Busted California Paramedics Stay on Job as EMTs

Paramedics stripped of their state licenses after being found guilty of sexual misconduct or patient neglect are returning to jobs as emergency medical technicians in ambulances, hospitals and fire departments, thanks to flaws in California's patchwork EMT licensing system, a Bee investigation has found.

California's system, unique in the United States, also lets people with serious criminal records get or keep EMT credentials, including some who are deliberately turning to the Office of the State Fire Marshal, where agency clerks don't do background checks on the applicants.

"This puts the public health and safety at risk," said Dr. Cesar Aristeiguieta, director of the state Emergency Medical Services Authority. "That people can circumvent the system, this really concerns me."

The EMTs have less advanced lifesaving skills and medical training than paramedics, but nonetheless do have contact with sick patients and accident and fire victims in emergencies.

While EMSA licenses this state's 16,000 paramedics, the 70,000 or so EMTs are certified by 61 county, public safety and local fire agencies, whose certifications are valid statewide.

In other states, where one government agency handles paramedics and regular EMTs, licensing disparities and disciplinary inconsistencies are rare, and officials tend to weed out undesirables.

In California, state officials' attempts to centralize the EMS licensing system have failed, leaving an unwary public exposed to potential risks.

Paramedic Floyd Horn groped a female patient in his ambulance in 1997. Paramedic Michael Chance neglected a patient who died under his watch in 2000. And paramedic Keith Harbrecht supplied a 16-year-old girl with alcohol and fondled her in his tent during a work-sponsored 2002 Explorer Scout camping trip, state enforcement records show.

The three lost their state paramedic licenses for misconduct, but all got back into emergency medicine with EMT credentials obtained from local agencies.

People with criminal records also are managing to keep their EMT credentials by exploiting weaknesses in the system. Denying them a credential because of their crimes is discretionary in many cases, and some counties don't check their backgrounds.

In March 2006, EMT Robert Eugene Chaney, 37, became the first person convicted in Santa Cruz County under a new state law prohibiting hidden cameras.

Chaney was convicted of hiding a camcorder in a Santa Cruz bathroom to videotape a teenage girl undressing in May 2005, court records show.

Yet Chaney continued to work in the San Jose area on an ambulance operated by American Medical Response until The Bee questioned his employer and county emergency medical officials about his conviction.

Initially, AMR spokesman Jason Sorrick said Chaney's misdemeanor conviction was "unrelated to his job" and warranted no further action by the ambulance company.

Then, Santa Clara County, where officials said they were unaware of Chaney's conviction in neighboring Santa Cruz, launched its own probe.

County officials discovered that Chaney's EMT certification card, issued by the Sierra-Sacramento EMS Agency, had expired on Oct. 31, 2005, and they maintain that a renewed Sierra-Sacramento card he presented was forged. Chaney was placed on administrative leave by AMR on Feb. 7.

AMR officials passed on messages to Chaney from The Bee, requesting his comments, but he did not return the calls.

Another loophole in EMT certification comes through the Office of the State Fire Marshal, where a spokesman suggested that ambulance companies, hospitals and fire departments that depend on the 4,000 EMTs currently certified by the office should do their own background checks.

Fire marshal staff members simply ask EMT applicants to disclose any convictions that might disqualify them, said spokesman Michael Jarvis. The state never double-checks and no law requires them to, Jarvis added.

That kept former Orange County EMT-firefighter Raymond Carl Smith's employer in the dark about his 1985 conviction for child molestation. Smith renewed his credentials with the state fire marshal for nearly two decades until he was rearrested on suspicion of molesting two girls in 2004. He was immediately assigned to a desk job before retiring with a full pension, said Battalion Chief Ed Fleming.

Fleming said his department learned Smith was a registered sex offender from the San Bernardino County sheriff -- and then only because the sheriff routinely notifies other public agencies when their workers are arrested.

Criminal past not a barrier Even admitting a criminal record does not necessarily prevent people from gaining EMT credentials.

Anthony Elenteny of Oakland was certified by Alameda County after completing his training and internships. Elenteny's past, which he disclosed to the county, included arrests for methamphetamine possession, a concealed firearm and a 10-year-old felony conviction and prison time for helping detonate an explosive device in an inhabited motor home.

Alameda County's Emergency Medical Services director, Dr. Jim Pointer, said Elenteny fully disclosed his past and presented letters of reference saying he had turned his life around.

After much internal discussion, consulting legal counsel and calling state officials at EMSA, Pointer said he decided to certify Elenteny.

Yet when Elenteny applied to move up to the paramedic level, EMSA turned him down, citing a regulation that required the rejection because 10 years had not elapsed since he got out of prison, according to documents The Bee obtained under the Public Records Act.

Elenteny, who is now a contractor, complained in an interview that he had put a decade between himself and his drug world past. The state "really jerked me around," he said.

Pointer said he was unaware of the state regulation that kept Elenteny from getting a license. He said he would have turned him down as an EMT had he known about that standard.

A 2005 EMSA survey of 32 county and regional agencies found that 14 didn't conduct Department of Justice background checks on EMT applicants; 31 didn't do FBI checks.

Santa Barbara emergency medical authorities told EMSA that after the county began background checks, some of its EMTs started going elsewhere for renewals.

"Most of our local fire department who had been certified through us will now, because of our new requirement, use the state Fire Marshal's Office," they reported.

Uniform system shot down Aristeiguieta argues that unevenness in enforcement and licensing standards between EMSA and local agencies shows the value of having the state interpret a single set of regulations, do background checks on all applicants and hand out discipline and punishments uniformly.

Local emergency medical agencies often lack investigative resources and training. Five of them haven't even submitted disciplinary policies for EMTs to EMSA as required by law.

Yet, as The Bee reported last month, EMSA has its own problems. Its misconduct investigations have often been painfully slow, it faces enforcement and licensing staff shortages and recently lost its chief investigator and general counsel.

In 2006, an EMSA-sponsored bill was introduced in the Legislature to create a statewide licensing and discipline system for EMTs. The proposal came seven years after a federal National Highway Traffic Safety Administration study, which called on California to create a single system.

Senate Bill 1811 was fiercely opposed by firefighter unions, which claimed that firefighter EMTs should be disciplined only by their fire departments.

The firefighters successfully pushed a rival bill to take away the powers of county agencies to discipline firefighter EMTs.

Gov. Arnold Schwarzenegger refused to sign Assembly Bill 2554 in October, saying it put public safety at risk because it was "in direct conflict" with the state's aim to have independent medical oversight -- not employer oversight -- of health care professionals in California.

Case of double standards The double standards that can result from the lack of centralized certification are illustrated by the case of a Southern California paramedic charged with groping a Los Angeles woman when she was at her most vulnerable, who went on to become an EMT.

That woman, her breast bruised and aching, walked into the Downey Police Department one morning in 1997, EMSA investigation reports show. She reported that the night before, Downey Fire Department paramedic Floyd Horn, also a reserve sheriff's deputy, had assaulted her in the back of his ambulance.

The woman, whom The Bee is not naming because of the sexual nature of her complaint, told detectives she had come forward to prevent Horn from assaulting other victims.

While being transported to the hospital, the woman said she was semiconscious but unable to move. Horn reached under her blouse and grabbed her breast, she said, first while wearing a rubber glove and then barehanded.

Horn's partner, ambulance driver Jose Garcia, witnessed the assault in his rearview mirror, according to state enforcement records. Garcia later told police and EMSA investigators that he shouted at Horn and asked what he was doing, but Horn ignored him.

Horn was charged with felony sexual battery charges and later pleaded no contest to misdemeanor charges of assault by a public officer. His state paramedic license was revoked in 1998, EMSA records show.

Since then, Horn has tried three times to regain his paramedic license, including in 1999, when he denied the incident ever happened. Each time, he was turned down.

Yet Los Angeles County Emergency Medical Services medical director Dr. William Koenig granted Horn an EMT certification in 2005, with knowledge of his assault, county records show.

That credential has allowed Horn to work as a temporary emergency room technician, dispatched through Pacifica Health Care in Encino, and as an EMT/ambulance driver for Cole-Schaefer Ambulances in Pomona, according to documents Horn filed with EMSA.

At an October EMSA hearing to consider Horn's third bid for the reinstatement of his paramedic license, he spoke of being a paramedic as a childhood dream. He insisted he now understands the gravity of his 1997 assault and has a better grasp of sexual harassment and gender issues.

"I get it," Horn told Aristeiguieta and other EMSA officials.

Aristeiguieta balked. "One counseling session, two hours of online course work, and a personal self-analysis and introspection does not provide a strong foundation as evidence of rehabilitation," he wrote in his Nov. 27, 2006, denial.

Given a second chance Like Horn, Keith Harbrecht applied to EMSA to get his paramedic license reinstated in 2006, complaining that losing it in 2003 was too harsh a punishment for his sexual misconduct.

Harbrecht lost his license after he supplied alcohol to and fondled a 16-year-old girl during a 2002 Explorer Scout campout, state records show. Back then, he was an American Medical Response paramedic in Concord.

"The biggest rehabilitative measure I have taken since revocation is to continue to work in the EMS field on an ambulance without any incident," Harbrecht wrote. "I feel like I was robbed of fulfilling a dream of mine for something so meaningless."

EMSA also denied Harbrecht's 2006 petition for reinstatement, saying he showed "no apparent remorse for his sexual misconduct with a minor."

After losing his paramedic license, Harbrecht applied for EMT certification in Contra Costa County but didn't get it, county documents show.

He turned to Solano County EMS officials, who made him an EMT in 2004, Harbrecht told The Bee. "They said, 'We're into giving you a second chance.' ... I made a mistake and we're all human and we learn not to do things again."

Solano County emergency medical administrator Michael Frenn said his decision followed careful scrutiny of what Harbrecht did.

"It didn't strike us as being predatory, vicious, malicious or violent," Frenn said. "It was behavior unbecoming, but there has to be an opportunity for contrite people to make good and play the straight and narrow."

Now director of operations for Royal Ambulance in San Leandro, Harbrecht said he thinks a single state agency should handle licensing and background checks on EMTs.

"Now, I'm in management and I'm seeing all the county EMT cards and how hard it can be to check and keep track of them all," he said.

Royal Ambulance employs one EMT certified by the state fire marshal, Harbrecht said. But, he added, he was not aware that the fire marshal doesn't do criminal background checks.

The Bee's Andrew McIntosh can be reached at (916) 321-1215 .

News stories provided by third parties are not edited by "Site Publication" staff. For suggestions and comments, please click the Contact link at the bottom of this page.