California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 5 - Community Paramedicine and Triage to Alternate Destination › Section 100183 - Program Requirements and Minimum Standards

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				A LEMSA that elects to develop a community paramedicine or triage to alternate
				destination program shall do all the following:
(1)
				Integrate the proposed community paramedicine or triage to alternate destination
				program into the LEMSA's EMS plan described in Article 2 (commencing with Section
				1797.250) of Chapter 4 of the Health
				and Safety Code.
(2) Provide medical
				control and oversight for the program(s).
(3) Approve, annually review, and facilitate any
				necessary agreements with one or more community paramedicine or triage to alternate
				destination providers for the delivery of community paramedicine or triage to
				alternate destination services within the LEMSA's jurisdiction.
(4) Prohibit triage and assessment protocols or a
				triage paramedic's decision to authorize transport to an alternate destination
				facility from being based on, or affected by, a patient's ethnicity, citizenship,
				age, preexisting medical condition, insurance status, economic status, ability to
				pay for medical services, or any other characteristic listed or defined in
				subsection (b) or (e) of Section
				51 of the Civil
				Code, except to the extent that a circumstance such as age, sex, preexisting medical
				condition, or physical or mental disability is medically significant to the
				provision of appropriate medical care to the patient.
(5) Facilitate funding discussions between a
				community paramedicine provider, triage to alternate destination provider, or
				incumbent emergency medical transport provider and public or private health system
				participants to support the implementation of the LEMSA's community paramedicine or
				triage to alternate destination program.
(6) Coordinate, review, and approve any agreements
				necessary for the provision of community paramedicine specialties as described in
				Section
				1815 of
				the Health and Safety Code consistent with all the following:
(A) Provide a first right of refusal to the public
				agency or agencies within the jurisdiction of the proposed program area to provide
				the proposed program specialties for community paramedicine. If the public agency or
				agencies agree to provide the proposed program specialties for community
				paramedicine, the LEMSA shall review and approve any written agreements necessary to
				implement the program with those public agencies.
(B) Review and approve agreements with community
				paramedicine providers that partner with a private provider to deliver those program
				specialties.
(C) If a public agency
				declines to provide the proposed program specialties pursuant to paragraph (A) or
				(B), the LEMSA shall develop a competitive process held at periodic intervals to
				select community paramedicine providers to deliver the program
				specialties.
(7) Establish a
				process to verify training and accreditation of community paramedics in each of the
				proposed community paramedicine program specialties described in subsections (a) and
				(b) of Section
				1815 of
				the Health and Safety Code, and a process to verify and training and accreditation
				of triage paramedics in each of the areas described in Section
				1819 of
				the Health and Safety Code.
(8) A LEMSA
				may exclude an existing ALS provider from the plan if it determines that the
				provider's participation will negatively impact patient care. If a LEMSA elects to
				exclude an ALS provider, the LEMSA shall do both of the following:
(A) Report to the Authority at the time the
				program is submitted for approval, the specific reasons for excluding an ALS
				provider.
(B) Inform the ALS provider of
				the reasons for exclusion.
(9)
				Facilitate any necessary agreements to ensure continuity of care and efficient
				transfer of care between the triage to alternate destination provider and the
				existing emergency medical transport provider to ensure transport to the appropriate
				facility.
(10) At the discretion of the
				LEMSA medical director, develop additional triage and assessment protocols
				commensurate with the need of the local programs authorized under this
				Chapter.
(11) Secure an agreement with
				the alternate destination facility that requires the facility to notify the LEMSA
				within twenty-four (24) hours if there are changes in the status of the facility
				with respect to protocols and the facility's ability to care for patients.
(12) Secure an agreement with the alternate
				destination facility that requires the facility to operate in accordance with
				Section
				1317 of
				the Health and Safety Code. The agreement shall provide that failure to operate in
				accordance with Section
				1317 of
				the Health and Safety Code shall result in the immediate termination of use of the
				facility as part of the triage to alternate destination program.
(13) In implementing a triage to alternate
				destination program specialties described in Section
				1819 of
				the Health and Safety Code, continue to use, and coordinate with, any emergency
				medical transport providers operating within the jurisdiction of the local LEMSA
				pursuant to Section
				1797.201
				or
				1797.224
				of the Health and Safety Code. The LEMSA shall not in any manner eliminate or reduce
				the services of the emergency medical transport providers.
(14) Establish a process for training and
				accreditation of triage paramedics in each of the proposed triage to alternate
				destination program's specialties described in Section
				1819 of
				the Health and Safety Code.
(15) Approve
				and annually review community paramedicine and triage to alternate destination
				training programs.
(16) Coordinate
				community paramedic personnel and training program(s).
(17) Notify the Authority of any reported
				complaints or unusual occurrences for any approved community paramedicine or triage
				to alternate destination program within seventy-two (72) hours of receiving them
				along with any supporting or explanatory documentation.