# California EMS Changes



## SafetyPro2 (Jul 8, 2004)

Well, just got back from our monthly EMS drill, and got some more details on the upcoming changes to EMS in California from our coordinator, who was at a briefing on it last week.

1) Effective Sept. 1, all counties will begin administering NREMT-B as the written test for new EMT-1s. This eliminates the current county-specific tests currently being used (some are already using National Registry, others have their own test). 

2) Currently certified EMT-1s will be grandfathered in and not have to take the National Registry test. However, if we let our certification lapse for any reason, we'll have to take it, and we can choose to take it if we want to become Nationally Registered. 

3) EMT-1s will no longer have to take any written test after their initial certification unless they let their certification lapse. Up until now, we've had to retest every 4 years.

4) Recertification will now require a recertification course of 24 hours total rather than 24 hours of continuing education courses. Doesn't make much difference for us as our monthly drills will become a "modular" recertification course, but it does mean you can't just go take 24 hours combined of seminars from different providers anymore.

5) Skills testing will still be required every other year and will be per the NREMT-B requirements.

6) EMT-2 (Intermediate) will no longer be offered in California. The State will continue to recognize current Intermediates, but will not certify any new ones.

7) EMT-1s will no longer be allowed to use any advanced airways. Turns out that our department is currently the ONLY BLS agency with AA in the State. Combitube will also NOT be part of the EMT-1 scope of practice.  :angry: OPAs and NPAs will be our only option.

Think that's it. Mostly good news on the new certification/recertification requirements, but the AA change bugs me. Losing Intermediate does too to some extent, but since we don't have them currently in LA County anyway, not a big impact in this area.


----------



## ffemt8978 (Jul 8, 2004)

> _Originally posted by SafetyPro_@Jul 7 2004, 10:51 PM
> * Well, just got back from our monthly EMS drill, and got some more details on the upcoming changes to EMS in California from our coordinator, who was at a briefing on it last week.
> 
> 1) Effective Sept. 1, all counties will begin administering NREMT-B as the written test for new EMT-1s. This eliminates the current county-specific tests currently being used (some are already using National Registry, others have their own test).
> ...


 I stunned.

They go to the National Registry program, but remove any advanced airway skills!

Someone should remind them that there is a reason it is called the ABC's.

EMT-2's (Itermediates) - What was the reason behind this change?

As far as the modular recertification program goes, Washington does the same thing with their OTEP program (36 hours every 3 years).  As long as you make the classes, your recert is almost automatic.  We have a practical evaluation and a written "knowledge assessment" (they won't call it a test) after every class.


----------



## SafetyPro2 (Jul 8, 2004)

Our coordinator got up at the meeting and basically asked why the California bureaucracy had decided to reduce the level of care available to patients in the state. They didn't really have an answer, but it sounds like it's the counties that pushed that change rather than the state. There was a lot of public comment and statistics from AA use in other states, but they refused to budge. I honestly don't understand it either, but it all goes back to the fact that EMTs (and to a lesser extend Paramedics) are allowed to do less in California than anywhere else in the country.

The Intermediate thing has been coming for awhile. California's never really known what to do with them. Most of the state (the urban areas) have basically operated as a two tier (EMT-1 and Paramedic) for a long time now. Only rural areas which have limited Paramedics have had EMT-2s. We've also never (at least in recent history) had First Responders as an official part of the system.

Just to clarify on the NREMT, it's only going to be the testing (written and skills) mechanism. California won't require EMTs to _maintain_ National Registry since the state-required hours of refresher training (24 hours) are less than the NREMT's requirement (48 hours) and since those of us who will be grandfathered in won't be Nationally Registered unless we choose to take the test.


----------



## ffemt8978 (Jul 9, 2004)

> _Originally posted by SafetyPro_@Jul 8 2004, 01:31 PM
> * Our coordinator got up at the meeting and basically asked why the California bureaucracy had decided to reduce the level of care available to patients in the state. They didn't really have an answer, but it sounds like it's the counties that pushed that change rather than the state. There was a lot of public comment and statistics from AA use in other states, but they refused to budge. I honestly don't understand it either, but it all goes back to the fact that EMTs (and to a lesser extend Paramedics) are allowed to do less in California than anywhere else in the country.
> 
> Just to clarify on the NREMT, it's only going to be the testing (written and skills) mechanism. California won't require EMTs to maintain National Registry since the state-required hours of refresher training (24 hours) are less than the NREMT's requirement (48 hours) and since those of us who will be grandfathered in won't be Nationally Registered unless we choose to take the test. *


 It almost sounds like a few select counties are trying to set state policy, but I may be wrong about this.

I understood what you meant about the National Registry.  My point was that if you're going to have to take the exam, they have to teach you the material.  California will not be able to remove the material from the course and expect the students to pass it.


----------



## SafetyPro2 (Jul 9, 2004)

> _Originally posted by ffemt8978_@Jul 8 2004, 09:38 PM
> * It almost sounds like a few select counties are trying to set state policy, but I may be wrong about this. *


 Oh, I think that's a fairly accurate assessment, and unfortunately, LA County's the ringleader, I believe.


----------



## ffemt8978 (Jul 9, 2004)

Same thing in Washington.  Four counties basically run the state.  King County (Seattle), Pierce County (Tacoma), Snohomish County (Everett), and Spokane County (Spokane).

These four counties are primarily democrat, while the rest of the state is primarily republican.  This is why our governor and both senators are democrats.

BTW, we often refer to the Seattle area as the "Left side of the state".


----------

