1841.
A local EMS agency that opts to develop a community paramedicine or triage to alternate destination program shall do all of the following:(a) Integrate the proposed community paramedicine or triage to alternate destination program into the local EMS agency’s emergency medical services plan described in Article 2 (commencing with Section 1797.250) of Chapter 4.
(b) Consistent with this article, develop a process to select community paramedicine providers, to provide services as described in Section 1815, at a periodic interval established by the local EMS agency.
(c) 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 local EMS agency’s jurisdiction that are consistent with the proposed community paramedicine or triage to alternate destination program. The local EMS agency shall provide medical control and oversight of the program.
(d) Any contract to provide the program specialties described in subdivisions (a) to (c), inclusive, of Section 1815 shall not be included as part of an existing or proposed contract for the delivery of emergency medical services as part of an exclusive operating area awarded pursuant to Section 1797.224 or the provision of, or administration of, emergency medical services authorized pursuant to Section 1797.201.
(e) If the community paramedicine program proposes to provide the program specialties described in subdivisions (a) to (c), inclusive, of Section 1815, the local EMS agency shall coordinate and review and approve any written agreements for the provision of those specialties to ensure compliance with the requirements of this chapter and according to the following:
(1) A local EMS agency shall provide a right of refusal for the public agency or agencies within the jurisdiction of the proposed program area to provide the proposed program specialties. If the public agency or agencies agree to provide the proposed program specialties, the local EMS agency shall review and approve written agreements with those public agencies.
(2) A local EMS agency shall review and approve agreements with community paramedicine providers that partner with a public agency or agencies to deliver those program specialties described in subdivisions (a) to (c), inclusive, of Section 1815.
(3) If no public agency chooses to provide the proposed program specialties pursuant to paragraph (1) or (2), the local EMS agency shall develop a process to select community paramedicine providers to deliver the specialties described in subdivisions (a) to (c), inclusive, of Section 1815.
(f) For triage to alternate destination program specialties described in Section 1819, the local EMS agency shall continue the use of existing providers operating within the local EMS agency’s jurisdiction pursuant to Section 1797.201 or 1797.224 and shall do all of the following:
(1) At the discretion of the local medical director, develop additional triage and assessment protocols commensurate with the need of the local programs authorized under this act.
(2) Require the triage and assessment protocols and decision of the triage paramedic to transport to an alternate destination facility to not be based upon, or affected by, the 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 subdivision (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.
(3) Certify and provide documentation and periodic updates to the Emergency Medical Service Authority showing that the alternate destination facility authorized to receive patients has adequate licensed medical and professional staff, facilities, and equipment that comply with the requirements of the Emergency Medical Services Authority’s regulations and the provisions of this chapter which shall include the following:
(A) Qualified staff to care for the degree and severity of a patient’s injuries and needs.
(B) Standardized medical and nursing procedures for nursing staff.
(C) The equipment and services available at an alternate destination facility necessary to care for patients requiring medical services, including, but not limited to, an automatic external defibrillator and at least one bed or mat per individual patient.
(D) The time of day and any limitations that may apply for an alternate destination facility to treat patients requiring medical services.
(4) Secure an agreement with the alternate destination facility that requires the facility to notify the local EMS agency within 24 hours if there are changes in the status of the facility with respect to the protocols and the facility’s ability to care for patients.
(5) Secure an agreement with the alternate destination facility attesting that the facility will operate in accordance with Section 1317 and providing that failure to operate in accordance with Section 1317 will result in the immediate termination of use of the facility as part of the triage to alternate destination facility.
(g) A local EMS agency shall establish the following training pursuant to the requirements established by the authority and the program specialty that is being proposed by the local EMS agency:
(1) Establish a process to verify training and accreditation of community paramedics in each of the proposed community paramedicine program’s specialties described in subdivisions (a) to (c), inclusive, of Section 1815.
(2) 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.
(h) Facilitate funding discussions between a community paramedicine or triage to alternate destination provider and public or private health system participants to support the implementation of the local EMS agency’s community paramedicine or triage to alternate destination program.