As a licensed paramedic or emergency medical technician (EMT), you make decisions that can save lives. These particular decisions come with a lot of stress. Unfortunately, one patient complaint, one arrest for a crime while off duty, or one administrative misunderstanding can lead to an Emergency Medical Services Authority (EMSA) investigation. These investigations could result in the loss of your license, reputation, and livelihood.
If the state or local licensing agency is taking action against your license under California Health and Safety Code Section 1798.200, navigate these complicated administrative proceedings without the help of an experienced attorney. San Jose License Attorney offers knowledgeable, committed legal representation to defend your right to be an emergency care provider. We know how hard you have worked to establish your career in healthcare and are ready to fight for you.
The Roles and Responsibilities of Paramedics and EMTs
Emergency medical responders work in physically and clinically challenging jobs that require making crucial split-second decisions in stressful environments. The professions of emergency medical technician (EMT) and licensed paramedic (LP) are closely related but have distinct educational and training requirements, as well as distinct permitted scopes of clinical care under California law.
Understanding the Basic Life Support (BLS) Scope of EMTs
The foundation of emergency medical services is EMTs. The education and certification program trains you to conduct rapid, non-invasive clinical evaluations and stabilize critically ill or injured patients in transit. You need to be physically strong, quick-thinking, and emotionally stable in stressful situations.
California regulations limit your basic life support (BLS) protocols to non-invasive medical procedures, which can lead to misunderstandings with the public about the extent of your intervention.
Your duties involve
- Measuring and monitoring patient vital signs, including:
- Respiratory rate
- Blood pressure
- Oxygen saturation
- Temperature
- Administering basic first aid, including
- Immobilization of the spine
- Splinting fractures
- Controlling bleeding
- Performing the following:
- Cardiopulmonary resuscitation (CPR)
- Automated external defibrillation (AED)
- Airway management using oropharyngeal and nasopharyngeal adjuncts
- Giving simple noninvasive or emergency medication such as the following:
- Epinephrine auto-injectors
- Naloxone (Narcan) for opioid overdose
- Other simple medications
These interventions involve the safe transport of patients to the emergency departments and the transfer of clinical information to staff at the receiving hospital in a structured format. These interventions, in turn, lead to safe transport to the emergency department and the transfer of structured clinical information to staff at the receiving hospital.
Navigating the Advanced Life Support (ALS) Responsibilities of Licensed Paramedics (LPs)
The highest level of prehospital care providers are licensed paramedics. In your advanced life support (ALS) training, you learn:
- Pharmacology
- Cardiology
- Physiology
- Invasive medical procedures
Each drug you select to administer in the field is your own responsibility when it comes to ethical and legal issues. During training, you can use more sophisticated equipment and introduce drugs into the body, since you are working under stressful conditions, without the presence of doctors.
Your role is to carry out these duties, which involve:
- Administering advanced cardiac life support (ACLS) medications
- Initiating intravenous (IV)
- Intraosseous access
In addition, you have advanced airway skills such as endotracheal intubation and emergency tracheostomy. You also need to read, analyze, and interpret complex diagnostic equipment data every day, including electrocardiograms (ECGs/EKGs).
As a health care professional under the direction of a medical professional, you are responsible for handling the critical role of administering controlled substances and narcotic pain medications. You also have the advanced training necessary to perform emergency childbirth procedures and to stabilize neonatal and pediatric emergencies.
Oversight Roles of EMSA and LEMSAs
California regulates emergency medical services in a multi-tiered approach, and prehospital personnel are under regulatory oversight for compliance with public safety standards. Oversight is shared between a state-level central department and county-level agencies that have statutory authority to audit on-duty and off-duty conduct, to process public complaints, and to enforce strict professional standards.
The Statewide Authority of the EMSA
The EMSA is the state’s primary regulatory agency. It has a wide range of administrative authority, such as the following:
- Issuing licenses
- Developing consistent operating protocols
- Prosecuting administrative disciplinary actions against licensed paramedics
- Administering licensing examinations
- Operating the comprehensive central registry of certified prehospital providers
- Formulating and enforcing statewide prehospital emergency medical policies and standard protocols
- Safeguarding the public interest by conducting investigations of formal complaints against licensed paramedics via its Enforcement Unit
County-Level Management by LEMSAs
Local EMS systems are managed at the county level by Local Emergency Medical Services Agencies (LEMSAs). The LEMSA is the agency that serves prehospital workers in San Jose. LEMSAs have direct authority over EMT certification, credentialing, and adherence to county-level treatment protocols. This local management will allow emergency responders to meet county standards while working under regional medical control systems.
To do this, the agency must review applications, do background checks, and issue local certifications for EMTs. LEMSAs also have the responsibility of creating and maintaining local medical control protocols and clinical guidelines that are tailored to the resources available in the county.
In addition, LEMSAs are responsible for receiving, reviewing, and investigating clinical complaints and deviations from protocols by local EMTs. They also have operational accountability through the implementation of county disciplinary actions or the referral of serious issues to EMSA for additional consideration.
Typical Violations and Actions That Trigger Administrative Disciplinary Action
The state and county licensing authorities have a keen eye on the licensing history for signs of safety issues and ethics breaches. California Health and Safety Code Section 1798.200 provides for serious discipline of licenses, such as probation, suspension, or revocation of the right to practice, for various clinical errors, off-duty conduct, and criminal acts.
Substance Abuse and Off-Duty DUI Arrests
Your off-duty behavior can be a big problem in your career. Alcohol, controlled substances, and prescription drugs are significant factors in triggering board actions. The Department of Justice sends the licensing board a notification of arrest and/or conviction for driving under the influence (DUI). Regulators determine if your off-duty substance use reflects an addiction that poses a threat to public safety when you are performing your emergency field duties.
Allegations of Gross Negligence, Clinical Errors, and Repeated Negligent Acts
Emergency care providers are required to meet specific standards of clinical practice. Failure to follow procedures, serious medication errors, or delayed treatment of patients may result in allegations of gross negligence or incompetence.
Gross negligence is a serious and reckless failure to provide medical care in accordance with the standard of care, and incompetence is usually defined as a failure to provide medical care because of a lack of medical training or physical ability. Multiple acts of negligence are a series of small clinical errors over a period of time.
Ethical Violations, Patient Abuse, and Breach of Confidentiality
Working with emergency patients should be strictly professional. The board investigates patient abuse, mistreatment, and excessive force during patient restraint. Also, according to the California Civil Code, it is a serious breach of patient privacy not to maintain confidentiality.
Patients’ information should not be shared on personal devices, patients’ cases should not be discussed online, or patients’ information used for sexual misconduct in the workplace, and any such cases will be investigated immediately.
Criminal Convictions Substantially Related to Prehospital Care Duties
Administrative action may be taken for a wide range of misdemeanor and felony convictions that are substantially related to your duties. The DOJ provides continuous electronic background monitoring, which means that all arrests are sent to your licensing agency. Crimes involving violence, dishonesty, or dangerous drugs are heavily prosecuted. These include:
- Driving while intoxicated (VC 23152)
- Assault or Battery charges (PCs 240 and 242)
- Theft, Robbery, or Burglary offenses (PCs 459 and 211)
- Possession, transportation, or sale of Controlled substances (HSC 11352)
- Child abuse allegations or domestic disputes (PC 273d)
- All sexual offenses that must be registered (PC 290)
The Step-by-Step Administrative Disciplinary Process and Hearing Procedure
It is important to understand the statutory deadlines and administrative court procedure when it comes to navigating the disciplinary pipeline. The process moves methodically from the initial complaint review to the formal investigation stages and administrative law hearings, with each stage of the process having significant consequences in terms of your livelihood and professional standing.
The Receipt and Preliminary Jurisdiction Review of a Complaint
The administrative disciplinary process begins when a patient, coworker, or employer makes a complaint on the Paramedic Investigation Request Form or regional county systems. The board’s initial consideration determines if the allegations are within the scope of the board’s regulatory authority and whether they have a sufficient basis to establish a case file. Any complaints not falling within their jurisdiction are rejected or referred to the appropriate agencies.
The Enforcement Investigation Stage and the Pitfalls of Uncounseled Statements
An assigned investigator collects evidence, reviews medical records, and conducts witness interviews after a case is opened. The board will inform you of the investigation and give you a brief time to respond. Talking to investigators or giving written statements without a lawyer is serious business. Once you make a statement on your initial phone calls, it is easily recorded and can be used against you on subsequent administrative trials.
The Filing of a Formal Accusation or Statement of Issues and Filing the Notice of Defense
If the investigation finds that there is enough evidence, the case is referred to the Office of the Attorney General, which prepares a formal Accusation/Statement of Issues. An Accusation targets licensees, while a Statement of Issues targets new applicants. You should file a Notice of Defense within 15 days of service. Failure to comply with this deadline results in a default order, which means automatic license cancellation without a hearing.
Resolving Allegations Through a Negotiated Stipulated Agreement
Your lawyer may be able to reach a stipulated settlement with the board’s attorney before trial. This is analogous to a plea bargain. A stipulated agreement is an agreement between you and the court to accept a specific penalty, such as a probation term or a public reprimand, in exchange for keeping your driving privileges and not having to wait for a full hearing.
The Administrative Bearing Trial at the Office of Administrative Hearings (OAH)
If no settlement is reached, the case will move on to a formal administrative hearing. The trial is held in front of an Administrative Law Judge (ALJ) in an Office of Administrative Hearings (OAH). This proceeding follows formal rules of law, and both parties:
- Give their opening statements
- Present documentary evidence
- Conduct direct examination of witnesses
- Cross-examine the other party’s witnesses
The Post-Hearing Proposed Decision by the ALJ and Final EMSA Determination
After the administrative trial, the ALJ will have 30 days to prepare a proposed decision that includes his or her findings and recommended sanctions. But the final decision is up to the EMSA director, who can accept, modify, or reject the ALJ’s proposal within 100 days. The board may impose a fine, probation on your license, or a final order of suspension or revocation.
You can appeal the board’s decision if the final administrative order is unfavorable or if it is procedurally defective. Your attorney can file a petition for a Writ of Administrative Mandate in the California Superior Court under Code of Civil Procedure Section 1094.5.
This judicial review is to review the board’s actions at your hearing and determine if they have acted improperly or if they have made any legal mistakes.
Defenses to Safeguard Your EMT Certificate or Paramedic License
When it comes to defending healthcare credentials, use strong legal strategies that rely on compelling evidence and interpretations of the rules. With the help of an experienced licensing defense attorney, you can respond to the prosecution’s arguments, draw attention to key procedural errors, and present well-organized arguments that save your livelihood and restore your professional reputation.
Challenging the “Substantial Relationship” of Criminal Offenses
The board is not legally allowed to discipline a licensee with a conviction unless the board can establish a link between the conviction and the skills, qualifications, or safety responsibilities of the licensee’s prehospital care profession. Your attorney may dispute the board’s reading of your criminal history and attempt to have it dismissed.
Demonstrating Strong Evidence of Rehabilitation & Remediation
If you are charged with substance abuse, demonstrate your rehabilitation. The ALJ will consider certain factors to decide whether or not you can practice safely. Showing that corrective measures are being taken in an active manner helps the board to know that there is no risk to public safety. You could present a certificate of completion for a state-approved substance abuse, chemical dependency, or mental health recovery program.
Using Mitigating Circumstances and Positive Performance Records
A strong mitigation argument helps to offset the severity of the discipline that is proposed. A long record of emergency service can be important evidence to help get a lesser sentence. Examples of performance records that you could use to mitigate your situation are:
- Letters of recommendation from professional supervisors outlining your competency and supervision over time
- certified copies of exemplary professional performance evaluations for multiple years
- Documented evidence of a long-term clinical career with no prior administrative warnings or complaints in public
- Evidence of voluntary reporting of the incident and/or compliance with early workplace corrective measures
Choose a Professional License Defense Attorney Near Me
Being placed on administrative investigation or under threat of suspension or revocation of your license by the EMSA or local EMS is a stressful event and requires strategic action. Any delay in responding to an Accusation may lead to automatic, default revocation of your license, making it essential to hire an experienced legal team to help protect your livelihood.
Whether you are an EMT or a paramedic, San Jose License Attorney offers full-service, expert legal representation and guidance tailored to the needs of paramedics and EMTs in Santa Clara County. To keep your license and keep going with your life-saving work, call our experienced attorneys today at 669-330-4517.
