text:
(a) (1) A person who, in good faith and not for compensation, renders emergency treatment at the scene of an opioid overdose or suspected opioid overdose by administering an opioid antagonist shall not be liable for civil damages resulting from an act or omission related to the rendering of the emergency treatment.

(2) A person who, in good faith and not for compensation, furnishes an opioid antagonist to a person for use at the scene of an opioid overdose or suspected opioid overdose shall not be liable for civil damages resulting from an act or omission related to the furnishing of the opioid antagonist.

(b) This section does not apply to an act or omission related to the rendering of emergency treatment at the scene of an opioid overdose or suspected opioid overdose by means of an opioid antagonist that constitutes gross negligence or willful or wanton misconduct.

(c) For purposes of this section, both of the following apply:

(1) A person who renders emergency treatment by means of an opioid antagonist, or who furnishes an opioid antagonist at the scene of an opioid overdose or suspected opioid overdose, and who is not compensated for doing so, but receives compensation for other actions as a result of their unrelated employment, is not “rendering emergency medical care or furnishing opioid antagonist for compensation.”

(2) “Opioid antagonist” means naloxone hydrochloride or any other opioid antagonist that is approved by the United States Food and Drug Administration for the treatment of an opioid overdose.

history: (History: Added by Stats. 2023, Ch. 97, Sec. 1. (AB 1166) Effective January 1, 2024.)


kind: section

code: HSC

text:
(a) A private provider of ambulance services licensed by the California Highway Patrol and any employees of that provider, when operating in accordance with the standards, regulations, policies, and protocols of local emergency medical services agencies, shall not be criminally or civilly liable for the continued detainment of a person when that detainment is requested by a peace officer, facility staff, or other professionals authorized to detain persons in any of the following circumstances:

(1) Transportation, and continuing the detainment, of a person properly detained in accordance with Section 5150, 5250, or 5260 of the Welfare and Institutions Code to a facility designated by the county for evaluation and treatment.

(2) Transportation, and continuing the detainment, of a person who is detained for evaluation and treatment in a hospital or other facility to a designated facility for psychiatric treatment in accordance with Section 5150, 5250, or 5260 of the Welfare and Institutions Code.

(3) Transportation, and continuing the detainment, of a person who is in an acute care hospital, medical clinic, or other psychiatric evaluation facility to a designated facility for psychiatric treatment, if so ordered by the attending physician, a professional staff person in charge of a facility designated by the county for evaluation and treatment, a member of the attending staff, or a professional staff person designated by the county, in accordance with Section 5250 or 5260 of the Welfare and Institutions Code.

(b) A private provider of ambulance services requested to provide transportation of persons consistent with this section shall provide care according to the policies and procedures established by the local emergency medical services agency in the county that the provider operates and the policies of the California Emergency Medical Services Authority.

(c) This section does not relieve the provider of ambulance services, or any of its employees, from liability for injuries caused by negligence, gross negligence, recklessness, or willful misconduct on the part of the provider or its employees while transporting a person to a designated facility.

(d) A private provider of ambulance services that provides transportation to a designated facility, as defined in Section 5008 of the Welfare and Institutions Code, shall not require a person who is voluntarily agreeing to transport to be placed on an involuntary hold as a precondition to that transport.

history: (History: Added by Stats. 2023, Ch. 474, Sec. 1. (AB 1376) Effective January 1, 2024.)

division: 2.5. EMERGENCY MEDICAL SERVICES

chapter: 9. Liability Limitation

path: 2.5. EMERGENCY MEDICAL SERVICES > 9. Liability Limitation


text:
(a) The State Department of Health Services shall contract with an organization with expertise in program evaluation, pediatric emergency medical services, and critical care, for the purposes specified in subdivision (b).

(b) The contractor, in consultation with a professional pediatric association, a professional emergency physicians association, a professional emergency medical services medical directors association, the Emergency Medical Services Authority, and the State Department of Health Services, shall perform a study that will identify the outcome criteria which can be used to evaluate pediatric critical care systems. This study shall include, but not be limited to, all of the following:

(1) Development of criteria to identify how changes in pediatric critical care systems affect the treatment of critically ill and injured children.

(2) Development of criteria to compare the systems in place in various areas of the state.

(3) Determination of whether the necessary data is currently available.

(4) Estimate of the cost to providers, such as emergency medical service agencies and hospitals, of collecting this data.

(5) Recommendations concerning the most reliable and cost-effective monitoring plan for use by agencies and facilities at the state, regional, and local levels.

history: (History: Added by renumbering Section 1199.200 by Stats. 1991, Ch. 1091, Sec. 68.)

path: 2.5. EMERGENCY MEDICAL SERVICES > 11. Emergency and Critical Care Services for Children


text: The contractor shall submit the results of the study to the Legislature and the Governor not later than January 1, 1991.

history: (History: Added by renumbering Section 1199.201 by Stats. 1991, Ch. 1091, Sec. 69.)

chapter: 11. Emergency and Critical Care Services for Children


text: This chapter shall be known and may be cited as the California Emergency Medical Services for Children Act of 1996.

history: (History: Added by Stats. 1996, Ch. 197, Sec. 3. Effective July 22, 1996.)

path: 2.5. EMERGENCY MEDICAL SERVICES > 12. Emergency Medical Services System for Children


text:
(a) For purposes of this chapter, the following definitions apply:

(1) “EMSC Program” means the Emergency Medical Services For Children Program administered by the authority.

(2) “Technical advisory committee” means a multidisciplinary committee with pediatric emergency medical services, pediatric critical care, or other related expertise.

(3) “EMSC component” means the part of the local agency’s EMS plan that outlines the training, transportation, basic and advanced life support care requirements, and emergency department and hospital pediatric capabilities within a local jurisdiction.

(b) Contingent upon available funding, an Emergency Medical Services For Children Program is hereby established within the authority.

(c) The authority shall do the following to implement the EMSC Program:

(1) Employ or contract with professional, technical, research, and clerical staff as necessary to implement this chapter.

(2) Provide advice and technical assistance to local EMS agencies on the integration of an EMSC Program into their EMS system.

(3) Oversee implementation of the EMSC Program by local EMS agencies.

(4) Establish an EMSC technical advisory committee.

(5) Facilitate cooperative interstate relationships to provide appropriate care for pediatric patients who must cross state borders to receive emergency and critical care services.

(6) Work cooperatively and in a coordinated manner with the State Department of Health Services and other public and private agencies in the development of standards and policies for the delivery of emergency and critical care services to children.

(7) On or before March 1, 2000, produce a report for the Legislature describing any progress on implementation of this chapter. The report shall contain, but not be limited to, a description of the status of emergency medical services for children at both the state and local levels, the recommendation for training, protocols, and special medical equipment for emergency services for children, an estimate of the costs and benefits of the services and programs authorized by this chapter, and a calculation of the number of children served by the EMSC system.

history: (History: Amended by Stats. 2001, Ch. 171, Sec. 3. Effective August 10, 2001.)

chapter: 12. Emergency Medical Services System for Children


text:
A local EMS agency may develop an EMSC Program in its jurisdiction, contingent upon available funding. If a local EMS agency develops an EMSC Program in its jurisdiction, the local EMS agency shall develop and incorporate in its EMS plan an EMSC component that complies with EMS plan requirements. The EMSC component shall include, but need not be limited to, the following:

(a) EMSC system planning, implementation, and management.

(b) Injury and illness prevention planning, that includes, among other things, coordination, education, and data collection.

(c) Care rendered to patients outside the hospital.

(d) Emergency department care.

(e) Interfacility consultation, transfer, and transport.

(f) Pediatric critical care and pediatric trauma services.

(g) General trauma centers with pediatric considerations.

(h) Pediatric rehabilitation plans that include, among other things, data collection and evaluation, education on early detection of need for referral, and proper referral of pediatric patients.

(i) Children with special EMS needs outside the hospital.

(j) Information management and system evaluation.


text: The authority may solicit and accept grant funding from public and private sources to supplement state funds.


text:
(a) An emergency ambulance provider shall offer to all emergency ambulance employees, upon the employee’s request, peer support services. The services shall provide peer representatives, reflective of the provider’s workforce both in job positions and personal experiences, who are available to come to the aid of their fellow employees on a broad range of emotional or professional issues. The emergency ambulance provider shall incorporate selection criteria for peer support team members into program policies.

(b) For purposes of this chapter, the following definitions apply:

(1) “Confidential communication” means any information, including, but not limited to, written or oral communication, transmitted between an emergency ambulance employee, a peer support team member, or a crisis hotline or crisis referral service staff member while the peer support team member provides peer support services or the crisis hotline or crisis referral service staff member provides crisis services and in confidence by a means that, as far as the emergency ambulance employee is aware, does not disclose the information to third parties other than those who are present to further the interests of the emergency ambulance employee in delivery of peer support services or those to whom disclosures are reasonably necessary for the transmission of the information or an accomplishment of the purposes for which the peer support team member is providing services. “Confidential communication” does not include a communication in which an emergency ambulance employee discloses the commission of a crime or a communication that reveals the emergency ambulance employee’s intent to defraud or deceive an investigation into a critical incident.

(2) “Crisis referral services” include all public or private organizations that provide consultation and treatment resources for personal problems, including mental health issues, chemical dependency, domestic violence, gambling, financial problems, and other personal crises. Neither crisis referral services nor crisis hotlines include services provided by an employee association, labor relations representative, or labor relations organization, or any entity owned or operated by an employee association, labor relations representative, or labor relations organization.

(3) “Critical incident” means an event or situation that involves crisis, disaster, trauma, or emergency.

(4) “Critical incident stress” means the acute or cumulative psychological stress or trauma that emergency ambulance personnel may experience in providing emergency services in response to a critical incident. The stress or trauma is an unusually strong emotional, cognitive, behavioral, or physical reaction that may interfere with normal functioning and could lead to post-traumatic stress injuries, including, but not limited to, one or more of the following:

(A) Physical and emotional illness.

(B) Failure of usual coping mechanisms.

(C) Loss of interest in the job or normal life activities.

(D) Personality changes.

(E) Loss of ability to function.

(F) Psychological disruption of personal life, including their relationship with a spouse, child, or friend.

(5) “Emergency ambulance employee” means a person who meets both of the following requirements:

(A) Is an emergency medical technician, dispatcher, paramedic, or other licensed or certified ambulance transport person who contributes to the delivery of ambulance services.

(B) Is employed by an emergency ambulance provider.

(6) “Emergency ambulance provider” means an employer that provides ambulance services, but not including the state, or any political subdivision thereof, in its capacity as the direct employer of a person meeting the description contained in subparagraph (A) of paragraph (5).

(A) “Emergency ambulance provider” does not include a provider that satisfies both of the following criteria:

(i) The provider operates emergency medical services aircraft.

(ii) The provider does not operate any ground ambulance services.

(B) For purposes of this paragraph, “emergency medical services aircraft” includes any aircraft utilized for the purpose of prehospital emergency patient response and transport as air service. These aircraft are specially constructed, modified, or equipped and used for the primary purposes of responding to emergency calls and transporting critically ill or injured patients whose medical flight crew has, at a minimum, two attendants certified or licensed in advanced life support.

(C) For purposes of this paragraph, “ground ambulance services” means the emergency, including advanced life support services, and nonemergency transportation of a person by an individual licensed pursuant to Article 1 (commencing with Section 2500) and Article 2 (commending with Section 2510) of Chapter 2.5 of Division 2 of the Vehicle Code and health care services are provided to a patient for the duration of the transportation.

(7) “Peer support program” means a program administered by the emergency ambulance provider to deliver peer support services to emergency ambulance employees consistent with this chapter.

(8) “Peer support services” means authorized peer support services provided by a peer support team member to emergency ambulance employees and their immediate families affected by a critical incident or the cumulative effect of witnessing multiple critical incidents. Peer support services assist those affected by a critical incident in coping with critical incident stress and mitigating reactions to critical incident stress, including reducing the risk of post-traumatic stress and other injuries. Peer support services may include any of the following:

(A) Precrisis education.

(B) Critical incident stress defusings.

(C) Critical incident stress debriefings.

(D) On-scene support services.

(E) One-on-one support services.

(F) Consultation.

(G) Referral services.

(H) Confidentiality obligations.

(I) The impact of toxic stress on health and well-being.

(J) Grief support.

(K) Substance abuse awareness and approaches.

(L) Active listening skills.

(M) Psychological first aid.

(9) “Peer support team” means a team or teams composed of emergency ambulance employees, hospital staff, clergy, and educators who have completed a peer support training course.

(10) “Peer support team member” means an emergency ambulance employee who has completed an approved peer support training course.

history: (History: Added by Stats. 2024, Ch. 943, Sec. 1. (AB 1843) Effective January 1, 2025.)

path: 2.5. EMERGENCY MEDICAL SERVICES > 12.5. Peer Support Services for Emergency Ambulance Employees


text:
(a) A peer support program shall be implemented through a labor-management agreement negotiated separately and apart from any collective bargaining agreement covering affected emergency ambulance employees. The labor-management agreement may cover topics, including any of the following:

(1) Program structure and administration.

(2) Selection and training of peer support team members.

(3) Peer support operations.

(4) Program evaluation, monitoring, and continuous improvement.

(5) Funding.

(6) Dispute resolution and program amendments.

(b) Sessions provided by a peer support program shall not count toward the total number of mental health treatments per issue required by Section 884 of the Labor Code.

chapter: 12.5. Peer Support Services for Emergency Ambulance Employees


text:
(a) In any civil, administrative, or arbitration proceeding, an emergency ambulance employee, whether or not a party to an action, has a right to refuse to disclose, and to prevent another from disclosing, a confidential communication between the emergency ambulance employee and a peer support team member made while the peer support team member was providing peer support services, or a confidential communication made to a crisis hotline or crisis referral service.

(b) Notwithstanding subdivision (a), a confidential communication described in subdivision (a) may be disclosed only under any of the following circumstances:

(1) The peer support team member reasonably must make an appropriate referral of the emergency ambulance employee to, or consult about the emergency ambulance employee with, another member of the peer support team or a peer support team clinician associated with the peer support team.

(2) The peer support team member, crisis hotline, or crisis referral service reasonably believes that disclosure is necessary to prevent death, substantial bodily harm, or commission of a crime.

(3) The peer support team member reasonably believes that disclosure is necessary pursuant to an obligation to report instances of child abuse, as required by Section 11166 of the Penal Code, or other obligation to disclose or report as a mandated reporter.

(4) The disclosure is made pursuant to a court order in a civil proceeding.

(5) In a criminal proceeding.

(6) If otherwise required by law.

(7) The emergency ambulance employee expressly agrees in writing that the confidential communication may be disclosed.

(c) Before an emergency ambulance employee participates in a peer support program, a peer support team member shall inform the emergency ambulance employee, in writing, of the confidentiality requirement described in subdivision (a) and the exceptions to that requirement described in subdivision (b).


text:
(a) Except as otherwise provided in subdivision (b), an emergency ambulance employee who provides peer support services as a member of a peer support team and who has received training, and the ambulance agency that employs them, shall not be liable for damages, including personal injury, wrongful death, property damage, or other loss related to an act, error, or omission in performing peer support services, unless the act, error, or omission constitutes gross negligence or intentional misconduct.

(b) Subdivision (a) does not apply to an action for medical malpractice.

(c) A person described in subdivision (a) shall not provide peer support services if, when serving in a peer support role, the individual’s relationship with a peer support recipient could reasonably be expected to impair objectivity, competence, or effectiveness in providing peer support, or otherwise risk exploitation or harm to a peer support recipient.

(d) A person described in subdivision (a) providing peer support services shall not provide those services to a peer support recipient if the provider and recipient were both involved in the same specific traumatic incident, unless the incident is a large-scale incident.

(e) A person described in subdivision (a) providing peer support services shall not provide those services to a peer support recipient if the provider and recipient are both involved in the same active or ongoing investigation.


text:
To be eligible for the confidentiality protections afforded by this chapter, a peer support team member shall complete a training course or courses on peer support approved by the emergency ambulance provider that may include, but is not limited to, the following:

(a) Precrisis education.

(b) Critical incident stress defusings.

(c) Critical incident stress debriefings.

(d) On-scene support services.

(e) One-on-one support services.

(f) Consultation.

(g) Referral services.

(h) Confidentiality obligations.

(i) The impact of toxic stress on health and well-being.

(j) Grief support.

(k) Substance abuse awareness and approaches.

(l) Active listening skills.

(m) Stress management.

(n) Psychological first aid.


citation: HSC § 1800

text: This chapter shall be known, and may be cited, as the Community Paramedicine or Triage to Alternate Destination Act of 2020.

history: (History: Added by Stats. 2020, Ch. 138, Sec. 4. (AB 1544) Effective January 1, 2021. Repealed as of January 1, 2031, pursuant to Section 1857.)

article: 1. General Provisions

path: 2.5. EMERGENCY MEDICAL SERVICES > 13. Community Paramedicine or Triage to Alternate Destination > 1. General Provisions


citation: HSC § 1801

text:
(a) It is the intent of the Legislature to establish state standards that govern the implementation of community paramedicine or triage to alternate destination programs by local EMS agencies in California.

(b) It is the intent of the Legislature that community paramedicine or triage to alternate destination programs be community-focused extensions of the traditional emergency response and transportation paramedic model that has developed over the last 50 years and be recognized as an emerging model of care created to meet an unmet need in California’s communities.

(c) It is the intent of the Legislature to improve the health of individuals in their communities by authorizing licensed paramedics, working under expert medical oversight, to deliver community paramedicine or triage to alternate destination services in California utilizing existing providers, promoting continuity of care, and maximizing existing efficiencies within the first response and emergency medical services system.

(d) It is the intent of the Legislature that a community paramedicine or triage to alternate destination program achieve all of the following:

(1) Improve coordination among providers of medical services, behavioral health services, and social services.

(2) Preserve and protect the underlying 911 emergency medical services delivery system.

(3) Preserve, protect, and deliver the highest level of patient care to every Californian.

(4) Preserve and protect the current health care workforce and empower local health care systems to provide care more effectively and efficiently.

(e) It is the intent of the Legislature that an alternate destination facility participating as part of an approved program always be staffed by a health care professional with a higher scope of practice, such as, at minimum, a registered nurse.

(f) It is the intent of the Legislature that the delivery of community paramedicine or triage to alternate destination services is a public good to be delivered in a manner that promotes the continuity of both care and providers. It is the intent of the Legislature that the delivery of these services be coordinate and consistent with, and complementary to, the existing first response and emergency medical response system in place within the jurisdiction of the local EMS agency.

(g) It is the intent of the Legislature that a community paramedicine or triage to alternate destination program be designed to improve community health and be implemented in a fashion that respects the current emergency medical system and its providers, and the health care delivery system. In furtherance of the public interest and good, agencies that provide first response services are well positioned to deliver care under a community paramedicine or triage to alternate destination program.

(h) It is the intent of the Legislature that the development of any community paramedicine or triage to alternate destination program reflect input from all practitioners of appropriate medical authorities, including, but not limited to, medical directors, physicians, nurses, mental health professionals, first responder paramedics, hospitals, and other entities within the emergency medical response system.

(i) It is the intent of the Legislature that local EMS agencies be authorized to develop a community paramedicine or triage to alternate destination program to improve patient care and community health. A community paramedicine or triage to alternate destination program should not be used to replace or eliminate health care workers, reduce personnel costs, harm the working conditions of emergency medical and health care workers, or otherwise compromise the emergency medical response or health care system. The highest priority of any community paramedicine or triage to alternate destination program shall be improving patient care.

(j) It is the intent of the Legislature to monitor and evaluate implementation of community paramedicine and triage to alternate destination programs by local EMS agencies in California and determine whether these programs should be modified or extended before the January 1, 2024, sunset date of this chapter.

chapter: 13. Community Paramedicine or Triage to Alternate Destination

article: 1. General Provisions


citation: HSC § 1810

text: Unless otherwise indicated in this chapter, the definitions contained in this article govern the provisions of this chapter.

article: 2. Definitions

path: 2.5. EMERGENCY MEDICAL SERVICES > 13. Community Paramedicine or Triage to Alternate Destination > 2. Definitions


citation: HSC § 1811

text: “Alternate destination facility” means a treatment location that is an authorized mental health facility, as defined in Section 1812 or an authorized sobering center as defined in Section 1813.

article: 2. Definitions


citation: HSC § 1812

text: “Authorized mental health facility” means a facility that is licensed or certified as a mental health treatment facility or a hospital, as defined in subdivision (a) or (b) of Section 1250, by the State Department of Public Health, and may include, but is not limited to, a licensed psychiatric hospital, a licensed psychiatric health facility, or a certified crisis stabilization unit. An authorized mental health facility may also be a psychiatric health facility licensed by the State Department of Health Care Services. The facility shall be staffed at all times with at least one registered nurse.

article: 2. Definitions


citation: HSC § 1813

text:
(a) “Authorized sobering center” means a noncorrectional facility that is staffed at all times with at least one registered nurse, that provides a safe, supportive environment for intoxicated individuals to become sober, that is identified as an alternate destination in a plan developed pursuant to Section 1843, and that meets any of the following requirements:

(1) The facility is a federally qualified health center, including a clinic described in subdivision (b) of Section 1206.

(2) The facility is certified by the State Department of Health Care Services, Substance Use Disorder Compliance Division to provide outpatient, nonresidential detoxification services.

(3) The facility has been accredited as a sobering center under the standards developed by the National Sobering Collaborative. Facilities granted approval for operation by OSHPD before November 28, 2017, under the Health Workforce Pilot Project No. 173, may continue operation until one year after the National Sobering Collaborative accreditation becomes available.

(b) Paragraphs (1) and (2) of subdivision (a) do not impose any new or additional licensure or oversight responsibilities on the State Department of Health Care Services or the State Department of Public Health with regard to authorized sobering centers.

(c) Paragraphs (1) and (2) of subdivision (a) do not make an authorized sobering center eligible for reimbursement under the Medicaid program.

article: 2. Definitions


citation: HSC § 1814

text: “Community paramedic” means a paramedic licensed under this division who has completed the curriculum for community paramedic training adopted pursuant to paragraph (1) of subdivision (d) of Section 1830, has received certification in one or more of the community paramedicine program specialties described in Section 1815, and is accredited to provide community paramedic services by a local EMS agency as part of an approved community paramedicine program.

article: 2. Definitions


citation: HSC § 1815

text:
(a) “Community paramedicine program” means a program developed by a local EMS agency and approved by the Emergency Medical Services Authority to provide community paramedicine services consisting of one or more of the program specialties described in this section under the direction of medical protocols developed by the local EMS agency that are consistent with the minimum medical protocols established by the authority. Community paramedicine services may consist of the following program specialties:

(1) Providing directly observed therapy (DOT) to persons with tuberculosis in collaboration with a public health agency to ensure effective treatment of the tuberculosis and to prevent spread of the disease.

(2) Providing case management services to frequent emergency medical services users in collaboration with, and by providing referral to, existing appropriate community resources.

(3) Providing short-term, postdischarge followup for persons recently discharged from a hospital due to a serious health condition, including collaboration with, and by providing referral to, home health services when eligible.

(b) On or before January 1, 2025, the authority shall amend regulations adopted pursuant to this chapter to include sufficient state-level program oversight that would allow for local EMS agencies to develop community paramedicine programs, as defined in subdivision (a), when a local EMS agency includes a community paramedicine program in their local EMS agency EMS plan.

history: (History: Amended by Stats. 2023, Ch. 270, Sec. 2. (AB 767) Effective January 1, 2024. Repealed as of January 1, 2031, pursuant to Section 1857.)

article: 2. Definitions


citation: HSC § 1816

text: “Community paramedicine provider” means an advanced life support provider authorized by a local EMS agency to provide advanced life support who has entered into a contract to deliver community paramedicine services as described in Section 1815 as part of an approved community paramedicine program developed by a local EMS agency and approved by the Emergency Medical Services Authority.

article: 2. Definitions


citation: HSC § 1817

text: “Public agency” means a city, county, city and county, special district, or other political subdivision of the state that provides first response services, including emergency medical care.

article: 2. Definitions


citation: HSC § 1818

text: “Triage paramedic” means a paramedic licensed under this division who has completed the curriculum for triage paramedic services adopted pursuant to paragraph (2) of subdivision (d) of Section 1830 and has been accredited by a local EMS agency in one or more of the triage paramedic specialties described in Section 1819 as part of an approved triage to alternate destination program.

article: 2. Definitions


citation: HSC § 1819

text:
(a) “Triage to alternate destination program” means a program developed by a local EMS agency and approved by the Emergency Medical Services Authority to provide triage paramedic assessments consisting of one or more specialties described in this section operating under triage and assessment protocols developed by the local EMS agency that are consistent with the minimum triage and assessment protocols established by the authority. Triage paramedic assessments may consist of the following program specialties:

(1) Providing care and comfort services to hospice patients in their homes in response to 911 calls by providing for the patient’s and the family’s immediate care needs, including grief support in collaboration with the patient’s hospice agency until the hospice nurse arrives to treat the patient. This paragraph does not impact or alter existing authorities applicable to a licensed paramedic operating under the medical control policies adopted by a local EMS agency medical director to treat and keep a hospice patient in the patient’s current residence, or otherwise require transport to an acute care hospital in the absence of an approved triage to alternate destination hospice program.

(2) Providing patients with advanced life support triage and assessment by a triage paramedic and transportation to an alternate destination facility, as defined in Section 1811.

(3) Providing transport services for patients who identify as veterans and desire transport to a local veterans administration emergency department for treatment, when appropriate.

(b) This section does not prevent or eliminate any authority to provide continuous transport of a patient to a participating hospital for priority evaluation by a physician, nurse practitioner, or physician assistant before transport to an alternate destination facility.

(c) This section does not impair or otherwise interfere with an emergency medical services provider’s ability to deliver emergency medical transport services as authorized pursuant to Section 1797.224 or a city or fire district to operate pursuant to Section 1797.201.

article: 2. Definitions


citation: HSC § 1820

text: “Triage to alternate destination provider” means an advanced life support provider authorized by a local EMS agency to provide advanced life support triage paramedic assessments as part of an approved triage to alternate destination program specialty, as described in Section 1819.

article: 2. Definitions


citation: HSC § 1825

text:
On or before March 1, 2021, the director of the Emergency Medical Services Authority shall establish a community paramedicine and triage to alternate destination oversight advisory committee pursuant to Section 1797.133, to advise the authority on the development and oversight of community paramedicine program and triage to alternate destination program specialties described in Sections 1815 and 1819, respectively. Committee membership shall include representatives from entities within the emergency medical response system, including, but not limited to, all of the following:

(a) Local emergency medical services agency administrators.

(b) Local emergency medical services agency medical directors.

(c) Public safety agency medical directors.

(d) Physicians and surgeons, including emergency room physicians.

(e) Nurses, including nurses that specialize in treatment of substance use disorders who treat patients in authorized sobering centers.

(f) Hospital administrators.

(g) Public first responder paramedics.

(h) Private first responder paramedics.

(i) Medical professionals specializing in all of the following:

(1) Home health care.

(2) Hospice care.

(3) Mental health.

(4) Substance abuse disorder treatment who treat patients in authorized sobering centers.

(j) Physicians and surgeons specializing in the comprehensive care of individuals with cooccurring mental health or psychosocial and substance use disorders who treat patients in authorized mental health facilities.

(k) Licensed clinical social workers, including social workers who have experience providing services described in subdivision (b) of Section 1815.

article: 3. State Administration

path: 2.5. EMERGENCY MEDICAL SERVICES > 13. Community Paramedicine or Triage to Alternate Destination > 3. State Administration


citation: HSC § 1830

text:
(a) The Emergency Medical Services Authority shall develop, and after approval by the commission, shall adopt regulations and establish minimum standards for the development of a community paramedicine or triage to alternate destination program.

(b) The regulations described in this section shall be based upon, and informed by, the Community Paramedicine Pilot Program under the Office of Statewide Health Planning and Development Health Workforce Pilot Project No. 173 and the protocols and operation of the pilot projects approved under the project.

(c) The regulations that establish minimum standards for the development of a community paramedicine or triage to alternate destination program shall consist of the following:

(1) Minimum standards and curriculum for each program specialty described in Section 1815. The authority, in developing the minimum standards and curriculum, shall provide for community paramedics to be trained in one or more of the program specialties described in Section 1815 and approved by the local EMS agency pursuant to Section 1840.

(2) Minimum standards and curriculum for each program specialty described in Section 1819. The authority, in developing the minimum standards and curriculum, shall provide for triage paramedics to be trained in one or more of the program specialties described in Section 1819 and approved by the local EMS agency pursuant to Section 1840.

(3) A process for certifying on a paramedic’s license the successful completion of the training described in paragraph (1) or (2) and accreditation by the local EMS agency.

(4) Minimum standards for approval, review, withdrawal, and revocation of a community paramedicine or triage to alternate destination program in accordance with Section 1797.105. Those standards shall include, but not be limited to, both of the following:

(A) A requirement that facilities participating in the program accommodate privately or commercially insured, Medi-Cal, Medicare, and uninsured patients.

(B) Immediate termination of participation in the program by the alternate destination facility or the community paramedicine or triage to alternate destination provider if it fails to operate in accordance with subdivision (b) of Section 1317.

(5) Minimum standards for collecting and submitting data to the authority to ensure patient safety that include consideration of both quality assurance and quality improvement. These standards shall include, but not be limited to, all of the following:

(A) Intervals for community paramedicine or triage to alternate destination providers, participating health facilities, and local EMS agencies to submit community paramedicine services data.

(B) Relevant program use data and the online public posting of program analyses.

(C) Exchange of electronic patient health information between community paramedicine or triage to alternate destination providers and health providers and facilities. The authority may grant a one-time temporary waiver, not to exceed five years, of this requirement for alternate destination facilities that are unable to immediately comply with the electronic patient health information requirement.

(D) Emergency medical response system feedback, including feedback from the emergency medical care committee described in subdivision (b) of Section 1797.273.

(E) If the triage to alternate destination program utilizes an alternate destination facility, consideration of ambulance patient offload times for the alternate destination facility, the number of patients that are turned away, diverted, or required to be subsequently transferred to an emergency department, and identification of the reasons for turning away, diverting, or transferring the patient.

(6) A process to assess each community paramedicine or triage to alternate destination program’s medical protocols or other processes.

(7) A process to assess the impact that implementation of a community paramedicine or triage to alternate destination program has on the delivery of emergency medical services, including the impact on response times in the local EMS agency’s jurisdiction.

article: 3. State Administration


citation: HSC § 1831

text:
Regulations adopted by the Emergency Medical Services Authority pursuant to Section 1830 relating to a triage to alternate destination program shall include all of the following:

(a) Local EMS agencies participating in providing patients with advanced life support triage and assessment by a triage paramedic and transportation to an alternate destination facility shall ensure that any patient who meets the triage criteria for transport to an alternate destination facility, but who requests to be transported to an emergency department of a general acute care hospital, shall be transported to the emergency department of a general acute care hospital.

(b) (1) Local EMS agencies participating in providing patients with advanced life support triage and assessment by a triage paramedic and transportation to an alternate destination facility shall require that a patient who is transported to an alternate destination facility and, upon assessment, is found to no longer meet the criteria for admission to an alternate destination facility, be immediately transported to the emergency department of a general acute care hospital.

(2) The local EMS agency shall require alternate destination facilities to send with each patient at the time of transfer or, in the case of an emergency, as promptly as possible, copies of all medical records related to the patient’s transfer. To the extent practicable and applicable to the patient’s transfer, the medical records shall include current medical findings, diagnosis, laboratory results, medications provided prior to transfer, a brief summary of the course of treatment provided prior to transfer, ambulation status, nursing and dietary information, name and contact information for the treating provider at the alternate destination facility, and, as appropriate, pertinent administrative and demographic information related to the patient, including name and date of birth. The requirements in this paragraph do not apply if the alternate destination facility has entered into a written transfer agreement with a local hospital that provides for the transfer of medical records.

(c) For authorizing transport to an alternate destination facility, training and accreditation for the triage paramedic shall include topics relevant to the needs of the patient population, including, but not limited to:

(1) A requirement that a participating triage paramedic complete instruction on all of the following:

(A) Mental health crisis intervention, to be provided by a licensed physician and surgeon with experience in the emergency department of a general acute care hospital.

(B) Assessment and treatment of intoxicated patients.

(C) Local EMS agency policies for the triage, treatment, transport, and transfer of care, of patients to an alternate destination facility.

(2) A requirement that the local EMS agency verify that the participating triage paramedic has completed training in all of the following topics meeting the standards of the United States Department of Transportation National Highway Traffic Safety Administration National Emergency Medical Services Education Standards:

(A) Psychiatric disorders.

(B) Neuropharmacology.

(C) Alcohol and substance abuse.

(D) Patient consent.

(E) Patient documentation.

(F) Medical quality improvement.

(d) For authorizing transport to a sobering center, a training component that requires a participating triage paramedic to complete instruction on all of the following:

(1) The impact of alcohol intoxication on the local public health and emergency medical services system.

(2) Alcohol and substance use disorders.

(3) Triage and transport parameters.

(4) Health risks and interventions in stabilizing acutely intoxicated patients.

(5) Common conditions with presentations similar to intoxication.

(6) Disease process, behavioral emergencies, and injury patterns common to those with chronic alcohol use disorders.

(e) A process for local EMS agencies to certify and provide periodic updates to the authority to demonstrate that the alternate destination facility authorized to receive patients maintains adequate licensed medical and professional staff, facilities, and equipment pursuant to the authority’s regulations and the provisions of this chapter, which shall include all of the following:

(1) Identification of qualified staff to care for the degree of a patient’s injuries and needs.

(2) Certification of standardized medical and nursing procedures for nursing staff.

(3) Certification that the necessary equipment and services are available at the alternate destination facility to care for patients, including, but not limited to, an automatic external defibrillator and at least one bed or mat per individual patient.

article: 3. State Administration


citation: HSC § 1832

text:
(a) The Emergency Medical Services Authority shall develop and periodically review and update the minimum medical protocols applicable to each community paramedicine program specialty described in Section 1815 and the minimum triage and assessment protocols for triage to alternate destination program specialties described in Section 1819.

(b) In complying with the requirements of this section, the authority shall establish and consult with an advisory committee comprised of the following members:

(1) Individuals in the fields of public health, social work, hospice, substance use, or mental health with expertise commensurate with the program specialty or specialties described in Section 1815 or 1819.

(2) Physicians and surgeons whose primary practice is emergency medicine.

(3) Two local EMS medical directors selected by the EMS Medical Directors Association of California.

(4) Two local EMS directors selected by the California Chapter of the American College of Emergency Physicians.

(c) The protocols developed pursuant to this section shall be based upon, and informed by, the Community Paramedicine Pilot Program under the Office of Statewide Health Planning and Development’s Health Workforce Pilot Project No. 173, and further refinements provided by local EMS agencies during the course and operation of the pilot projects.

article: 3. State Administration


citation: HSC § 1833

text:
(a) Notwithstanding Section 10231.5 of the Government Code, the Emergency Medical Services Authority shall submit an annual report on the community paramedicine or triage to alternate destination programs operating in California to the relevant policy committees of the Legislature in accordance with Section 9795 of the Government Code and shall post the annual report on its internet website. The authority shall submit and post its first report one year after the authority adopts the regulations described in Section 1830. Thereafter, the authority shall submit and post its report annually on or before January 1 of each year.

(b) The report required by this section shall include all of the following:

(1) An assessment of each program specialty, including an assessment of patient outcomes in the aggregate and an assessment of any adverse patient events resulting from services provided under plans approved pursuant to this chapter.

(2) An assessment of the impact that the program specialties have had on the emergency medical system.

(3) An update on the implementation of program specialties operating in local EMS agency jurisdictions.

(4) Policy recommendations for improving the administration of local plans and patient outcomes.

(c) All data collected by the authority shall be posted on its internet website in a downloadable format and in a manner that protects the confidentiality of individually identifiable patient information.

article: 3. State Administration


citation: HSC § 1834

text:
(a) Notwithstanding Section 10231.5 of the Government Code, on or before April 1, 2028, the Emergency Medical Services Authority shall submit a final report on the results of the community paramedicine or triage to alternate destination programs operating in California to the relevant policy committees of the Legislature, in accordance with Section 9795 of the Government Code, and shall post the report on its internet website.

(b) The authority shall develop the report required by this section.

(c) The report shall include all of the following:

(1) A detailed assessment of each community paramedicine or triage to alternate destination program operating in local EMS agency jurisdictions.

(2) An assessment of patient outcomes in the aggregate resulting from services provided under approved plans under the program.

(3) An assessment of workforce impact due to implementation of the program.

(4) An assessment of the impact of the program on the emergency medical services system.

(5) An assessment of how the currently operating program specialties achieve the legislative intent stated in Section 1801.

(6) An assessment of community paramedic and triage training.

(d) The report may include recommendations for changes to, or the elimination of, community paramedicine or triage to alternate destination program specialties that do not achieve the community health and patient goals described in Section 1801.

history: (History: Amended by Stats. 2023, Ch. 270, Sec. 3. (AB 767) Effective January 1, 2024. Repealed as of January 1, 2031, pursuant to Section 1857.)

article: 3. State Administration


citation: HSC § 1835

text:
(a) The Emergency Medical Services Authority shall review a local EMS agency’s proposed community paramedicine or triage to alternate destination program using procedures consistent with Section 1797.105 and review the local EMS agency’s program protocols in order to ensure compliance with the statewide minimum protocols developed under Section 1832.

(b) The authority may impose conditions as part of the approval of a community paramedicine or triage to alternate destination program that the local EMS agency is required to incorporate into its program to achieve consistency with the authority’s regulations and the provisions of this chapter.

(c) The authority shall approve or deny the proposed community paramedicine or triage to alternate destination program no later than six months after it is submitted by the local EMS agency.

article: 3. State Administration


citation: HSC § 1836

text:
(a) A community paramedicine pilot program approved under the Office of Statewide Health Planning and Development’s Health Workforce Pilot Project No. 173 before January 1, 2020, is authorized to operate until one year after the regulations described in Section 1830 become effective.

(b) Notwithstanding subdivision (a), a community paramedicine short-term, postdischarge followup pilot program that was approved on or before January 1, 2019, under the Office of Statewide Health Planning and Development’s Health Workforce Pilot Project No. 173, and was continuing to enroll patients as of January 1, 2019, may continue operation until one year after the regulations described in subdivision (b) of Section 1815 become effective.

history: (History: Amended by Stats. 2023, Ch. 270, Sec. 4. (AB 767) Effective January 1, 2024. Repealed as of January 1, 2031, pursuant to Section 1857.)

article: 3. State Administration


citation: HSC § 1840

text: A local EMS agency may develop a community paramedicine or triage to alternate destination program that is consistent with the Emergency Medical Services Authority’s regulations and the provisions of this chapter and submit evidence of compliance with the requirements of Section 1841 and Sections 1842 and 1843, as applicable, to the authority for approval pursuant to Section 1835.

article: 4. Local Administration

path: 2.5. EMERGENCY MEDICAL SERVICES > 13. Community Paramedicine or Triage to Alternate Destination > 4. Local Administration


citation: HSC § 1841

text:
A local EMS agency that elects 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) Provide medical control and oversight.

(c) Consistent with this article, develop a process to select community paramedicine providers or triage to alternate destination providers, to provide services as described in Section 1815 or 1819, at a periodic interval established by the local EMS agency.

(d) 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.

(e) The local EMS agency shall not include, in a request for proposal or otherwise, the provision of community paramedic program specialties or triage to alternate destination program specialties as part of an existing or proposed contract for the delivery of emergency medical transport services awarded pursuant to Section 1797.224. The local EMS agency shall not offer additional points or preferences to a bidder for emergency medical transport services on the basis that the bidder will provide, or has negotiated or agreed to provide, community paramedicine or triage to alternate destinations.

(f) The local EMS agency shall prohibit triage and assessment protocols or a triage paramedic’s decision to authorize transport to an alternate destination facility from being based on, or affected by, a 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.

history: (History: Amended by Stats. 2023, Ch. 270, Sec. 5. (AB 767) Effective January 1, 2024. Repealed as of January 1, 2031, pursuant to Section 1857.)

article: 4. Local Administration


citation: HSC § 1842

text:
In addition to the requirements of Section 1841, a local EMS agency that elects to develop a community paramedicine program shall do both of the following:

(a) Coordinate, review, and approve any agreements necessary for the provision of community paramedicine specialties as described in Section 1815 consistent with all of the following:

(1) Provide a first right of refusal to the public agency or agencies within the jurisdiction of the proposed program area to provide the proposed program specialties for community paramedicine. If the public agency or agencies agree to provide the proposed program specialties for community paramedicine, the local EMS agency shall review and approve any written agreements necessary to implement the program with those public agencies.

(2) Review and approve agreements with community paramedicine providers that partner with a private provider to deliver those program specialties.

(3) If a public agency declines to provide the proposed program specialties pursuant to paragraph (1) or (2), the local EMS agency shall develop a competitive process held at periodic intervals to select community paramedicine providers to deliver the program specialities.

(b) Establish a process to verify training and accreditation of community paramedics in each of the proposed community paramedicine program specialties described in subdivision (a) of Section 1815.

history: (History: Amended by Stats. 2023, Ch. 270, Sec. 6. (AB 767) Effective January 1, 2024. Repealed as of January 1, 2031, pursuant to Section 1857.)

article: 4. Local Administration


citation: HSC § 1843

text:
In addition to the requirements of Section 1841, a local EMS agency that elects to develop a triage to alternate destination program shall do all of the following:

(a) (1) Develop a plan that includes existing advanced life supports (ALS) providers, including public agencies, operating in the proposed program area to deliver the triage to alternate destination services. An ALS provider operating in the area may opt out of the plan. If an ALS provider chooses to opt out of the plan, the local EMS agency may, in order to achieve the plan goals, select another existing ALS provider operating within the agency’s jurisdiction to provide the triage to alternate destination services in the operational area where the ALS provider has opted out.

(A) The plan shall recognize existing operational boundaries of ALS providers and basic life support (BLS) providers providing emergency medical transport services pursuant to Section 1797.201 or 1797.224 in the proposed program area.

(B) An ALS provider providing emergency medical transport services pursuant to Section 1797.201 may contract with private providers to deliver triage to alternate destination services in the proposed program areas. This subparagraph does not impair or alter an existing right to contract or provide for administration of emergency medical services pursuant to Section 1797.201.

(C) An ALS provider who is authorized to provide emergency medical transport services pursuant to Section 1797.224 may enter into agreements with public agency ALS providers to deliver the triage to alternate destination program specialties. This subparagraph does not impair or alter an existing right to provide emergency medical transportation services pursuant to Section 1797.224. This subparagraph does not confer to the parties of the agreement a right to provide emergency medical transportation services pursuant to Section 1797.224.

(2) A local EMS agency may exclude an existing ALS provider from the plan if it determines that the provider’s participation will negatively impact patient care. If a local EMS agency elects to exclude an ALS provider, the EMS agency shall do both of the following:

(A) Report to the authority at the time the program is submitted for approval, the specific reasons for excluding an ALS provider.

(B) Inform the ALS provider of the reasons for exclusion.

(b) Facilitate any necessary agreements to ensure continuity of care and efficient transfer of care between the triage to alternate destination program provider and the existing emergency medical transport provider to ensure transport to the appropriate facility.

(c) At the discretion of the local EMS medical director, develop additional triage and assessment protocols commensurate with the need of the local programs authorized under this chapter.

(d) Certify and provide documentation and updates to the Emergency Medical Services Authority showing that the alternate destination facility authorized to receive patients maintains 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.

(e) 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 protocols and the facility’s ability to care for patients.

(f) Secure an agreement with the alternate destination that requires the facility to operate in accordance with Section 1317. The agreement shall provide 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) In implementing a triage to alternate destination program specialties described in Section 1819, continue to use, and coordinate with, any emergency medical transport providers operating within the jurisdiction of the local EMS agency pursuant to Section 1797.201 or 1797.224. The local EMS agency shall not in any manner eliminate or reduce the services of the emergency medical transport providers.

(h) 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.

article: 4. Local Administration


citation: HSC § 1850

text: A community paramedicine pilot program approved under the Office of Statewide Health Planning and Development’s Health Workforce Pilot Project No. 173 before September 1, 2020, to deliver community paramedicine services, as described in Section 1815, is authorized to continue the use of existing providers and is exempt from paragraphs (1) to (3), inclusive, of subdivision (a) of Section 1842 unless the provider elects to reduce or eliminate one or more of those community paramedicine services approved under the pilot program or fails to comply with the program standards as required by this chapter.

article: 5. Miscellaneous

path: 2.5. EMERGENCY MEDICAL SERVICES > 13. Community Paramedicine or Triage to Alternate Destination > 5. Miscellaneous


citation: HSC § 1851

text: A person or organization shall not provide community paramedicine or triage to alternate destination services or represent, advertise, or otherwise imply that it is authorized to provide community paramedicine or triage to alternate destination services unless it is expressly authorized by a local EMS agency to provide those services as part of a community paramedicine or triage to alternate destination program approved by the Emergency Medical Services Authority in accordance with Section 1835.

article: 5. Miscellaneous


citation: HSC § 1852

text: A community paramedic shall provide community paramedicine services only if the community paramedic has been certified and accredited to perform those services by a local EMS agency and is working as an employee of an authorized community paramedicine provider.

article: 5. Miscellaneous


citation: HSC § 1853

text: A triage paramedic shall provide triage to alternate destination services only if the triage paramedic has been certified and accredited to perform those services by a local EMS agency and is working as an employee of an authorized triage to alternate destination provider.

article: 5. Miscellaneous


citation: HSC § 1854

text: The disciplinary procedures for a community paramedic or triage paramedic shall be consistent with subdivision (d) of Section 1797.194.

article: 5. Miscellaneous


citation: HSC § 1855

text: Entering into an agreement to be a community paramedicine or triage to alternate destination provider pursuant to this chapter shall not alter or otherwise supersede Section 1797.201 or 1797.224.

article: 5. Miscellaneous


citation: HSC § 1856

text: The liability provisions described in Chapter 9 (commencing with Section 1799.100) apply to this chapter.

article: 5. Miscellaneous


citation: HSC § 1857

text: This chapter shall remain in effect only until January 1, 2031, and as of that date is repealed.

history: (History: Amended by Stats. 2023, Ch. 270, Sec. 7. (AB 767) Effective January 1, 2024. Repealed as of January 1, 2031, by its own provisions Note: Repeal affects Chapter 13, commencing with Section 1800.)

article: 5. Miscellaneous


citation: HSC § 1860

text: This chapter shall be known, and may be cited, as the California POLST eRegistry Act.

history: (History: Added by Stats. 2021, Ch. 143, Sec. 15. (AB 133) Effective July 27, 2021.)

chapter: 14. California POLST eRegistry Act

path: 2.5. EMERGENCY MEDICAL SERVICES > 14. California POLST eRegistry Act


citation: HSC § 1861

text:
For purposes of this chapter:

(a) “Authorized user” means a person authorized by the authority to submit information to, or to receive information from, the POLST eRegistry, including health care providers, as defined in Section 4781 of the Probate Code, and their designees.

(b) “CEDRS” means the California Emergency Medical Services Data Resource System.

(c) “POLST” means a Physician Orders for Life Sustaining Treatment form that fulfills the requirements, in any format, of Section 4780 of the Probate Code.

(d) “POLST eRegistry” means the registry established pursuant to this chapter to make electronic, in addition to other modes of submission and transmission, POLST information available to authorized users in conjunction with, and as a part of, CEDRS.


citation: HSC § 1862

text:
(a) The Emergency Medical Services Authority shall establish a POLST eRegistry, in consultation with the Coalition for Compassionate Care of California and other pertinent stakeholders, to operate a statewide electronic registry system for the purpose of collecting a patient’s POLST information received from a physician, nurse practitioner, physician assistant, or the designee of a physician, nurse practitioner, or physician assistant, and disseminating the information to an authorized user.

(b) The authority shall adopt regulations for the operation of the POLST eRegistry and shall hold at least one public hearing regarding the proposed regulations. The regulations shall include, but not be limited to, standards and procedures regarding all of the following:

(1) The means by which initial or subsequent POLST information may be submitted to the POLST eRegistry, which shall include a method for electronic delivery of this information and the use of legally sufficient electronic signatures. Submitted information may include new, modified, updated, or voided POLST information.

(2) Methods by which the information in the POLST eRegistry may be disseminated to an authorized user, including a method for electronic access.

(3) Standards and procedures for verifying the identity of an authorized user.

(4) Standards and procedures to ensure the accuracy of, and to appropriately protect the confidentiality of, POLST information submitted to the POLST eRegistry, consistent with state and federal privacy laws.

(c) The authority shall implement the POLST eRegistry in conjunction with CEDRS. The authority shall ensure all of the following requirements are met and that the timing is consistent with the CEDRS project development timeline:

(1) An authorized user shall ensure that the most current version of all POLST forms they have signed have been submitted to the POLST eRegistry.

(2) An electronic version of a POLST shall be the only acceptable format to submit a form to the POLST eRegistry. This section does not prohibit an authorized user from printing out a paper copy of a POLST form for a patient to have on hand, upon request by a patient or the patient’s legally recognized decisionmaker.

history: (History: Amended by Stats. 2023, Ch. 42, Sec. 21. (AB 118) Effective July 10, 2023.)


citation: HSC § 1863

text:
(a) For the 2021–22 fiscal year, the sum of ten million dollars ($10,000,000) is hereby appropriated from the General Fund to the Emergency Medical Services Authority to support the planning, development, and implementation of a statewide POLST eRegistry to be included with the CEDRS system. The ten million dollars ($10,000,000) for the 2021–22 fiscal year to support these efforts shall not fully fund the POLST eRegistry’s implementation or maintenance and operations costs. These costs will be determined through the California Department of Technology planning process, known as the Project Approval Life Cycle (PAL). The authority shall only utilize funds for development and implementation of the POLST eRegistry after it obtains full PAL approval.

(b) For the 2022–23 fiscal year, and annually thereafter, the sum of seven hundred fifty thousand dollars ($750,000) is hereby appropriated annually from the General Fund to the Emergency Medical Services Authority for state operations to prepare for and support the POLST eRegistry. State operations costs may include, but are not limited to, promotion of POLST quality, such as ongoing education and training of health care professionals, community education, and outreach, and adherence to quality standards. The authority may contract for these activities as necessary.


citation: HSC § 1890

text:
For the purposes of this division, the following definitions apply:

(a) “Agency” means the California Health and Human Services Agency.

(b) “Department” means a department or other subdivision within the agency.

(c) “Emergency” means any condition or degree of emergency established under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code).

(d) “Office” means the Office of Response and Resilience.

history: (History: Added by Stats. 2022, Ch. 50, Sec. 4. (SB 187) Effective June 30, 2022.)

division: 2.8. OFFICE OF RESPONSE AND RESILIENCE

path: 2.8. OFFICE OF RESPONSE AND RESILIENCE


citation: HSC § 1891

text: Commencing July 1, 2022, there is hereby established within the California Health and Human Services Agency the Office of Response and Resilience. The office shall provide policy, fiscal, and operational organization, coordination, and management when departments are preparing for, mitigating, responding to, or helping communities recover from an emergency. The office shall be administered by a director who shall be appointed by the secretary of the agency.


citation: HSC § 1892

text:
In addition to the general duties set forth in Section 1891, the office shall have the following responsibilities:

(a) The office shall have the following emergency preparedness and mitigation duties.

(1) Perform a threat and risk assessment for each department, by hazard.

(2) Document each department’s capacity to respond to each hazard.

(3) Develop interdepartmental emergency training, exercises, and continuity programs.

(b) The office shall have the following emergency response duties:

(1) Provide policy, fiscal, and operational organization, coordination, and management related to department emergency response.

(2) Create and document a coordinated, interdepartmental response framework to lead departments through multiple, simultaneous, and complex hazards and emergency events.

(3) Maintain and update, as needed, the agency All Hazards Dashboard. The All Hazards Dashboard shall do both of the following:

(A) Identify the impacts of emergency and hazardous events on communities by establishing a single reference point for situational awareness and cross-departmental coordination.

(B) Provide key data necessary to support agency response operations and automate related reporting processes.

(c) The office shall have the following emergency recovery responsibilities:

(1) Coordinate and manage interdepartmental fiscal and programmatic emergency recovery after any emergency.

(2) Work, in coordination with the Office of Emergency Services, to obtain federal resources for departments that may be available as a result of an emergency.

(d) The office shall provide a report to the Legislature, pursuant to Section 9795 of the Government Code, by August 31, 2024, on the effectiveness of the office and whether it enhances operations throughout the emergency management continuum.


citation: HSC § 1893

text: For purposes of implementing this division, the agency and the office may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. On or before June 30, 2024, contracts entered into or amended pursuant to this section are exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the State Administrative Manual, and are exempt from the review or approval of any division of the Department of General Services.


citation: HSC § 1894

text: Implementation of this division is contingent upon an appropriation of funds by the Legislature in the annual Budget Act for the express purposes of this division.


citation: HSC § 2000

text: This chapter shall be known and may be cited as the Mosquito Abatement and Vector Control District Law.

history: (History: Added by Stats. 2002, Ch. 395, Sec. 6. Effective January 1, 2003.)

division: 3. PEST ABATEMENT

article: 1. General Provisions

path: 3. PEST ABATEMENT > 1. Mosquito Abatement and Vector Control Districts > 1. General Provisions


citation: HSC § 2001

text:
(a) The Legislature finds and declares all of the following:

(1) California’s climate and topography support a wide diversity of biological organisms.

(2) Most of these organisms are beneficial, but some are vectors of human disease pathogens or directly cause other human diseases such as hypersensitivity, envenomization, and secondary infections.

(3) Some of these diseases, such as mosquitoborne viral encephalitis, can be fatal, especially in children and older individuals.

(4) California’s connections to the wider national and international economies increase the transport of vectors and pathogens.

(5) Invasions of the United States by vectors such as the Asian tiger mosquito and by pathogens such as the West Nile virus underscore the vulnerability of humans to uncontrolled vectors and pathogens.

(b) The Legislature further finds and declares:

(1) Individual protection against the vectorborne diseases is only partially effective.

(2) Adequate protection of human health against vectorborne diseases is best achieved by organized public programs.

(3) The protection of Californians and their communities against the discomforts and economic effects of vectorborne diseases is an essential public service that is vital to public health, safety, and welfare.

(4) Since 1915, mosquito abatement and vector control districts have protected Californians and their communities against the threats of vectorborne diseases.

(c) In enacting this chapter, it is the intent of the Legislature to create and continue a broad statutory authority for a class of special districts with the power to conduct effective programs for the surveillance, prevention, abatement, and control of mosquitoes and other vectors.

(d) It is also the intent of the Legislature that mosquito abatement and vector control districts cooperate with other public agencies to protect the public health, safety, and welfare. Further, the Legislature encourages local communities and local officials to adapt the powers and procedures provided by this chapter to meet the diversity of their own local circumstances and responsibilities.

chapter: 1. Mosquito Abatement and Vector Control Districts

article: 1. General Provisions


citation: HSC § 2002

text:
As used in this chapter:

(a) “Abate” means to put an end to a public nuisance, or to reduce the degree or the intensity of a public nuisance.

(b) “Board of trustees” means the legislative body of a district.

(c) “City” means any city, whether general law or chartered, including a city and county, and including any city the name of which includes the word “town.”

(d) “Control” means to prevent or reduce vectors.

(e) “Department” means the State Department of Health Services.

(f) “District” means any mosquito abatement and vector control district created pursuant to this chapter or any of its statutory predecessors.

(g) “Principal county” means the county having all or the greater portion of the entire assessed value, as shown on the last equalized assessment roll of the county or counties, of all taxable property within a district at the time of formation.

(h) “Property” means land and improvements, and includes water.

(i) “Public agency” means any state agency, board, or commission, including the California State University and the University of California, any county, city and county, city, regional agency, school district, special district, redevelopment agency, or other political subdivision.

(j) “Public nuisance” means any of the following:

(1) Any property, excluding water, that has been artificially altered from its natural condition so that it now supports the development, attraction, or harborage of vectors. The presence of vectors in their developmental stages on a property is prima facie evidence that the property is a public nuisance.

(2) Any water that is a breeding place for vectors. The presence of vectors in their developmental stages in the water is prima facie evidence that the water is a public nuisance.

(3) Any activity that supports the development, attraction, or harborage of vectors, or that facilitates the introduction or spread of vectors.

(k) “Vector” means any animal capable of transmitting the causative agent of human disease or capable of producing human discomfort or injury, including, but not limited to, mosquitoes, flies, mites, ticks, other arthropods, and rodents and other vertebrates.

( l) “Voter” means a voter as defined by Section 359 of the Elections Code.

article: 1. General Provisions


citation: HSC § 2003

text:
(a) This chapter provides the authority for the organization and powers of mosquito abatement and vector control districts. This chapter succeeds the former Chapter 5 (commencing with Section 2200) as added by Chapter 60 of the Statutes of 1939, as subsequently amended, and any of its statutory predecessors.

(b) Any mosquito abatement and vector control district formed pursuant to the former Chapter 5 (commencing with Section 2200) or any of its statutory predecessors that was in existence on January 1, 2003, shall remain in existence as if it had been organized pursuant to this chapter. Any zone of a mosquito abatement and vector control district formed pursuant to former Section 2291 to former Section 2291.4, inclusive, and any of their statutory predecessors that was in existence on January 1, 2003, shall remain in existence as if it had been formed pursuant to this chapter.

(c) Any indebtedness, special tax, benefit assessment, fee, election, ordinance, resolution, regulation, rule, or any other action of a district taken pursuant to the former Chapter 5 (commencing with Section 2200) or any of its statutory predecessors that was taken before January 1, 2003, shall not be voided solely because of any error, omission, informality, misnomer, or failure to comply strictly with this chapter.

article: 1. General Provisions


citation: HSC § 2004

text: This chapter is necessary to protect the public health, safety, and welfare, and shall be liberally construed to effectuate its purposes.

article: 1. General Provisions


citation: HSC § 2005

text: If any provision of this chapter or the application of any provision of this chapter in any circumstance or to any person, city, county, special district, school district, the state, or any agency or subdivision of the state, including the California State University and the University of California, is held invalid, that invalidity shall not affect other provisions or applications of this chapter that can be given effect without the invalid provision or application of the invalid provision, and to this end the provisions of this chapter are severable.

article: 1. General Provisions


citation: HSC § 2006

text:
(a) Any action to determine the validity of either the organization, or any action, of a district shall be brought pursuant to Chapter 9 (commencing with Section 860) of Title 10 of Part 2 of the Code of Civil Procedure.

(b) Any judicial review of an action taken pursuant to this chapter shall be conducted pursuant to Chapter 2 (commencing with Section 1084) of Title 1 of Part 3 of the Code of Civil Procedure.

article: 1. General Provisions


citation: HSC § 2007

text:
(a) Except as provided in this section, territory, whether incorporated or unincorporated, whether contiguous or noncontiguous, may be included in a district. Territory that is already within a mosquito abatement and vector control district formed pursuant to this chapter may not be included within another mosquito abatement and vector control district.

(b) Except as otherwise provided in this chapter, the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000, Division 3 (commencing with Section 56000) of Title 5 of the Government Code, shall govern any change of organization or reorganization of a district. In the case of any conflict between that division and this chapter, the provisions of this chapter shall prevail.

(c) A district shall be deemed an “independent special district,” as defined by Section 56044 of the Government Code.

article: 1. General Provisions


citation: HSC § 2010

text: A new district may be formed pursuant to this article.

article: 2. Formation

path: 3. PEST ABATEMENT > 1. Mosquito Abatement and Vector Control Districts > 2. Formation


citation: HSC § 2011

text:
(a) A proposal to form a new district may be made by petition. The petition shall do all of the things required by Section 56700 of the Government Code. In addition, the petition shall:

(1) Set forth the methods by which the district will be financed, including, but not limited to, special taxes, special benefit assessments, and fees.

(2) Propose a name for the district.

(3) Specify the size of the initial board of trustees and the method of their appointment.

(b) The petitions, the proponents, and the procedures for certifying the sufficiency of the petitions shall comply with Chapter 2 (commencing with Section 56700) of Part 3 of Division 3 of Title 5 of the Government Code. In the case of any conflict between Chapter 2 (commencing with Section 56700) of Part 3 of Division 3 of Title 5 of the Government Code and this article, the provisions of this article shall prevail.

(c) The petition shall be signed by not less than 25 percent of the registered voters residing in the area to be included in the district, as determined by the local agency formation commission.

article: 2. Formation


citation: HSC § 2012

text:
(a) Before circulating any petition, the proponents shall publish a notice of intention that includes a written statement not to exceed 500 words in length, setting forth the reasons for forming the district and the methods by which the district will be financed. The notice shall be published pursuant to Section 6061 of the Government Code in one or more newspapers of general circulation within the territory proposed to be included in the district. If the territory proposed to be included in the district is located in more than one county, publication of the notice shall be made in at least one newspaper of general circulation in each of the counties.

(b) The following shall be signed by a representative of the proponent, and shall be in substantially the following form:

“Notice of Intent to Circulate Petition

“Notice is hereby given of the intention to circulate a petition proposing to form the _______________ (name of the district). The reasons for forming the proposed district are: _______________. The method(s) by which the proposed district will be financed are: _______________.”

(c) Within five days after the date of publication, the proponents shall file with the executive officer of the local agency formation commission of the principal county a copy of the notice together with an affidavit made by a representative of the newspaper in which the notice was published certifying to the fact of the publication.

(d) After the filing required pursuant to subdivision (c), the petition may be circulated for signatures.

article: 2. Formation


citation: HSC § 2013

text:
(a) A proposal to form a new district may also be made by the adoption of a resolution of application by the legislative body of any county or city that contains the territory proposed to be included in the district. Except for the provisions regarding the signers, signatures, and the proponents, a resolution of application shall contain all of the matters required for inclusion in a petition in Section 2011.

(b) Before adopting a resolution of application, the legislative body shall hold a public hearing on the resolution. Notice of the hearing shall be published pursuant to Section 6061 of the Government Code in one or more newspapers of general circulation within the county or city. At least 20 days before the hearing, the legislative body shall give mailed notice of its hearing to the executive officer of the local agency formation commission of the principal county. The notice shall generally describe the proposed formation of the district and the territory proposed to be included in the district.

(c) At the hearing required by subdivision (b), the legislative body shall give any person an opportunity to present his or her views on the resolution.

(d) The clerk of the legislative body shall file a certified copy of the resolution of application with the executive officer of the local agency formation commission of the principal county.

article: 2. Formation


citation: HSC § 2014

text:
(a) Once the proponents have filed a sufficient petition or a legislative body has filed a resolution of application, the local agency formation commission shall proceed pursuant to Part 3 (commencing with Section 56650) of Division 3 of Title 5 of the Government Code.

(b) If the local agency formation commission approves the proposal for the formation of a district, then, notwithstanding Section 57007 of the Government Code, the commission shall proceed pursuant to Part 4 (commencing with Section 57000) of Division 3 of Title 5 of the Government Code.

(c) Notwithstanding Section 57075 of the Government Code, the local agency formation commission shall take one of the following actions:

(1) If a majority protest exists in accordance with Section 57078 of the Government Code, the commission shall terminate proceedings.

(2) If no majority protest exists, the commission shall either:

(A) Order the formation without an election.

(B) Order the formation subject to the approval by the voters of a special tax or the approval by the property owners of a special benefit assessment.

(d) If the local agency formation commission orders the formation of a district pursuant to subparagraph (B) of paragraph (2) of subdivision (c), the commission shall direct the board of supervisors to direct county officials to conduct the necessary elections on behalf of the proposed district.

article: 2. Formation


citation: HSC § 2020

text: A legislative body of at least five members known as the board of trustees shall govern every district. The board of trustees shall establish policies for the operation of the district. The board of trustees shall provide for the faithful implementation of those policies which is the responsibility of the employees of the district.

article: 3. Boards of Trustees and Officers

path: 3. PEST ABATEMENT > 1. Mosquito Abatement and Vector Control Districts > 3. Boards of Trustees and Officers


citation: HSC § 2021

text:
Within 30 days after the effective date of the formation of a district, a board of trustees shall be appointed as follows:

(a) In the case of a district that contains only unincorporated territory in a single county, the board of supervisors shall appoint five persons to the board of trustees.

(b) In the case of a district that is located entirely within a single county and contains both incorporated territory and unincorporated territory, the board of supervisors may appoint one person to the board of trustees, and the city council of each city that is located in whole or in part within the district may appoint one person to the board of trustees. If those appointments result in a board of trustees with less than five trustees, the board of supervisors shall appoint enough additional persons to make a board of trustees of five members.

(c) In the case of a district that contains only unincorporated territory in more than one county, the board of supervisors of each county may appoint one person to the board of trustees. If those appointments result in a board of trustees with less than five persons, the board of supervisors of the principal county shall appoint enough additional persons to make a board of trustees of five members.

(d) In the case of a district that is located in two or more counties and contains both incorporated territory and unincorporated territory, the board of supervisors of each county may appoint one person to the board of trustees, and the city council of each city that is located in whole or part within the district may appoint one person to the board of trustees. If those appointments result in less than five persons, the board of supervisors of the principal county shall appoint enough additional persons to make a board of trustees of five members.

article: 3. Boards of Trustees and Officers


text:
(a) Notwithstanding Section 2021, the Board of Trustees of the San Mateo County Mosquito and Vector Control District may be appointed as follows:

(1) The San Mateo County Board of Supervisors shall appoint two trustees.

(2) The city selection committee in the County of San Mateo, established pursuant to Article 11 (commencing with Section 50270) of Chapter 1 of Part 1 of Division 1 of Title 5 of the Government Code, shall appoint one trustee from each county supervisorial district; however, the committee shall not appoint a trustee to serve on the board at the same time as another trustee if both trustees would represent the same city as a result of that appointment.

(b) This section shall apply only if a majority of the legislative bodies that include the city councils in, and the Board of Supervisors of, the County of San Mateo adopt resolutions approving the change in board composition.

(c) Upon adoption of a resolution pursuant to subdivision (b), the city council or board of supervisors shall forward a copy of the resolution to the local agency formation commission. If a majority of the legislative bodies that include the city councils in, and the Board of Supervisors of, the County of San Mateo adopt a resolution, the local agency formation commission shall adopt procedures for the reorganization of the board of trustees and notify the San Mateo County Mosquito and Vector Control District and the city selection committee in the County of San Mateo.

history: (History: Added by Stats. 2016, Ch. 288, Sec. 1. (AB 1362) Effective January 1, 2017.)

article: 3. Boards of Trustees and Officers


citation: HSC § 2022

text:
(a) Each person appointed by a board of supervisors to be a member of a board of trustees shall be a voter in that county and a resident of that portion of the county that is within the district.

(b) Each person appointed by a city council to be a member of a board of trustees shall be a voter in that city and a resident of that portion of the city that is within the district.

(c) Notwithstanding any other provision of law including the common law doctrine that precludes the simultaneous holding of incompatible offices, a member of a city council may be appointed and may serve as a member of a board of trustees if that person also meets the other applicable qualifications of this chapter.

(d) It is the intent of the Legislature that persons appointed to boards of trustees have experience, training, and education in fields that will assist in the governance of the districts.

(e) All trustees shall exercise their independent judgment on behalf of the interests of the residents, property owners, and the public as a whole in furthering the purposes and intent of this chapter. The trustees shall represent the interests of the public as a whole and not solely the interests of the board of supervisors or the city council that appointed them.

article: 3. Boards of Trustees and Officers


citation: HSC § 2023

text:
(a) The initial board of trustees of a district formed on or after January 1, 2003, shall be determined pursuant to this section.

(b) The persons appointed to the initial board of trustees shall meet on the first Monday after 45 days after the effective date of the formation of the district.

(c) At the first meeting of the initial board of trustees, the trustees shall classify themselves by lot into two classes, as nearly equal as possible. The term of office of the class having the greater number shall expire at noon on the first Monday in January that is closest to the second year from the appointments made pursuant to Section 2021. The term of office of the class having the lesser number shall expire at noon on the first Monday in January that is closest to the first year from the appointments made pursuant to Section 2021.

article: 3. Boards of Trustees and Officers


citation: HSC § 2024

text:
(a) Except as provided in Section 2023, the term of office for a member of the board of trustees shall be for a term of two or four years, at the discretion of the appointing authority. Terms of office commence at noon on the first Monday in January.

(b) Any vacancy in the office of a member appointed to a board of trustees shall be filled pursuant to Section 1779 of the Government Code. Any person appointed to fill a vacant office shall fill the balance of the unexpired term.

article: 3. Boards of Trustees and Officers


citation: HSC § 2025

text:
(a) Under no circumstances shall a board of trustees consist of less than five members. Except as provided in Section 2026, the number of members who represent the unincorporated territory of a county may not exceed five members.

(b) A board of trustees may adopt a resolution requesting the board of supervisors of any county that contains territory within the district to increase or decrease the number of members of the board of trustees who represent the unincorporated territory of that county within the district. The resolution shall specify the number of members and the areas of the unincorporated territory for which the board of trustees requests the increase or decrease.

(c) Within 60 days of receiving a resolution adopted pursuant to subdivision (b), the board of supervisors shall order the increase or decrease in the number of members of the board of trustees, consistent with the board of trustees’ resolution.

(d) If the board of supervisors orders an increase in the number of members of the board of trustees, the board of supervisors shall appoint a person or persons to the board of trustees and specify their term of office, consistent with the requirements of this chapter. If the board of supervisors orders a decrease in the number of members of the board of trustees, the board of supervisors shall designate the trustee or trustees whose office shall be eliminated at the termination of the trustee’s current term of office. Any trustee whose office is designated to be eliminated shall continue to serve until his or her term of office expires.

article: 3. Boards of Trustees and Officers


citation: HSC § 2026

text:
(a) A local agency formation commission, in approving either a consolidation of districts or the reorganization of two more districts into a single district, may, pursuant to subdivisions (k) and (n) of Section 56886 of the Government Code, change the number of members on the board of trustees of the consolidated or reorganized district, provided that the resulting number of trustees shall be an odd number but not less than five.

(b) Upon the expiration of the terms of the members of the board of trustees of the consolidated or reorganized district whose terms first expire following the effective date of the consolidation or reorganization, the total number of members on the board of trustees shall be reduced until the number equals the number of members determined by the local agency formation commission.

(c) Notwithstanding subdivision (b) of Section 2024, in the event of a vacancy on the board of trustees of the consolidated or reorganized district at a time when the number of members of the board of trustees is greater than the number determined by the local agency formation commission, the vacancy shall not be filled and the membership of the board of trustees shall be reduced by one member.

article: 3. Boards of Trustees and Officers


citation: HSC § 2027

text:
(a) At the first meeting of the initial board of trustees of a newly formed district, and in the case of an existing district at the first meeting in January every year or every other year, the board of trustees shall elect its officers.

(b) The officers of a board of trustees are a president and a secretary. The president shall be a trustee. The secretary may be either a trustee or a district employee. A board of trustees may create additional officers and elect members to those positions. No trustee shall hold more than one office.

(c) Except as provided in Section 2077, the county treasurer of the principal county shall act as the district treasurer. The county treasurer shall receive no compensation for the receipt and disbursement of money of the district.

article: 3. Boards of Trustees and Officers


citation: HSC § 2028

text: A board of trustees shall meet at least once every three months. Meetings of the board of trustees are subject to the provisions of the Ralph M. Brown Act, Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code.

article: 3. Boards of Trustees and Officers


citation: HSC § 2029

text:
(a) A majority of the board of trustees shall constitute a quorum for the transaction of business.

(b) Except as otherwise specifically provided to the contrary in this chapter, a recorded vote of a majority of those trustees present and voting is required on each action.

(c) The board of trustees shall act only by ordinance, resolution, or motion.

(d) The board of trustees shall keep a record of all of its acts, including financial transactions.

(e) The board of trustees shall adopt rules for its proceedings.

article: 3. Boards of Trustees and Officers