CA Paramedic Regulator Chided on Backlog

A top California ambulance executive, a leading fire chief and a union official representing rescuers blasted the Emergency Medical Services Authority on Wednesday, saying the regulator takes too long to investigate paramedic misconduct while cases pile up and languish for years.

The three men -- all members of the state's Emergency Medical Services Commission, appointed by the governor and legislators -- leveled the searing criticism at EMSA and its director, Dr. Cesar Aristeiguieta, during a commission meeting in Sacramento.

EMSA's backlog of enforcement cases is unacceptable to paramedic employers, said Commissioner Sheldon Gilbert, president of the California Fire Chiefs Association.

"Discipline is about correcting behavior," Gilbert said. "It's pretty hard to do that five years after the fact."

"There is such a thing as due process," added Commissioner Louis K. Meyer, chief executive of ambulance giant American Medical Response's U.S. Northwest operations. "What we have here is people hanging in limbo for up to four years. That's not in the interest of the individual or the state."

The criticism follows an investigative Bee series that highlighted the state's weak oversight of paramedics in California.

The Bee reported that EMSA's backlog was almost 300 cases and included, at the time, an unresolved misconduct case from 2002.

Aristeiguieta told commissioners Wednesday that a 2003 case still remains on EMSA's books, although most are from 2005 and 2006. His agency has cut the backlog to 140 cases, he said, adding that its elimination has been one of his top priorities since he became EMSA director in 2005.

In the future, he said, he aims to resolve all new enforcement cases in 180 days.

"Our enforcement mission is to protect the public," Aristeiguieta said. "If it takes four or five years to resolve a case, we may not be keeping up with that mission."

Commissioner Lewis Stone, a firefighter representing the California Professional Firefighters union, accused EMSA of running an enforcement system that "is above the law" because it operates probes without a statute of limitations. Most cases can be resolved in 30 days, Stone suggested.

In other business, Commissioner Bruce Lee announced that the commission is calling for mandatory criminal background checks and the creation of a statewide licensing and certification registry system for the state's 70,000 emergency medical technicians. Those rescuers, overseen by county agencies, have less advanced lifesaving skills than the 13,000 paramedics who are directly overseen by EMSA.

The Bee series highlighted how EMTs with serious criminal pasts obtain EMT certification cards, often without undergoing background checks, from county agencies and from the state Fire Marshal's Office.

"We feel the bar needs to be raised," said Lee, who is an emergency medical system administrator for Santa Clara County.

A bill introduced by Sen. Mark Ridley-Thomas, D-Los Angeles, will be amended to reflect the commission's recommendations. Lee said more debate will follow in the Legislature.

A rival bill by Sen. Roy Ashburn, R-Bakersfield, also calls for statewide licensing of EMTs, mandatory EMT background checks and a diversion program to help paramedics and EMTs with substance abuse problems.

The Bee's Andrew McIntosh can be reached at (916) 321-1215 or amcintosh@sacbee.com

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