
tion
whi
ch a
llow
s al
l elig
ible
faci
litie
s to
appl
y;
c) th
e pr
oces
s for
det
erm
inin
g th
e ne
ed fo
r in-
hous
e m
edic
al d
irect
ion
for p
rovi
der a
genc
ies.
Y
Y
Bas
e H
ospi
tals
th
roug
hout
Cou
nty
are
desi
gnat
ed a
nd
agre
emen
ts a
re in
pl
ace.
Pr
otoc
ols e
stab
lishe
d w
hen
base
hos
pita
l co
ntac
t is t
o be
mad
e.
A p
roce
ss h
as b
een
deve
lope
d to
aud
it an
d de
sign
ate
base
ho
spita
ls.
Long
O
bjec
tive
met
.
Atta
chm
ent D
Pa
ge 5
of 2
2
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
1.26
Tra
uma
Syst
em P
lan
Stan
dard
: The
LEM
SA sh
all d
evel
op a
trau
ma
care
syst
em p
lan,
bas
ed o
n co
mm
unity
nee
ds a
nd
utili
zatio
n of
app
ropr
iate
reso
urce
s, w
hich
de
term
ines
: a)
the
optim
al sy
stem
des
ign
for t
raum
a ca
re in
th
e EM
S ar
ea;
b) th
e pr
oces
s whi
ch a
llow
s all
elig
ible
faci
litie
s to
app
ly.
Y
Y
The
Trau
ma
Syst
em
Plan
was
last
upd
ated
in
200
7 an
d is
cur
rent
ly
bein
g up
date
d.
REM
SA p
artic
ipat
es
in R
TCC
. Lo
ng
Obj
ectiv
e m
et.
1.27
Ped
iatr
ic S
yste
m P
lan
Stan
dard
: The
LEM
SA sh
all d
evel
op a
ped
iatri
c em
erge
ncy
med
ical
and
crit
ical
car
e sy
stem
pla
n,
base
d on
com
mun
ity n
eeds
and
util
izat
ion
of
appr
opria
te re
sour
ces w
hich
det
erm
ines
: a)
the
optim
al sy
stem
des
ign
for p
edia
tric
emer
genc
y m
edic
al a
nd c
ritic
al c
are
in th
e EM
S sy
stem
, and
; b)
the
proc
ess f
or a
ssig
ning
role
s to
syst
em
parti
cipa
nts,
incl
udin
g a
proc
ess w
hich
allo
ws
elig
ible
faci
litie
s to
appl
y.
Y
Y
EMSC
revi
ew in
201
0 in
dica
tes t
hat
preh
ospi
tal p
rovi
ders
m
eet t
he st
anda
rds f
or
basi
c pe
diat
ric
emer
genc
y m
edic
al
care
. R
CR
MC
PIC
U C
CS
appr
oval
with
Ped
iatri
c Tr
aum
a C
ente
r de
sign
atio
n.
An
EMSC
surv
ey
was
com
plet
ed a
t th
e en
d of
201
0.
Parti
cipa
tion
in
annu
al E
MSC
ac
tivat
es.
Long
O
bjec
tive
met
.
2.01
Ass
essm
ent o
f Nee
ds
Stan
dard
: The
LEM
SA sh
all r
outin
ely
asse
ss
pers
onne
l and
trai
ning
nee
ds.
Rec
omm
ende
d G
uide
line:
1) D
evel
op o
n-go
ing
train
ing
prog
ram
s bas
ed o
n tre
nd id
entif
icat
ion
thro
ugh
the
CQ
I pro
cess
. R
ecom
men
ded
Gui
delin
e: 2
) Re-
eval
uate
st
affin
g re
quire
men
ts.
Y
Y
Initi
al tr
aini
ng a
nd
cont
inui
ng e
duca
tion
prog
ram
s are
app
rove
d,
mon
itore
d an
d re
view
ed re
gula
rly.
Add
ition
al tr
aini
ng
need
s are
iden
tifie
d by
th
e C
QI p
roce
ss.
CQ
I TA
G h
as
deve
lope
d pe
rfor
man
ce
stan
dard
s for
hig
h ris
k / l
ow fr
eque
ncy
skill
s.
Shor
t O
bjec
tive
met
.
Atta
chm
ent D
Pa
ge 6
of 2
2
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
2.02
App
rova
l of T
rain
ing
Stan
dard
: The
EM
S au
thor
ity a
nd/o
r loc
al E
MS
agen
cies
shal
l hav
e a
mec
hani
sm to
app
rove
EM
S ed
ucat
ion
prog
ram
s whi
ch re
quire
app
rova
l (a
ccor
ding
to re
gula
tions
) and
shal
l mon
itor
them
to e
nsur
e th
at th
ey c
ompl
y w
ith st
ate
regu
latio
ns.
Rec
omm
ende
d G
uide
line:
App
rove
CE
prov
ider
s, ac
cord
ing
to st
ate
guid
elin
es, a
nd
mon
itor t
o en
sure
com
plia
nce.
Y
Y
EMS
Polic
y M
anua
l. EM
S C
.E. p
rovi
der a
nd
train
ing
prog
ram
ap
plic
atio
n pr
oces
ses.
Site
vis
its. T
o m
onito
r co
mpl
ianc
e.
Trai
ning
pro
gram
s ha
ve su
bmitt
ed
upda
ted
curr
icul
a an
d lis
t of c
ours
es
for a
ppro
val.
Non
e gi
ven
Obj
ectiv
e m
et.
2.03
Per
sonn
el
Stan
dard
: The
LEM
SA sh
all h
ave
mec
hani
sms t
o ac
cred
it, a
utho
rize,
and
cer
tify
preh
ospi
tal
med
ical
per
sonn
el a
nd c
ondu
ct c
ertif
icat
ion
revi
ews,
in a
ccor
danc
e w
ith st
ate
regu
latio
ns.
This
shal
l inc
lude
a p
roce
ss fo
r pre
hosp
ital
prov
ider
s to
iden
tify
and
notif
y th
e LE
MSA
of
unus
ual o
ccur
renc
es w
hich
cou
ld im
pact
EM
S pe
rson
nel c
ertif
icat
ion.
Y
Y
EMS
Polic
y M
anua
l. C
rede
ntia
ling
polic
ies h
ave
been
up
date
.
Non
e gi
ven
Obj
ectiv
e m
et.
Atta
chm
ent D
Pa
ge 7
of 2
2
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
2.04
Dis
patc
h T
rain
ing
Stan
dard
: a) P
ublic
safe
ty a
nsw
erin
g po
int
(PSA
P) o
pera
tors
with
med
ical
resp
onsi
bilit
y sh
all h
ave
emer
genc
y m
edic
al o
rient
atio
n; b
) m
edic
al d
ispa
tch
pers
onne
l (bo
th p
ublic
and
pr
ivat
e) sh
all r
ecei
ve e
mer
genc
y m
edic
al
disp
atch
trai
ning
in a
ccor
danc
e w
ith th
e EM
S A
utho
rity’
s Em
erge
ncy
Med
ical
Dis
patc
h G
uide
lines
. R
ecom
men
ded
Gui
delin
e: P
ublic
safe
ty
answ
erin
g po
int (
PSA
P) o
pera
tors
with
med
ical
di
spat
ch re
spon
sibi
litie
s and
all
med
ical
dis
patc
h pe
rson
nel (
both
pub
lic a
nd p
rivat
e) sh
ould
be
train
ed a
nd te
sted
in a
ccor
danc
e w
ith th
e EM
S A
utho
rity’
s Em
erge
ncy
Med
ical
Dis
patc
h G
uide
lines
.
N
N
N/A
O
bjec
tive
not m
et.
Ensu
re a
ll EM
S 9-
1-1
calls
are
han
dled
by
a P
SAP
in
acco
rdan
ce w
ith
EMSA
EM
D
guid
elin
es.
Long
REM
SA n
eeds
to fo
rmul
ate
a pl
an to
ad
dres
s thi
s obj
ectiv
e.
2.05
Fir
st R
espo
nder
Tra
inin
g St
anda
rd: A
t lea
st o
ne p
erso
n on
eac
h no
n-tra
nspo
rting
EM
S fir
st re
spon
se u
nit s
hall
have
be
en tr
aine
d to
adm
inis
ter f
irst a
id a
nd C
PR
with
in th
e pr
evio
us th
ree
year
s. R
ecom
men
ded
Gui
delin
es: 1
) At l
east
one
pe
rson
on
each
non
-tran
spor
ting
EMS
first
re
spon
se u
nit s
houl
d be
cur
rent
ly c
ertif
ied
to
prov
ide
defib
rilla
tion
and
have
ava
ilabl
e eq
uipm
ent c
omm
ensu
rate
with
such
scop
e of
pr
actic
e, w
hen
such
a p
rogr
am is
just
ified
by
the
resp
onse
tim
es fo
r oth
er A
LS p
rovi
ders
.
Y
N/A
A
ll no
n-tra
nspo
rting
EM
S pe
rson
nel a
re
requ
ired
to m
aint
ain
first
aid
and
CPR
ce
rtific
atio
n.
Non
e gi
ven
Long
Long
rang
e pl
an.
No
obje
ctiv
e st
ated
Atta
chm
ent D
Pa
ge 8
of 2
2
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
2.06
Res
pons
e St
anda
rd: P
ublic
safe
ty a
genc
ies a
nd in
dust
rial
first
aid
team
s sha
ll be
enc
oura
ged
to re
spon
d to
m
edic
al e
mer
genc
ies a
nd sh
all b
e ut
ilize
d in
ac
cord
ance
with
the
LEM
SA p
olic
ies.
Rec
omm
ende
d G
uide
line:
At l
east
one
per
son
on e
ach
non-
trans
porti
ng E
MS
first
resp
onse
uni
t sh
ould
be
curr
ently
cer
tifie
d at
the
EMT-
1 le
vel
and
have
ava
ilabl
e eq
uipm
ent c
omm
ensu
rate
w
ith su
ch sc
ope
of p
ract
ice.
Y
N
All
Publ
ic S
afet
y A
genc
ies a
re
enco
urag
ed to
resp
ond.
Agr
eem
ents
with
pu
blic
safe
ty &
in
dust
rial f
irst a
id
team
s. O
bjec
tive
not
met
.
Long
R
EMSA
nee
ds to
form
ulat
e an
act
ion
plan
to m
eet t
he o
bjec
tive.
2.08
EM
T-1
Tra
inin
g St
anda
rd: A
ll em
erge
ncy
med
ical
tran
spor
t ve
hicl
e pe
rson
nel s
hall
be c
urre
ntly
cer
tifie
d at
le
ast a
t the
EM
T-1
leve
l. R
ecom
men
ded
Gui
delin
e: If
adv
ance
d lif
e su
ppor
t per
sonn
el a
re n
ot a
vaila
ble,
at l
east
one
pe
rson
on
each
em
erge
ncy
med
ical
tran
spor
t ve
hicl
e sh
ould
be
train
ed to
pro
vide
de
fibril
latio
n.
Y
Y
All
ambu
lanc
es h
ave
pers
onne
l cer
tifie
d at
th
e EM
T le
vel.
REM
SA w
ill b
e re
quiri
ng a
ll B
LS
trans
port
prov
ider
s to
be
AED
pro
vide
r.
Long
R
EMSA
is in
the
proc
ess o
f m
odify
ing
its a
mbu
lanc
e pe
rmit
appl
icat
ion
to m
eet t
his o
bjec
tive.
2.10
Adv
ance
d L
ife S
uppo
rt
Stan
dard
: All
emer
genc
y de
partm
ent p
hysi
cian
s an
d re
gist
ered
nur
ses w
ho p
rovi
de d
irect
em
erge
ncy
patie
nt c
are
shal
l be
train
ed in
ad
vanc
ed li
fe su
ppor
t.
Y
N
All
RN
s reg
ular
ly
assi
gned
to th
e ED
are
re
quire
d to
hav
e A
LS
train
ing
in o
rder
to b
e a
Para
med
ic R
ecei
ving
H
ospi
tal.
Rec
eivi
ng c
ente
r po
licie
s and
ag
reem
ents
are
in
the
proc
ess.
Long
R
EMSA
is w
orki
ng o
n a
rece
ivin
g ce
nter
pol
icy.
Atta
chm
ent D
Pa
ge 9
of 2
2
Stan
dard
s and
Rec
omm
ende
d G
uide
lines
M
eets
st
d.
Mee
ts
Obj
. D
escr
iptio
n of
ac
hiev
ing
Stan
dard
s &
Gui
delin
es
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
2.11
Acc
redi
tatio
n Pr
oces
s St
anda
rd: T
he L
EMSA
shal
l est
ablis
h a
proc
edur
e fo
r acc
redi
tatio
n of
adv
ance
d lif
e su
ppor
t per
sonn
el w
hich
incl
udes
orie
ntat
ion
to
syst
em p
olic
ies a
nd p
roce
dure
s, or
ient
atio
n to
th
e ro
les a
nd re
spon
sibi
litie
s of p
rovi
ders
with
in
the
loca
l EM
S sy
stem
, tes
ting
in a
ny o
ptio
nal
scop
e of
pra
ctic
e, a
nd e
nrol
lmen
t int
o th
e LE
MSA
’s q
ualit
y as
sura
nce/
qual
ity
impr
ovem
ent p
roce
ss.
Y
Y
EMS
Polic
y M
anua
l. O
bjec
tive
met
. EM
S po
licie
s hav
e be
en
upda
ted
base
d on
th
e C
ount
ywid
e Q
ualit
y Im
prov
emen
t Pla
n.
Shor
t O
bjec
tive
met
.
2.13
Bas
e H
ospi
tal P
erso
nnel
St
anda
rd: A
ll ba
se h
ospi
tal/a
ltern
ativ
e ba
se
stat
ion
pers
onne
l who
pro
vide
med
ical
dire
ctio
n to
pre
hosp
ital p
erso
nnel
shal
l be
know
ledg
eabl
e ab
out L
EMSA
pol
icie
s and
pro
cedu
res a
nd h
ave
train
ing
in ra
dio
com
mun
icat
ions
tech
niqu
es.
Y
Y
The
Bas
e H
ospi
tal
cont
ract
s inc
lude
this
re
quire
men
t.
Upd
ate
MIC
N
auth
oriz
atio
n po
licy
base
d on
the
Cou
ntyw
ide
Qua
lity
Impr
ovem
ent P
lan.
Non
e gi
ven
Obj
ectiv
e m
et.
MIC
N a
utho
rizat
ion
polic
ies h
ave
been
upd
ated
.
3.01
Com
mun
icat
ion
Plan
St
anda
rd: T
he L
EMSA
shal
l pla
n fo
r EM
S co
mm
unic
atio
ns. T
he p
lan
shal
l spe
cify
the
med
ical
com
mun
icat
ions
cap
abili
ties o
f em
erge
ncy
med
ical
tran
spor
t veh
icle
s, no
n-tra
nspo
rting
adv
ance
d lif
e su
ppor
t res
pond
ers,
and
acut
e ca
re fa
cilit
ies a
nd sh
all c
oord
inat
e th
e us
e of
freq
uenc
ies w
ith o
ther
use
rs.
Rec
omm
ende
d G
uide
line:
The
LEM
SA’s
co
mm
unic
atio
ns p
lan
shou
ld c
onsi
der t
he
avai
labi
lity
and
use
of sa
telli
tes a
nd c
ellu
lar
tele
phon
es.
N
N
REM
SA’s
Rad
io
Com
mun
icat
ions
St
anda
rd o
utlin
es.
Rad
io c
omm
unic
atio
ns
requ
irem
ents
. C
urre
ntly
EM
S pr
ovid
ers r
ely
heav
ily
on c
ellu
lar p
hone
s.
REM
SA is
cur
rent
ly
wor
king
und
er a
C
ount
ywid
e.
Com
mun
icat
ions
Pl
an to
impr
ove
the
EMS
radi
o co
mm
unic
atio
ns
infr
astru
ctur
e.
Long
EM
S pl
an st
ates
REM
SA d
oes n
ot
mee
t the
stan
dard
whi
ch c
onfli
cts w
ith
curr
ent s
tatu
s exp
lana
tion.
Atta
chm
ent D
Pa
ge 1
0 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
3.02
Rad
ios
Stan
dard
: Em
erge
ncy
med
ical
tran
spor
t veh
icle
s an
d no
n-tra
nspo
rting
adv
ance
d lif
e su
ppor
t re
spon
ders
shal
l hav
e tw
o-w
ay ra
dio
com
mun
icat
ions
equ
ipm
ent w
hich
com
plie
s with
th
e lo
cal E
MS
com
mun
icat
ions
pla
n an
d w
hich
pr
ovid
es fo
r dis
patc
h an
d am
bula
nce-
to-h
ospi
tal
com
mun
icat
ion.
R
ecom
men
ded
Gui
delin
e: E
mer
genc
y m
edic
al
trans
port
vehi
cles
shou
ld h
ave
two-
way
radi
o co
mm
unic
atio
ns e
quip
men
t whi
ch c
ompl
ies w
ith
the
loca
l EM
S co
mm
unic
atio
ns p
lan
and
whi
ch
prov
ide
for v
ehic
le-to
-veh
icle
com
mun
icat
ion.
Y
N
Rad
io C
omm
unic
atio
ns
Stan
dard
. A
Cou
ntyw
ide
Com
mun
icat
ions
pl
an h
as b
een
deve
lope
d in
co
ordi
natio
n w
ith
the
Cou
ntyw
ide
Com
mun
icat
ions
gr
oup.
Long
D
oes n
ot m
eet t
he o
bjec
tive
yet.
3.03
Inte
rfac
ility
Tra
nsfe
r St
anda
rd: E
mer
genc
y m
edic
al tr
ansp
ort v
ehic
les
used
for i
nter
-fac
ility
tran
sfer
s sha
ll ha
ve th
e ab
ility
to c
omm
unic
ate
with
bot
h th
e se
ndin
g an
d re
ceiv
ing
faci
litie
s. Th
is c
ould
be
acco
mpl
ishe
d by
cel
lula
r tel
epho
nes.
Y
N
Am
bula
nce
perm
it pr
oces
s and
the
EMS
Polic
y M
anua
l req
uire
am
bula
nces
to b
e ab
le
to m
eet t
his s
tand
ard.
Sing
le so
urce
of
cont
act f
or IF
T.
Obj
ectiv
e no
t met
.
Long
R
EMSA
nee
ds to
com
e up
with
an
actio
n pl
an to
mee
t the
obj
ectiv
e.
3.04
Dis
patc
h C
ente
r St
anda
rd: A
ll em
erge
ncy
med
ical
tran
spor
t ve
hicl
es w
here
phy
sica
lly p
ossi
ble,
(bas
ed o
n ge
ogra
phy
and
tech
nolo
gy),
shal
l hav
e th
e ab
ility
to c
omm
unic
ate
with
a si
ngle
dis
patc
h ce
nter
or d
isas
ter c
omm
unic
atio
ns c
omm
and
post
.
N
N
This
stan
dard
can
not b
e m
et d
ue to
the
geog
raph
y of
Riv
ersi
de
Cou
nty
and
the
exis
ting
com
mun
icat
ions
in
fras
truct
ure.
Cou
ntyw
ide
Com
mun
icat
ions
Pl
an h
as b
een
deve
lope
d.
Obj
ectiv
e no
t met
.
Long
D
oes n
ot m
eet t
he o
bjec
tive
yet.
Atta
chm
ent D
Pa
ge 1
1 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
3.05
Hos
pita
ls
Stan
dard
: All
hosp
itals
with
in th
e lo
cal E
MS
syst
em sh
all (
whe
re p
hysi
cally
pos
sibl
e) h
ave
the
abili
ty to
com
mun
icat
e w
ith e
ach
othe
r by
two-
way
radi
o.
Rec
omm
ende
d G
uide
line:
All
hosp
itals
shou
ld
have
dire
ct c
omm
unic
atio
ns a
cces
s to
rele
vant
se
rvic
es in
oth
er h
ospi
tals
with
in th
e sy
stem
(e
.g.,
pois
on in
form
atio
n, p
edia
tric
and
traum
a co
nsul
tatio
n).
Y
Y
Th
is st
anda
rd c
anno
t be
met
due
to th
e ge
ogra
phy
of R
iver
side
C
ount
y an
d th
e ex
istin
g ra
dio
com
mun
icat
ions
in
fras
truct
ure.
Cou
ntyw
ide
Com
mun
icat
ions
Pl
an h
as b
een
deve
lope
d. R
egul
ar
drill
s are
don
e on
th
e R
eddi
Net
.
Long
O
bjec
tive
met
.
3.06
MC
I/D
isas
ters
St
anda
rd: T
he L
EMSA
shal
l rev
iew
co
mm
unic
atio
ns li
nkag
es a
mon
g pr
ovid
ers
(pre
hosp
ital a
nd h
ospi
tal)
in it
s jur
isdi
ctio
n fo
r th
eir c
apab
ility
to p
rovi
de se
rvic
e in
the
even
t of
mul
ti-ca
sual
ty in
cide
nts a
nd d
isas
ters
.
Y
Y
EMS
Polic
y M
anua
l.
RA
CES
. A
com
mun
icat
ions
gr
oup
has b
een
esta
blis
hed
and
the
ambu
lanc
e pe
rmit
proc
ess i
s bei
ng
mod
ified
.
Long
B
LS a
mbu
lanc
e se
rvic
es w
ill b
e re
quire
d to
hav
e ra
dio
com
mun
icat
ions
equ
ipm
ent.
REM
SA
is e
ncou
ragi
ng h
ospi
tals
to im
prov
e th
e H
EAR
syst
em.
3.08
9-1
-1 P
ublic
Edu
catio
n St
anda
rd: T
he L
EMSA
shal
l be
invo
lved
in
publ
ic e
duca
tion
rega
rdin
g th
e 9-
1-1
tele
phon
e se
rvic
e as
it im
pact
s sys
tem
acc
ess.
N
N
Oth
er C
ount
y of
fices
pr
ovid
e pu
blic
ed
ucat
ion
prog
ram
s.
To a
scer
tain
the
effe
ctiv
enes
s and
fe
asib
ility
of 9
-1-1
ed
ucat
ion
prog
ram
s. O
bjec
tive
not m
et.
Long
R
EMSA
nee
ds to
form
ulat
e an
as
sess
men
t/Act
ion
Plan
.
3.09
Dis
patc
h T
riag
e St
anda
rd: T
he L
EMSA
shal
l est
ablis
h gu
idel
ines
fo
r pro
per d
ispa
tch
triag
e w
hich
iden
tifie
s ap
prop
riate
med
ical
resp
onse
. R
ecom
men
ded
Gui
delin
e: T
he L
EMSA
shou
ld
esta
blis
h an
em
erge
ncy
med
ical
dis
patc
h pr
iorit
y re
fere
nce
syst
em, i
nclu
ding
syst
emiz
ed c
alle
r in
terr
ogat
ion,
dis
patc
h tri
age
polic
ies,
and
pre-
arriv
al in
stru
ctio
ns.
Y
N
REM
SA h
as
esta
blis
hed
EMD
gu
idel
ines
.
Obj
ectiv
e no
t met
. Lo
ng
REM
SA n
eeds
to fo
rmul
ate
a pl
an to
ad
dres
s Cou
ntyw
ide
impl
anta
tion
of
EMD
to in
clud
e di
sast
er re
spon
se
disp
atch
tria
ge p
roto
cols
.
Atta
chm
ent D
Pa
ge 1
2 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
3.10
Inte
grat
ed D
ispa
tch
Stan
dard
: The
loca
l EM
S sy
stem
shal
l hav
e a
func
tiona
lly in
tegr
ated
dis
patc
h w
ith sy
stem
w
ide
emer
genc
y se
rvic
es c
oord
inat
ion,
usi
ng
stan
dard
ized
com
mun
icat
ion
freq
uenc
ies.
Rec
omm
ende
d G
uide
line:
The
LEM
SA sh
ould
de
velo
p a
mec
hani
sm to
ens
ure
appr
opria
te
syst
em w
ide
ambu
lanc
e co
vera
ge d
urin
g pe
riods
of
pea
k de
man
d.
Y
N
REM
SA’s
Rad
io
Com
mun
icat
ions
St
anda
rd.
Am
bula
nce
prov
ider
agr
eem
ents
.
REM
SA h
as
deve
lope
d a
plan
to
addr
ess E
MS
radi
o co
mm
unic
atio
ns
need
s. O
bjec
tive
not
met
Long
D
oes n
ot m
eet t
his o
bjec
tive
yet.
Atta
chm
ent D
Pa
ge 1
3 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
4.05
Res
pons
e T
ime
Stan
dard
St
anda
rd: E
ach
loca
l age
ncy
shal
l dev
elop
re
spon
se ti
me
stan
dard
s for
med
ical
resp
onse
s. Th
ese
stan
dard
s sha
ll ta
ke in
to a
ccou
nt th
e to
tal
time
from
rece
ipt o
f the
cal
l at t
he p
rimar
y pu
blic
safe
ty a
nsw
erin
g po
int (
PSA
P) to
arr
ival
of
the
resp
ondi
ng u
nit a
t the
scen
e, in
clud
ing
all
disp
atch
inte
rval
s and
driv
ing
time.
R
ecom
men
ded
Gui
delin
e: E
mer
genc
y m
edic
al
serv
ice
area
s (re
spon
se z
ones
) sha
ll be
de
sign
ated
so th
at, f
or n
inet
y pe
rcen
t of
emer
gent
resp
onse
s:
a) th
e re
spon
se ti
me
for a
bas
ic li
fe su
ppor
t and
C
PR c
apab
le fi
rst r
espo
nder
doe
s not
exc
eed:
Met
ro/u
rban
--5
min
utes
Subu
rban
/rura
l--15
min
utes
Wild
erne
ss—
as q
uick
as p
ossi
ble
b) th
e re
spon
se ti
me
for a
n ea
rly d
efib
rilla
tion-
capa
ble
resp
onde
r doe
s not
exc
eed:
Met
ro/u
rban
--5
min
utes
Subu
rban
/rura
l—as
qui
ck a
s pos
sibl
e
Wild
erne
ss—
as q
uick
as p
ossi
ble
c)
the
resp
onse
tim
e fo
r an
adva
nced
life
supp
ort
capa
ble
resp
onde
r ( n
ot fu
nctio
ning
as t
he fi
rst
resp
onde
r) d
oes n
ot e
xcee
d :
M
etro
/urb
an--
8 m
inut
es
Su
burb
an/ru
ral--
20 m
inut
es
W
ilder
ness
—as
qui
ck a
s pos
sibl
e d)
the
resp
onse
tim
e fo
r an
EMS
trans
porta
tion
unit
(not
func
tioni
ng a
s the
firs
t res
pond
er) d
oes
not e
xcee
d:
M
etro
/urb
an--
8 m
inut
es
Su
burb
an/ru
ral--
20 m
inut
es
W
ilder
ness
—as
qui
ck a
s pos
sibl
e
N
N
Cou
ntyw
ide
resp
onse
tim
e cr
iteria
has
not
be
en e
stab
lishe
d fo
r fir
st re
spon
der s
ervi
ces.
Obj
ectiv
e no
t met
. Lo
ng
REM
SA n
eeds
to d
evel
op a
pla
n to
m
eet t
he o
bjec
tive.
Atta
chm
ent D
Pa
ge 1
4 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
4.07
Fir
st R
espo
nder
Age
ncie
s St
anda
rd: T
he L
EMSA
shal
l int
egra
te q
ualif
ied
EMS
first
resp
onde
r age
ncie
s (In
clud
ing
publ
ic
safe
ty a
genc
ies a
nd in
dust
rial f
irst a
id te
ams)
in
to th
e sy
stem
.
Y
N
Firs
t res
pond
ers a
re
inte
grat
ed in
to th
e EM
S sy
stem
. In
dust
rial f
irst a
id
team
s are
inte
grat
ed
thro
ugh
disa
ster
pr
epar
edne
ss p
rogr
ams.
Enco
urag
e pu
blic
sa
fety
and
indu
stria
l fir
st a
id te
ams t
o ad
opt E
MS
polic
ies.
Obj
ectiv
e no
t met
.
Long
R
EMSA
nee
ds to
dev
elop
a p
lan
to
addr
ess t
he o
bjec
tive
4.08
Med
ical
Res
cue
Air
craf
t St
anda
rd: T
he L
EMSA
shal
l hav
e a
proc
ess f
or
cate
goriz
ing
med
ical
and
resc
ue a
ircra
ft an
d sh
all d
evel
op p
olic
ies a
nd p
roce
dure
s reg
ardi
ng:
a) a
utho
rizat
ion
of a
ircra
ft to
be
utili
zed
in
preh
ospi
tal p
atie
nt c
are;
b) r
eque
stin
g of
EM
S ai
rcra
ft; c
) dis
patc
hing
of E
MS
airc
raft;
d)
dete
rmin
atio
n of
EM
S ai
rcra
ft pa
tient
de
stin
atio
n; e
) orie
ntat
ion
of p
ilots
and
med
ical
fli
ght c
rew
s to
the
loca
l EM
S sy
stem
; and
, f)
addr
essi
ng a
nd re
solv
ing
form
al c
ompl
aint
s re
gard
ing
EMS
airc
raft.
Y
Y
Am
bula
nce
Ord
inan
ce.
Am
bula
nce
Perm
it Pr
oces
s. EM
S Po
licy
Man
ual.
REM
SA h
as
esta
blis
hed
the
HEM
S C
QI g
roup
an
d is
in th
e pr
oces
s of
upd
atin
g po
licie
s to
mee
t EM
SA a
ir m
edic
al g
uide
lines
.
Shor
t O
bjec
tive
met
.
4.10
Air
craf
t Ava
ilabi
lity
Stan
dard
: The
LEM
SA sh
all i
dent
ify th
e av
aila
bilit
y an
d st
affin
g of
med
ical
and
resc
ue
airc
raft
for e
mer
genc
y pa
tient
tran
spor
tatio
n an
d sh
all,
mai
ntai
n w
ritte
n ag
reem
ents
with
ae
rom
edic
al se
rvic
es o
pera
ting
with
in th
e EM
S ar
ea.
N
N
Am
bula
nce
Perm
it pr
oces
s. A
mbu
lanc
e O
rdin
ance
.
Form
ulat
e ag
reem
ents
with
all
air p
rovi
ders
. O
bjec
tive
not m
et.
Long
R
EMSA
nee
ds to
form
ulat
e a
plan
to
mee
t the
obj
ectiv
e
4.12
Dis
aste
r R
espo
nse
Stan
dard
: The
LEM
SA, i
n co
oper
atio
n w
ith th
e lo
cal o
ffic
e of
em
erge
ncy
serv
ices
(OES
), sh
all
plan
for m
obili
zing
resp
onse
and
tran
spor
t ve
hicl
es fo
r dis
aste
r.
Y
N
Am
bula
nce
Ord
inan
ce a
nd
agre
emen
ts.
MC
I Pol
icy
has
been
upd
ated
. Th
e al
l haz
ards
dis
aste
r m
edic
al re
spon
se
plan
is st
ill b
eing
up
date
d.
Shor
t Th
e al
l haz
ards
med
ical
resp
onse
pla
n st
ill n
eeds
to b
e up
date
d to
mee
t the
ob
ject
ive.
Atta
chm
ent D
Pa
ge 1
5 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
4.13
Inte
r-co
unty
Res
pons
e St
anda
rd: T
he L
EMSA
shal
l dev
elop
agr
eem
ents
pe
rmitt
ing
inte
r-co
unty
resp
onse
of e
mer
genc
y m
edic
al tr
ansp
ort v
ehic
les a
nd E
MS
pers
onne
l. R
ecom
men
ded
Gui
delin
e: T
he L
EMSA
shou
ld
enco
urag
e an
d co
ordi
nate
dev
elop
men
t of
mut
ual a
id a
gree
men
ts w
hich
iden
tify
finan
cial
re
spon
sibi
lity
for m
utua
l aid
resp
onse
s.
Y
N
Reg
ion
VI m
utua
l aid
ag
reem
ent i
s in
plac
e.
Coo
rdin
ate
with
su
rrou
ndin
g LE
MSA
s and
A
rizon
a.
Long
R
EMSA
nee
ds to
form
ulat
e a
plan
to
mee
t the
obj
ectiv
e
4.14
Inci
dent
Com
man
d Sy
stem
St
anda
rd: T
he L
EMSA
shal
l dev
elop
mul
ti-ca
sual
ty re
spon
se p
lans
and
pro
cedu
res w
hich
in
clud
e pr
ovis
ions
for o
n-sc
ene
med
ical
m
anag
emen
t, us
ing
the
Inci
dent
Com
man
d Sy
stem
.
Y
Y
EMS
Polic
y M
anua
l. M
CI p
olic
y &
trai
ning
pr
ogra
m.
A sy
stem
-wid
e M
CI
plan
has
bee
n de
velo
ped
and
is
bein
g im
plem
ente
d
Shor
t O
bjec
tive
met
.
4.15
MC
I Pla
ns
Stan
dard
: Mul
ti-ca
sual
ty re
spon
se p
lans
and
pr
oced
ures
shal
l util
ize
stat
e st
anda
rds a
nd
guid
elin
es.
Y
Y
EMS
Polic
y M
anua
l. M
CI p
olic
y &
trai
ning
pr
ogra
m.
A sy
stem
-wid
e M
CI
plan
has
bee
n de
velo
ped
and
is
bein
g im
plem
ente
d.
Shor
t O
bjec
tive
met
.
4.16
AL
S St
affin
g St
anda
rd: A
ll A
LS a
mbu
lanc
es sh
all b
e st
affe
d w
ith a
t lea
st o
ne p
erso
n ce
rtifie
d at
the
adva
nced
lif
e su
ppor
t lev
el a
nd o
ne p
erso
n st
affe
d at
the
EMT-
1 le
vel.
Rec
omm
ende
d G
uide
line:
The
LEM
SA sh
ould
de
term
ine
whe
ther
adv
ance
d lif
e su
ppor
t uni
ts
shou
ld b
e st
affe
d w
ith tw
o A
LS c
rew
mem
bers
or
with
one
ALS
and
one
BLS
cre
w m
embe
rs.
On
any
emer
genc
y A
LS u
nit w
hich
is n
ot st
affe
d w
ith tw
o A
LS c
rew
mem
bers
, the
seco
nd c
rew
m
embe
r sho
uld
be tr
aine
d to
pro
vide
de
fibril
latio
n, u
sing
ava
ilabl
e de
fibril
lato
r
Y
N
Am
bula
nce
Perm
it Pr
oces
s A
mbu
lanc
e.
Am
bula
nce
Ord
inan
ce.
EOA
Con
tract
s.
Nee
ds st
atem
ent:
“Est
ablis
h a
mec
hani
sm
man
datin
g al
l EM
T-I w
orki
ng o
n AL
S am
bula
nces
to b
e AE
D c
ertif
ied”
. N
o ob
ject
ive
stat
ed.
Long
R
EMSA
nee
ds to
det
erm
ine
the
nece
ssity
to m
eet t
he re
com
men
ded
guid
elin
e.
Atta
chm
ent D
Pa
ge 1
6 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
4.18
Com
plia
nce
Stan
dard
: The
LEM
SA sh
all h
ave
a m
echa
nism
(e
.g.,
an o
rdin
ance
and
/or w
ritte
n pr
ovid
er
agre
emen
ts) t
o en
sure
that
EM
S tra
nspo
rtatio
n ag
enci
es c
ompl
y w
ith a
pplic
able
pol
icie
s and
pr
oced
ures
rega
rdin
g sy
stem
ope
ratio
ns a
nd
clin
ical
car
e.
Y
Y
Am
bula
nce
Perm
it Pr
oces
s. A
mbu
lanc
e O
rdin
ance
. EO
A C
ontra
cts.
A st
anda
rdiz
ed
proc
ess h
as b
een
deve
lope
d to
m
easu
re
com
plia
nce.
Long
O
bjec
tive
met
.
5.01
Ass
essm
ent o
f Cap
abili
ties
Stan
dard
: The
LEM
SA sh
all a
sses
s and
pe
riodi
cally
reas
sess
the
EMS-
re
late
d ca
pabi
litie
s of a
cute
car
e fa
cilit
ies i
n its
se
rvic
e ar
ea.
Rec
omm
ende
d G
uide
line:
The
LEM
SA sh
ould
ha
ve w
ritte
n ag
reem
ents
with
acu
te c
are
faci
litie
s.
Y
N
Bas
e ho
spita
l aud
its
Agr
eem
ents
with
Bas
e H
ospi
tals
Obj
ectiv
e no
t met
. Lo
ng
REM
SA is
wor
king
on
a R
ecei
ving
C
ente
r Pol
icy
and
agre
emen
ts.
5.02
Tri
age
&T
rans
fer
Prot
ocol
s St
anda
rd: T
he L
EMSA
shal
l est
ablis
h pr
ehos
pita
l tria
ge p
roto
cols
and
shal
l ass
ist
hosp
itals
with
the
esta
blis
hmen
t of t
rans
fer
prot
ocol
s and
agr
eem
ents
.
Y
Y
EMS
Trau
ma
Plan
EM
SC S
tand
ards
EM
S Po
licy
Man
ual
Polic
ies h
ave
been
de
velo
ped
for t
he
trans
fer o
f tra
uma
and
STEM
I pat
ient
s
Long
O
bjec
tive
met
.
Atta
chm
ent D
Pa
ge 1
7 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
5.10
Ped
iatr
ic S
yste
m D
esig
n St
anda
rd: L
ocal
EM
S ag
enci
es th
at d
evel
op
pedi
atric
em
erge
ncy
med
ical
and
crit
ical
car
e sy
stem
s sha
ll de
term
ine
the
optim
al sy
stem
, in
clud
ing:
a) t
he n
umbe
r and
role
of s
yste
m
parti
cipa
nts,
parti
cula
rly o
f em
erge
ncy
depa
rtmen
ts; b
) the
des
ign
of c
atch
men
t are
as
(incl
udin
g ar
eas i
n ot
her c
ount
ies,
as
appr
opria
te),
with
con
side
ratio
n of
wor
kloa
d an
d pa
tient
mix
; c) i
dent
ifica
tion
of p
atie
nts w
ho
shou
ld b
e pr
imar
ily tr
iage
d or
seco
ndar
ily
trans
ferr
ed to
a d
esig
nate
d ce
nter
, inc
ludi
ng
cons
ider
atio
n of
pat
ient
s who
shou
ld b
e tri
aged
to
oth
er sp
ecia
lty c
are
cent
ers;
d) i
dent
ifica
tion
of p
rovi
ders
who
are
qua
lifie
d to
tran
spor
t suc
h pa
tient
s to
a de
sign
ated
faci
lity;
e) i
dent
ifica
tion
of te
rtiar
y ca
re c
ente
rs fo
r ped
iatri
c cr
itica
l car
e an
d pe
diat
ric tr
aum
a; f)
the
role
of n
on-p
edia
tric
spec
ialty
car
e ho
spita
ls in
clud
ing
thos
e w
hich
ar
e ou
tsid
e of
the
prim
ary
triag
e ar
ea; g
) a p
lan
for m
onito
ring
and
eval
uatio
n of
the
syst
em.
Y
N
EMSC
Sta
ndar
ds,
surv
eys a
nd si
te v
isits
. O
bjec
tive
not m
et.
Long
rang
e pl
an.
Long
R
EMSA
nee
ds to
form
ulat
e a
plan
to
mee
t the
obj
ectiv
e.
Atta
chm
ent D
Pa
ge 1
8 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
5.11
Em
erge
ncy
Dep
artm
ents
St
anda
rd: L
ocal
EM
S ag
enci
es sh
all i
dent
ify
min
imum
stan
dard
s for
ped
iatri
c ca
pabi
lity
of
emer
genc
y de
partm
ents
incl
udin
g: a
) sta
ffin
g; b
) tra
inin
g; c
) equ
ipm
ent;
d) id
entif
icat
ion
of
patie
nts f
or w
hom
con
sulta
tion
with
a p
edia
tric
criti
cal c
are
cent
er is
app
ropr
iate
; e) q
ualit
y as
sura
nce/
qual
ity im
prov
emen
t; an
d, f)
dat
a re
porti
ng to
the
LEM
SA.
Rec
omm
ende
d G
uide
line:
Loc
al E
MS
agen
cies
sh
ould
dev
elop
met
hods
of i
dent
ifyin
g em
erge
ncy
depa
rtmen
ts w
hich
mee
t sta
ndar
ds
for p
edia
tric
care
and
for p
edia
tric
criti
cal c
are
cent
ers a
nd p
edia
tric
traum
a ce
nter
s.
Y
N/A
EM
SC st
anda
rds,
surv
eys a
nd si
te v
isits
. R
EMSA
nee
ds to
pe
rfor
m p
erio
dic
revi
ews o
f ped
iatri
c ca
re o
f rec
eivi
ng
faci
litie
s. N
o O
bjec
tive
stat
ed.
Long
Id
entif
ied
as a
long
rang
e pl
an a
nd
need
stat
emen
t giv
en b
ut n
o ob
ject
ive
stat
emen
t.
6.01
QA
/QI P
rogr
am
Stan
dard
: The
LEM
SA sh
all e
stab
lish
an E
MS
qual
ity a
ssur
ance
/qua
lity
impr
ovem
ent (
QA
/QI)
pr
ogra
m to
eva
luat
e th
e re
spon
se to
em
erge
ncy
med
ical
inci
dent
s and
the
care
pro
vide
d to
sp
ecifi
c pa
tient
s. Th
e pr
ogra
ms s
hall
addr
ess t
he
tota
l EM
S sy
stem
, inc
ludi
ng a
ll pr
ehos
pita
l pr
ovid
er a
genc
ies,
base
hos
pita
ls, a
nd re
ceiv
ing
hosp
itals
. It s
hall
addr
ess c
ompl
ianc
e w
ith
polic
ies,
proc
edur
es, a
nd p
roto
cols
and
id
entif
icat
ion
of p
reve
ntab
le m
orbi
dity
and
m
orta
lity
and
shal
l util
ize
stat
e st
anda
rd a
nd
guid
elin
es. T
he p
rogr
am sh
all u
se p
rovi
der b
ased
Q
A/Q
I pro
gram
s and
shal
l coo
rdin
ate
them
with
ot
her p
rovi
ders
.
R
ecom
men
ded
Gui
delin
e: T
he L
EMSA
shou
ld
have
the
reso
urce
s to
eval
uate
the
resp
onse
to,
and
the
care
pro
vide
d to
, spe
cific
pat
ient
s.
Y
Y
EMS
Polic
y M
anua
l. C
QI p
lans
& In
divi
dual
In
cide
nt re
view
pr
oces
s. Tr
aum
a A
udit
Proc
ess.
EOA
con
tract
s.
CQ
I TA
G m
eets
re
gula
rly to
upd
ate
CQ
I pla
ns a
nd
addr
ess s
yste
m
impr
ovem
ents
.
Long
O
bjec
tive
met
.
Atta
chm
ent D
Pa
ge 1
9 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
6.02
Pre
hosp
ital R
ecor
ds
Stan
dard
: Pre
hosp
ital r
ecor
ds fo
r all
patie
nt
resp
onse
s sha
ll be
com
plet
ed a
nd fo
rwar
ded
to
appr
opria
te a
genc
ies a
s def
ined
by
the
LEM
SA.
Y
Y
EMS
Polic
y M
anua
l. A
new
dat
a co
llect
ion
syst
em
has b
een
impl
emen
ted.
A
docu
men
tatio
n po
licy
has b
een
esta
blis
hed.
Shor
t O
bjec
tive
met
.
6.03
Pre
hosp
ital C
are
Aud
its
Stan
dard
: Aud
its o
f pre
hosp
ital c
are,
incl
udin
g bo
th sy
stem
resp
onse
and
clin
ical
asp
ects
, sha
ll be
con
duct
ed.
Rec
omm
ende
d G
uide
line:
The
LEM
SA sh
ould
ha
ve a
mec
hani
sm to
link
pre
hosp
ital r
ecor
ds
with
dis
patc
h, e
mer
genc
y de
partm
ent,
in-p
atie
nt
and
disc
harg
e re
cord
s.
Y
N
Aud
its a
re p
erfo
rmed
by
EM
S pr
ovid
er
agen
cies
, hos
pita
ls a
nd
REM
SA.
REM
SA is
mak
ing
som
e pr
ogre
ss o
n ac
hiev
ing
this
ob
ject
ive.
Long
R
EMSA
still
nee
ds to
add
ress
the
abili
ty to
link
EM
S da
ta to
in-p
atie
nt
and
disc
harg
e re
cord
s sys
tem
wid
e.
6.04
Med
ical
Dis
patc
h St
anda
rd: T
he L
EMSA
shal
l hav
e a
mec
hani
sm
to re
view
med
ical
dis
patc
hing
to e
nsur
e th
at th
e ap
prop
riate
leve
l of m
edic
al re
spon
se is
sent
to
each
em
erge
ncy
and
to m
onito
r the
ap
prop
riate
ness
of p
re-a
rriv
al/p
ost d
ispa
tch
dire
ctio
ns.
Y
N
Thro
ugh
appr
oval
of
EMD
pro
gram
s. Es
tabl
ish
a tim
elin
e fo
r Cou
ntyw
ide
adop
tion
of E
MD
by
all
EMS
PSA
Ps
and
EDC
s.
Obj
ectiv
e no
t met
.
Long
R
EMSA
nee
ds to
form
ulat
e a
plan
to
mee
t thi
s obj
ectiv
e
Atta
chm
ent D
Pa
ge 2
0 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
6.05
Dat
a M
anag
emen
t Sys
tem
St
anda
rd: T
he L
EMSA
shal
l est
ablis
h a
data
m
anag
emen
t sys
tem
whi
ch su
ppor
ts it
s sys
tem
w
ide
plan
ning
and
eva
luat
ion
(incl
udin
g id
entif
icat
ion
of h
igh
risk
patie
nt g
roup
s) a
nd th
e Q
A/Q
I aud
it of
the
care
pro
vide
d to
spec
ific
patie
nts.
It sh
all b
e ba
sed
on st
ate
Stan
dard
. R
ecom
men
ded
Gui
delin
e: T
he L
EMSA
shou
ld
esta
blis
h an
inte
grat
ed d
ata
man
agem
ent s
yste
m
whi
ch in
clud
es sy
stem
resp
onse
and
clin
ical
(b
oth
preh
ospi
tal a
nd h
ospi
tal)
data
.
Y
N
REM
SA h
as
esta
blis
hed
CEM
SIS
as
for R
iver
side
Cou
nty.
REM
SA is
mak
ing
prog
ress
on
achi
evin
g th
is
obje
ctiv
e.
Long
Sa
me
obje
ctiv
e as
stan
dard
6.0
3
6.06
Sys
tem
Des
ign
Eva
luat
ion
Stan
dard
: The
LEM
SA sh
all e
stab
lish
an
eval
uatio
n pr
ogra
m to
eva
luat
e EM
S sy
stem
de
sign
and
ope
ratio
ns, i
nclu
ding
syst
em
effe
ctiv
enes
s at m
eetin
g co
mm
unity
nee
ds,
appr
opria
tene
ss o
f gui
delin
es a
nd S
tand
ard,
pr
even
tion
stra
tegi
es th
at a
re ta
ilore
d to
co
mm
unity
nee
ds, a
nd a
sses
smen
t of r
esou
rces
ne
eded
to a
dequ
atel
y su
ppor
t the
syst
em. T
his
shal
l inc
lude
stru
ctur
e, p
roce
ss, a
nd o
utco
me
eval
uatio
ns, u
tiliz
ing
stat
e St
anda
rd a
nd
guid
elin
es.
Y
N
Rev
iew
of r
espo
nse
times
, pat
ient
out
com
es
and
oper
atio
nal
stan
dard
s. C
QI p
roce
ss
and
advi
sory
co
mm
ittee
mee
tings
.
Hire
a c
onsu
ltant
to
perf
orm
a c
ompl
ete
EMS
syst
em d
esig
n an
d op
erat
ions
ev
alua
tion.
O
bjec
tive
not m
et.
Long
R
EMSA
nee
ds to
form
ulat
e a
plan
to
mee
t thi
s obj
ectiv
e.
6.09
AL
S A
udit
Stan
dard
: The
pro
cess
use
d to
aud
it tre
atm
ent
prov
ided
by
adva
nced
life
supp
ort p
rovi
ders
sh
all e
valu
ate
both
bas
e ho
spita
ls a
nd p
reho
spita
l ac
tiviti
es.
Rec
omm
ende
d G
uide
line:
The
LEM
SA’s
in
tegr
ated
dat
a m
anag
emen
t sys
tem
shou
ld
incl
ude
preh
ospi
tal,
base
hos
pita
l, an
d re
ceiv
ing
hosp
ital d
ata.
Y
N
QA
/QI p
roce
ss.
EMS
Polic
y M
anua
l.
Obj
ectiv
e no
t met
. Lo
ng
Sam
e ob
ject
ive
as st
anda
rd 6
.03
Atta
chm
ent D
Pa
ge 2
1 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
6.11
Tra
uma
Cen
ter
Dat
a St
anda
rd: T
he L
EMSA
shal
l ens
ure
that
de
sign
ated
trau
ma
cent
ers p
rovi
de re
quire
d da
ta
to th
e EM
S ag
ency
, inc
ludi
ng p
atie
nt sp
ecifi
c in
form
atio
n w
hich
is re
quire
d fo
r qua
lity
assu
ranc
e/qu
ality
impr
ovem
ent a
nd sy
stem
ev
alua
tion.
R
ecom
men
ded
Gui
delin
e: T
he L
EMSA
shou
ld
seek
dat
a on
trau
ma
patie
nts w
ho a
re tr
eate
d at
no
n-tra
uma
cent
er h
ospi
tals
and
shal
l inc
lude
th
is in
form
atio
n in
thei
r qua
lity
assu
ranc
e/qu
ality
im
prov
emen
t and
syst
em e
valu
atio
n pr
ogra
m.
Y
N
Trau
ma
Plan
Tr
aum
a A
udit
Com
mitt
ee
Rec
eivi
ng c
ente
r ag
reem
ents
re
quiri
ng
subm
issi
on o
f tra
uma
data
. O
bjec
tive
not m
et.
Long
R
EMSA
is in
the
proc
ess o
f wor
king
on
this
obj
ectiv
e.
8.01
Dis
aste
r M
edic
al P
lann
ing
Stan
dard
: In
coor
dina
tion
with
the
loca
l off
ice
of
emer
genc
y se
rvic
es (O
ES),
the
LEM
SA sh
all
parti
cipa
te in
the
deve
lopm
ent o
f med
ical
re
spon
se p
lans
for c
atas
troph
ic d
isas
ters
, in
clud
ing
thos
e in
volv
ing
toxi
c su
bsta
nces
.
Y
N
Don
e th
roug
h ac
tiviti
es
with
PH
EPR
. C
ount
ywid
e M
CI
plan
of s
yste
m-w
ide
MC
Is. O
bjec
tive
not
met
.
Non
e gi
ven.
N
eed
to d
evel
op a
pla
n to
add
ress
the
obje
ctiv
e.
8.02
Res
pons
e Pl
ans
Stan
dard
: Med
ical
resp
onse
pla
ns a
nd
proc
edur
es fo
r cat
astro
phic
dis
aste
rs sh
all b
e ap
plic
able
to in
cide
nts c
ause
d by
a v
arie
ty o
f ha
zard
s, in
clud
ing
toxi
c su
bsta
nces
. R
ecom
men
ded
Gui
delin
e: T
he C
alifo
rnia
Off
ice
of E
mer
genc
y Se
rvic
es’ m
ulti-
haza
rd fu
nctio
nal
plan
s sho
uld
serv
e as
the
mod
el fo
r the
de
velo
pmen
t of m
edic
al re
spon
se p
lans
for
cata
stro
phic
dis
aste
rs.
Y
N
Cou
nty
Dis
aste
r Pla
n.
Cou
ntyw
ide
MC
I pl
an o
f sys
tem
-wid
e M
CIs
. Doe
s not
m
eet t
he o
bjec
tive.
Non
e gi
ven.
N
eed
to d
evel
op a
pla
n to
add
ress
the
obje
ctiv
e.
Atta
chm
ent D
Pa
ge 2
2 of
22
St
anda
rds a
nd R
ecom
men
ded
Gui
delin
es
Mee
ts
std.
M
eets
O
bj.
Des
crip
tion
of
achi
evin
g St
anda
rds
& G
uide
lines
Des
crip
tion
of
achi
evin
g O
bj.
Plan
R
ange
N
eeds
/Act
ion
Plan
/ C
omm
ents
8.04
Inci
dent
Com
man
d Sy
stem
St
anda
rd: M
edic
al re
spon
se p
lans
and
pr
oced
ures
for c
atas
troph
ic d
isas
ters
shal
l use
the
Inci
dent
Com
man
d Sy
stem
(IC
S) a
s the
bas
is fo
r fie
ld m
anag
emen
t. R
ecom
men
ded
Gui
delin
e: T
he L
EMSA
shou
ld
ensu
re th
at IC
S tra
inin
g is
pro
vide
d fo
r all
med
ical
pro
vide
rs.
Y
N
EMS
Polic
y M
anua
l. C
ount
ywid
e M
CI
plan
of s
yste
m-w
ide
MC
Is. D
oes n
ot
mee
t the
obj
ectiv
e.
Non
e gi
ven
See
stan
dard
s 8.0
1 &
8.0
2.
8.05
Dis
trib
utio
n of
Cas
ualti
es
Stan
dard
: The
LEM
SA, u
sing
stat
e gu
idel
ines
, sh
all e
stab
lish
writ
ten
proc
edur
es fo
r dis
tribu
ting
disa
ster
cas
ualti
es to
the
med
ical
ly m
ost
appr
opria
te fa
cilit
ies i
n its
serv
ice
area
. R
ecom
men
ded
Gui
delin
e: T
he L
EMSA
, usi
ng
stat
e gu
idel
ines
, and
in c
onsu
ltatio
n w
ith
Reg
iona
l Poi
son
Cen
ters
, sho
uld
iden
tify
hosp
itals
with
spec
ial f
acili
ties a
nd c
apab
ilitie
s fo
r rec
eipt
and
trea
tmen
t of p
atie
nts w
ith
radi
atio
n an
d ch
emic
al c
onta
min
atio
n an
d in
jurie
s.
Y
N
Red
diN
et is
use
d fo
r th
e di
strib
utio
n of
ca
sual
ties.
Cou
ntyw
ide
MC
I pl
an o
f sys
tem
-wid
e M
CIs
. Doe
s not
m
eet t
he o
bjec
tive.
Long
See
stan
dard
s 8.0
1, 8
.02
& 8
.04.
8.10
Mut
ual A
id A
gree
men
ts
Stan
dard
: The
LEM
SA sh
all e
nsur
e ex
iste
nce
of
med
ical
mut
ual a
id a
gree
men
ts w
ith o
ther
co
untie
s in
its O
ES re
gion
and
els
ewhe
re, a
s ne
eded
, whi
ch e
nsur
e th
at su
ffic
ient
em
erge
ncy
med
ical
resp
onse
and
tran
spor
t veh
icle
s, an
d ot
her r
elev
ant r
esou
rces
will
be
mad
e av
aila
ble
durin
g si
gnifi
cant
med
ical
inci
dent
s and
dur
ing
perio
ds o
f ext
raor
dina
ry sy
stem
dem
and.
Y
N
OES
Reg
ion
VI m
utua
l ai
d ag
reem
ent i
n fo
rce
for a
ll m
embe
r cou
ntie
s
Ensu
re th
e ex
iste
nce
of m
edic
al m
utua
l ai
d ag
reem
ents
with
ot
her c
ount
ies i
n th
e O
ES re
gion
and
el
sew
here
if n
eede
d.
Non
e gi
ven
Nee
d to
dev
elop
a p
lan
to a
ddre
ss th
e ob
ject
ive.
BOARD OF SUPERVISORS REPORT ATTACHMENT E
Date: March 24, 2011
To: Emergency Medical Care Committee (EMCC)
From: Brian MacGavin, EMS Agency Assistant Director
Subject: EMCC Board of Supervisor Report
Recommended Action: Approve and Direct EMS Agency to Send to the Board of Supervisors
Discussion:
The draft EMCC report was submitted as a handout at the last EMCC meeting on January 5, 2011. At that time it was requested that members review and give comment to REMSA before final approval and submission to the Board of Supervisors. It was requested that language be added regarding recent activity on ALS ambulance agreements; this has been added to the report. The EMS Agency is requesting approval of this report for submission to the Board of Supervisors.
Attachment E Page 2 of 5
INTRODUCTION
This report documents Riverside County Emergency Medical Care Committee’s (EMCC) observations and recommendations on EMS in Riverside County. By virtue of the EMCC’s membership (pursuant to Board of Supervisors Resolution No. 2001-358), these observations and recommendations are composed by a varied group of individuals which forms this EMS advisory group. Reporting these observations and recommendations will help to reinforce positive changes within Riverside County’s EMS System.
EMCC MEMBERSHIP
EMCC Membership has been established by Board of Supervisors Resolution No. 2001-358 which currently consists of the following individuals:
Prehospital Medical Advisory Committee (PMAC) Physician Representative—Stephen Patterson Hospital Association Representative (ex-officio)—Christina Bivona-Tellez Riverside County Medical Association Representative—Kenneth Nickson, MD Riverside County Ambulance Association Representative—Peter Hubbard Riverside County Fire Chiefs’ Association Representative –David Waltemeyer Coachella Valley Association of Governments Representative—Mike Marlow Western Riverside Council of Governments Representative—Grant Yates Riverside County Law Enforcement Agency Admin Assoc. Representative—Tom McCreary PMAC Prehospital Representative—Jim Price Riverside County Fire Department Representative—Phil Rawlings Supervisorial District One Representative—Gloria Huerta Supervisorial District Two Representative—Stan Grube Supervisorial District Three Representative—Mike Norris Supervisorial District Four Representative—Bary Freet Supervisorial District Five Representative—Kent McCurdy
STAFFING AND TRAINING
Over the last 10 years requests for EMS have increased by over 10 percent. For the calendar year of 2008 there were 218,953 responses reported for EMS services; in 2009 there were 215,899 reported. The total EMS response numbers for 2010 were not available at the time of this report.
For the 2009/2010 ambulance permit cycle there were 238 ambulances permitted in Riverside County; for the current permit cycle (2010/2011) there are 251 ambulances permitted in Riverside County.
Thirty-eight hundred EMS personnel applications were processed by REMSA in 2010; two hundred Mobile Intensive Care Nurses (MICN), nine hundred paramedics and 2,700 EMTs.
The 2009 EMS Plan update identified that uniform performance standards and objective evaluation tools were needed. Since that time new performance standards have been adopted
Attachment E Page 3 of 5
and incorporated into Riverside County EMS Agency’s (REMSA) Protocol, Policy and Procedure Manual. Additionally, train-the-trainer classes have been competed to ensure a system-wide uniform application of the performance standards and evaluation tools for implementation starting January 1, 2011.
COMMUNICATIONS
REMSA has conducted an assessment of the EMS system’s communications infrastructure. This assessment has identified needed communication system improvements. REMSA plans to redesign and develop a radio and data communications system that provides a reliable and comprehensive communications platform that EMS providers can use for daily on-line medical direction as well as for hospital destination coordination during large scale incidents. The first phase of this plan has been accomplished with the completion of REMSA’s communications center. However, much work needs to be accomplished in order to have a highly functional communications system that will meet Riverside County’s EMS communications needs and remain functional during times of high demand.
ALS AMBULANCE EXCLUSIVE OPERATING AGREEMENTS
In 2009 the County agreements with American Medical Response (AMR) and Idyllwild Fire Protection District (IFPD) were amended with modifications.
Highlights of the IFPD agreement amendment include:
• Two separate agreements for Zones I & II and Zone III were combined putting them on the same timeline as the master agreement with AMR
• Modified the annual CSA-38 subsidy from four percent to two percent • Modified language on ambulance staffing requirements • Added language requiring IFPD to communicate with the CSA-38 Advisory Board on
the status of ambulance services
Highlights of the AMR agreement amendment include:
• Increases regulatory monitoring and reporting requirements • Improved ambulance backup and mutual aid requirements • Improved clinical management infrastructure and oversight • Requirement for additional field supervision • Clarification of resource command and control during EMS surge and disaster events • Addition of a third subzone in the Northwest Zone • Subzone average response time requirement increase to 90 percent monthly • Response time fine penalty increase for responses over 5 minutes late • Response time fine credits for performance over the required minimum standards • Countywide deployment of Computer Aided Dispatch (CAD) integrated AVL/GPS • Requirement standards for professionalism • Increased educational and training requirements • Improved first responder restock agreement requirements • Increased oversight responsibilities for EMS Zone Administrative Groups
Attachment E Page 4 of 5
TRANSPORTATION PLAN
Subsequent to our submission of the EMS Plan update, the EMS Agency received a letter on July 6, 2010 from the State EMS Authority (EMSA) stating the following issues in our EMS Transportation Plan needed to be addressed in order to receive their approval: clarification on Indio Fire Department’s eligibility for exclusivity, and the completion of a competitive bidding process for the Pass and Mountain Plateau Exclusive Operating Areas. EMCC has been discussing ways to address these issues.
Other transportation components needing to be addressed are establishing County ALS ambulance agreements with REACH Air, Mercy Air and Cathedral City Fire Department.
HOSPITALS
Base hospital agreements were renewed in 2010 with enhancements. Audits were performed on the seven base hospitals in Riverside County. Three base hospitals passed the audit and three had to make a few minor corrections. Palo Verde Hospital is working on reestablishing their base hospital status which was suspended on October 1, 2010. Receiving Hospital Agreements need to be established with the 15 acute care hospitals in Riverside County.
Riverside County’s EMS system now recognizes the following six hospitals as ST Elevation Myocardial Infarction (STEMI) Receiving Centers: Desert Regional Medical Center, Eisenhower Medical Center, Loma Linda University Medical Center, Palomar Medical Center (San Diego County), Riverside Community Hospital and San Antonio Community Hospital (San Bernardino County). This program has improved the ability for STEMI patients to be transported directly to a hospital prepared to provide immediate advanced interventions, thereby reducing the time for coronary artery reperfusions.
Emergency Department (ED) ambulance wait times continue to be an issue causing a potential negative impact on the EMS system. REMSA has been closely monitoring ED ambulance wait times since 2008. While some hospitals have been showing improvement, others struggle in keeping their ED ambulance wait times down. REMSA has been taking a much more assertive approach in getting hospitals to keep their ED ambulance wait times down and is working on language in receiving hospital agreements that would discourage the practice of holding patients on ambulance gurneys in the hallways of hospital emergency departments.
MEDICAL CONTROL
Medical control is maintained through REMSA’s protocols, policies and procedures, and through on-line direction with base hospitals. REMSA continually updates their Protocol, Policy and Procedure Manual to keep abreast of new developments and improvements in the industry. Additionally, REMSA has been restructuring their Protocol, Policy and Procedure Manual in order to develop better adherence to quality assurance and improvement standards. Through the Continuous Quality Improvement Technical Advisory Group (CQI TAG), REMSA has incorporated performance standards and skills verification forms as part of REMSA’s Protocol, Procedure and Protocol Manual. Additionally, base hospital agreements have been updated and modified, and a base hospital policy has been implemented to improve the base hospitals’ ability to provide on-line direction to paramedics.
Attachment E Page 5 of 5
DATA COLLECTION AND EVALUATION
In 2010, the County’s agreement for an EMS data collection vendor expired and REMSA completed a Request for Proposal (RFP) for a new data collection system (ePCR) vendor. Sansio emerged as the leader over several vendors being considered for the agreement. Currently, Pechanga Fire Department and Corona Fire Department are using Sansio. Idyllwild Fire Protection District, March Air Force Reserve, Murrieta Fire Department, Norco Fire Department, Palm Springs Fire Department, Riverside City Fire Department and Riverside County Fire Department (CAL Fire) are in the process of implementing their use of Sansio. All providers will be required to submit EMS data to REMSA for evaluation.
PUBLIC INFORMATION AND EDUCATION
There are many organizations that train members of the public on first aid and CPR. Additionally, changes in the organizational structure of large organizations such as the American Heart Association and the American Red Cross make it impossible to gather information on the number of lay individuals that are trained in first aid and CPR.
DISASTER RESPONSE
The Department of Public Health Administration saw the need to improve disaster preparedness and response in Riverside County. Therefore, in 2002 Riverside County Public Health Emergency Preparedness and Response (PHEPR) Branch was established. REMSA and PHEPR work together to improve the County’s response to public health emergencies and hazards. For 2010, PHEPR and REMSA have continued to collaborate on emergency preparedness planning and exercises.
CONCLUSION
It is the focus of the EMCC to provide observations and recommendations in order to improve Riverside County’s EMS system. This is accomplished through its diverse membership and direct involvement in advising and planning activities that influence Riverside County’s EMS system at EMCC meetings and through the EMS Plan updates. We thank the Board of Supervisors for their support in improving Riverside County’s EMS system.