Section 300 - System Providers

purpose: provide standards for the permitting of ALS providers in SCC

A. Submit a letter of intent detailing proposed services, including service area, delivery method, personnel, and timeline for implementation.

B. Meet with the Agency to discuss the proposal.

C. The proposal will be reviewed and approved by the EMS Medical Director.

D. Negotiate an agreement with Santa Clara County, which must be signed before services can be provided, following established County procedures.

requirments:
A. an approved providser must submit a quality improvement plan for approval by the agency.
B. " " " must follow all policies, procedures, & protocols in accordance with Agency policy, prior to provision of services


personnel:
EMT and Paramedic personnel must:
A. Hold appropriate licensure or certification as per California regulations.

B. Attend an approved orientation to the County EMS System.

C. Paramedic personnel must also be accredited to practice in Santa Clara County under the EMS Medical Director's direction.

purpose: to provide minimum standards related to the use of supplemental EMS sys resources including EMTs & paramedics working in non-traditional environments w/in SCC & when serving on an authorized mutual aid assignment

This policy outlines the use of supplemental EMS resources in Santa Clara County as follows:

A. Authorized ALS or BLS System Provider Agencies may provide supplemental services within their jurisdiction.

B. Supplemental resources must augment standard EMS resources, not replace them.

C. Providers must obtain written authorization from the EMS Agency before providing supplemental services.

D. Approval for supplemental resources must be obtained annually from the EMS Agency.

E. Policy applies only to personnel working for approved Santa Clara County EMS Provider Agencies.

F. County Ambulance has two Alternative Transport Ambulances for deployment as authorized by the EMS Agency:
1. County Ambulance has exclusivity for patient transport within the County Service Area and may deploy these ambulances with EMS Agency approval.
2. EMS System partners can request the deployment of Alternative Transport Ambulances for preplanned events, which County Ambulance will review and submit to the EMS Agency for approval.
3. The cost of using Alternative Transport Ambulances is detailed in Appendix M of the agreement with the County EOA operator.

This section outlines the guidelines for the use of Supplemental EMS Resources:

A. Supplemental EMS Resources can only be dispatched alongside a standard EMS System Response, which includes first responder and/or ambulance response.

B. Once on the scene, Supplemental EMS Resources have the authority to cancel incoming units if deemed appropriate.

C. Supplemental EMS Resources must be tracked by an authorized Public Safety Answering Point (PSAP).

D. These resources may also be deployed for special or planned events, but a standard EMS System response must still be dispatched to the incident unless the resource is specifically deployed for on-scene support.

This section outlines inventory requirements for Fireline EMTs and paramedics:

A. Minimum inventory requirements are detailed in Schedules A-E, with specific items listed.

B. Items listed in Schedules A and B are below FireScope's recommended inventory levels for Fireline EMTs and paramedics, suggesting departments may consider augmenting them with additional inventory from FireScope.

C. In addition to the minimum inventory, each resource must have sufficient restock to ensure continuous service while meeting the minimum standards.

schedule A: fireline EMT & special event EMT

schedule B: tactical paramedic

schedule C: fireline paramedic

schedule D: special event paramedic (motorized response)

schedule E: special event paramedic

purpose: establish replacement levels for radio translucent spine boards requirements for permitted prehospital care assets in SCC

This section outlines requirements for radio translucent spine boards:
A. Prehospital care assets from Policy 302, Section II are included.

B. Each provider agency must supply and maintain Santa Clara County EMS Agency-approved radio translucent spine boards.

C. Replacement requirements are determined by the County.

D. The replenishment schedule specifies the minimum number of spine boards each provider must put into
service annually.

E. Provider agencies must annually demonstrate compliance by submitting evidence of placing the minimum required spine boards into service to the County.

# of permitted assets annual replenishment requirement
1 to 10 1
11 to 20 2
21 to 30 3
31 to 40 4
41 to 50 5
51 to 60 6
61 to 70 7
71 to 80 8
81 to 90 9
91 to 100 10
101 & greater 12

purpose: establish standardized criterai for the approval & maintenantce of EMT optional scope of practice programs in SCC

Summary:

A. Santa Clara County prehospital provider agencies can request approval to add optional or enhanced practice skills. The request should include:
1. Statement of Need and Necessity with supporting documents.
2. Proposal outlining program implementation, including equipment procurement, training, and operational aspects.
3. Quality assurance and improvement plan.
4. Description of the geographic area of implementation.
5. Information about the EMS Program Manager responsible for program management.
6. Acknowledgment that the EMS Agency Medical Director will serve as the Medical Director unless otherwise approved.

B. The proposal from the requesting agency undergoes review and, if satisfactory, receives approval from the Santa Clara County EMS Medical Director.

C. Proposals must be submitted at least sixty (60) days before the first scheduled course of instruction or program implementation.

D. The Agency acknowledges receipt of the application within fourteen (14) days and notifies the applicant of its decision within sixty (60) days.

E. Approval remains continuous as long as the program meets eligibility requirements, unless suspended or revoked by the Santa Clara County EMS Medical Director.

F. The Agency has the authority to deny, revoke, or place on probation a program for various reasons, including but not limited to:
1. Violation or attempted violation of relevant health and safety codes and regulations.
2. Failure to address identified deficiencies within a specified timeframe after receiving written notification.
3. Any material misrepresentation of fact provided by the program provider or applicant.

1. In case of denial, suspension, or revocation of application, the applicant or provider can appeal in writing to the Agency within 30 days of notification. The appeals process must be completed within 45 days of receiving the appeal.

2. If provider approval is revoked or denied, any interim training approval will be withdrawn until the appeals process concludes.

3. If a provider is placed on probation, the Agency will determine probation terms, including approving a corrective action plan. Provider approval renewal during probation depends on successfully implementing the approved action plan.

purpose: establish standards for continuing education providers (CEPs) in SCC

The requirements for Continuing Education Providers may be found in the Santa Clara
Prehospital Care Manual Reference Guide 809: Continuing Education Providers Guide.

any negative action taken in relation to a CEP shall be in accordance with SCC prehosp care manual, EMS policy #305

purpose: provide a procedure for suspending or revoking EMT or paramedic training program approval for failure to comply with Division 2.5 of the California Health & Safety Code or any rules or regulations adopted pursuant thereto

A. establish need to review

B. investigation

C. submission to medical director

D. issue formal accusation & inform program of rights

E. response to allegations

F. proceedings of an independant review panel (IRP)

G. IRP decision

H. final review

I. probation or suspension of program approval

J. immediate suspension

purpose: establish standardized criteria for the approval of Public Safety Answering Points (PSAP) EMD programs consisten with applicable state statues, regulations & guidelines

A. The PSAP must use the International Academies of Emergency Dispatch (IAED)’s Medical Priority Dispatch System (MPDS), approved by the County EMS Agency Medical Director.

B. PSAPs not yet approved for EMD must submit a proposal to the County EMS Agency.

C. Proposal requirements include:
1. Description of the service area.
2. Justification for EMD implementation.
3. Agreement to use IAED MPDS protocols.
4. Presence of a physician medical advisor.
5. Dispatchers trained and certified to IAED standards.

C2. Emergency Medical Dispatch Quality Improvement Plan participation.
6. The Agency will respond to the application within 60 days, indicating approval or denial with reasons provided.

A. PSAP shall maintain a physician medical advisor

B. PSAP shall participate in the County's EMD QI committee

C. PSAPS shall maintain utilization of IAED's MPDS protocols (International Academids of Emergency Dispatch/Medical Priority Dispatch System)

purpose: establish a mechanism for the provision of BLS public safety response w/in the SCC's exclusive operating area(s) (EOAs) under county contract

A. PSAP of BLSFR provider must use IAED’s MPDS, approved by County EMS Agency Medical Director.

B. BLSFR agrees to maintain response time standards for each call priority.

C. BLSFR ensures dispatching two qualified EMTs to every call triaged as "Basic Life Support."

D. PSAP submits Emergency Medical Dispatch Quality Improvement Plan to County EMS Agency for approval.

E. PSAP and BLSFR participate in Emergency Medical Dispatch Quality Improvement Committee.

F. PSAP provides monthly drift determinant reports to County EMS Agency within 30 days.

G. BLSFR submits a letter to County EMS Director stating intent to provide BLSFR and meeting requirements, with a response expected within 60 days.

purpose: identify the requirements for automated vehicle location reporting to enable unit location tracking in real time or near-real time for 911 call dispatching

A. AVL is a technology combining hardware and software to determine and report vehicle positions accurately.

B. Sometimes, non-911 ambulance providers not regularly dispatched to 911 calls are needed by the 911 System.

C. AVL services, viewable via Common Regional Operating Picture (CROP) by County Communications, assist in dispatching the most suitable unit for each call when non-911 providers are called upon.

D. All permitted ambulances must share their location data as per this policy.

A. Vehicle location data from participating providers is used solely for dispatching 911 calls to the nearest and most suitable unit.

B. Vehicle location data is visible only when the tracked vehicle is actively logged into the 911 CAD system.

C. The EMS Agency and County Communications do not store vehicle location data.

D. Vehicle location information belongs to the provider agency responsible for the tracked vehicle.

A. The Unit Status Update data exchange is issued periodically.

B. The AVL System should issue the Unit Status Update at least every thirty (30) seconds, with a nominal interval of about sixty (60) seconds.

C. Non-911 ambulance provider systems must use the non-911 ambulance Agency ID and system ID provided in the Unit Status Update to reconcile unit status against non-911 ambulance provider incidents in the AVL System.

D. Non-911 ambulance provider AVL Systems must be capable of receiving and processing a Unit Status Update response.

E. The Unit Status Update response includes a unit identifier, unit status, and the provider organization and system IDs.

A. The Unit Status Update exchange includes specific data elements in the request from the requesting AVL System:
1. Parent Element identifying Unit Status Update

2. Agency Event ID (alphanumeric)

3. System ID

4. Timestamp indicating when the AVL System creates/sends the request

5. For each unit in the requesting AVL System, a status containing:
a. Unit # / Unit Identifier
b. Unit Status Code (native to AVL System issuing the report)
c. Unit Local Event Identifier (unit assigned to a BLS Contractor event)
d. Unit Remote Event Identifier (unit assigned to a correlated remote event)

purpose: identify standards for the use of protective gear & to establish a mechanism for rapid identification of vairous types of private ambulance service EMS personnel on the scene of an emergency

A. EMS personnel are required to wear agency-identifying uniforms during EMS calls.

B. Personnel attached to permitted private ambulances or EMS units must wear provided PPE while in the field.

C. Uniforms must clearly display "EMT," "PARAMEDIC," "CCT NURSE," or "Flight Nurse" for easy identification.

D. On-duty EMS personnel must carry valid photo identification.

E. All on-duty EMS personnel must visibly display a Santa Clara County EMS System Identification Badge.

A. Protective gear is mandatory when directed by Incident Commander, public safety personnel, County, or EMS Field Supervisor, excluding biohazard precautions.
1. Adherence to OSHA and CalOSHA PPE requirements is mandatory.

2. Prehospital care personnel in permitted private ambulance services must wear County-designated protective jackets.

3. Prehospital care personnel in permitted private ambulance services must wear County-designated protective helmets.

4. Private ambulance service employers must provide one pair of work gloves and shatter-resistant clear eyewear per employee.

Protective gear (helmet, protective jacket, gloves, and eyewear) is required in the following situations:
A. Federal Aviation Administration (FAA) Alerts.

B. Multiple Casualty Incident Plan Activations.

C. Actual/Suspected Hazardous Materials Events.

D. Incidents on roadways and freeways.

E. Working with aircraft.

F. Mutual or automatic aid responses.

G. When clear identificationecognition is necessary due to multi-agency response, environmental conditions, or general safety.
H. Anytime deemed necessary by prehospital provider, public safety official, supervisor, or county.

A. The protective gear requirements aim to offer minimal protection for those not involved in hazardous environments, ensuring rapid identification and passive protection during rescue operations.

B. Non-public safety personnel aren't assumed to participate in extrication or hazardous activities, with public safety agencies handling such tasks.

C. The policy doesn't cover basic OSHA requirements; employers decide uniform components like footwear and attire.

D. County-provided PPE is only for use when representing the Santa Clara County Emergency Medical Services System officially.

A. County-issued ballistic carriers and helmets provided to the County Emergency Ambulance (EOA) provider will be stored with EMS Field Supervisors and used as described.

B. Personal ballistic carriers and helmets can be used following this policy and Policy 309, Schedule C.

C. Use of ballistic gear is restricted to large-scale or high-risk events, not routine responses considered safe by law enforcement or other first responders.

D. Ballistic carriers and helmets can be utilized during active shooter situations, mass casualty incidents involving firearms, civil unrest, standbys with large crowds, high-risk search warrants, high-risk dignitary protection, or at the discretion of EMS Field Supervisors, EMS Duty Chiefs, or on-scene Public Safety Incident Commanders.

the use of aballistic carriers & ballistic helmets outside the parameters identified in section VI of this policy will constitue a violation of this policy

purpose: identify protective helmet standards for EMS personnel employed with county permitted private ambulance services

A. Prehospital care personnel in permitted private ambulance services must wear the standard protective helmet designated by the County.

B. Ambulance services are responsible for replacing and providing helmets for each employee on field duty, not per ambulance unit.

C. County-provided personal protective equipment (PPE) can only be worn or displayed while representing the Santa Clara County Emergency Medical Services System officially.

A. Prehospital care personnel in permitted private ambulance services must wear the standard protective helmet designated by the County.

B. Each ambulance service is responsible for replacing and providing helmets for each individual employee assigned to field duty, not per-unit.

C. County-provided personal protective equipment (PPE) can only be worn or displayed while serving officially as a representative of the Santa Clara County Emergency Medical Services System.

R&R:
A. Santa Clara County EMS service providers must ensure replacement of personal protective equipment (PPE) in cases of loss, repair, or damage.

B. Permitted private ambulance services are prohibited from deploying any individual who lacks appropriate PPE.

1. blue in color zith protective goggles or shield

2. SCC approved markings indicating the operational area & company 3 letter identifier

3. an individual's last name may be affixed to the rear of the helmet for identification purposes

4. yellow reflective striping

1. blue in color zith protective goggles or shield

2. SCC approved markings indicating the operational area & company 3 letter identifier

3. an individual's last name may be affixed to the rear of the helmet for identification purposes

4. yellow reflective striping

5. a title crescent entitled 'CCT-RN' may be affixed to helmet

1. blue in color zith protective goggles or shield

2. SCC approved markings indicating the operational area & company 3 letter identifier

3. an individual's last name may be affixed to the rear of the helmet for identification purposess.

4. blue reflective striping shall be located on the rear & L/R sides of the helmet

1. blue in color zith protective goggles or shield

2. SCC approved markings indicating the operational area & company 3 letter identifier

3. an individual's last name may be affixed to the rear of the helmet for identification purposess.

4. blue reflective striping shall be located on the rear & L/R sides of the helmet

5. a red helmet shield shall be placed on the front of the helmet as approved by the county

1. blue in color zith protective goggles or shield

2. SCC approved markings indicating the operational area & company 3 letter identifier

3. an individual's last name may be affixed to the rear of the helmet for identification purposess.

4. red reflective striping shall be located on the rear and L/R sides of the helmet

5. a tital crescent, as approved bythe County, may be affixed to helmets for positions not identified in this policy (liaison, support, etc)

purpose: identify protective jacket standards for EMS personnel employed with the county permitted private ambulance services

- Type: 5.11 hi-visibility responder parka or other county approved manufacturer

- color: navy blue

- EMT/Paramedic/EMS Field Supervisor

- front patch: SCC EMT/Paramedic

- back logo: silver refelctive heat press + [SCC & EMT/Paramedic]

- type: 5.11 hi-vis responder parka

- color: royal blue

- EMT/Paramedic

- type: 5.11 hi-vis responder parka

- color: red

- Observer/Intern

- front patch: SCC Observer

- back logo: silver reflective heat press + [SCC & Observer]

purpose: identify ballistic carriers & ballistic helmet standards for EMS personnel employed with county permitted private ambulance services

A. Ballistic carriers and helmets must meet specified minimum standards, with only two approved manufacturer options: Gladiator Solutions and Safe Life Defense First Response Multi-Threat Vest.

B. Ballistic carriers must adhere to specific marking standards outlined in the provided table, with no additional markings allowed.

C. Ballistic helmets must not have any markings, including decals, stickers, or images.

1. Color-navy blue, outer plate carrier with single plate
compartment storage (front & back)

2. Level IIIA ballistic plates or higher ballistic rating (front and
back)

3. Equipment, radio and flashlight pouches (front)

4. Reflective silver stripe (front and back)

5. Star of Life in reflective silver (front)

1. Color-navy blue, “First Response Multi-Threat Vest” with
single plate compartment storage (front & back)

2. Level IIIA ballistic plates or higher ballistic rating (front and
back)

3. Equipment, radio and flashlight pouches (front)

4. Reflective silver stripe (front and back)

1. The carrier shall be equipped with a Velcro® back panel
identifier

2. The identifier will be navy to match the vest with silver
reflective writing that notes one of following identifiers for
personnel

3. Panel dimensions 3” height by 10” wide

4. Font 1” height

1. Color-black, NIJ 0106.01 Level IIIA MIL-STD-662F
Fragmentation V50, ACH Shaped
2. Team Wendy Padding and Harness System (EPIC Air -
BOA)
3. Siderails, NVG Mount, Velcro®, Aramid

purpose: to outline the scope of practice for Firefighters, Peace Officers, and Lifeguards who have undergone training according to California Code of Regulations, Title 22, Division 9, Chapter 1.5 in Santa Clara County.
- Additionally, it defines the criteria for approving optional skills programs within this scope of practice.

A. Public safety personnel must adhere to the Santa Clara County Public Safety First Aid scope of practice when working within a Santa Clara County public safety agency, unless they have received EMT or paramedic training and are employed accordingly.

B. The scope of practice for public safety first aid personnel is limited to activities authorized by California Code of Regulations, Title 22, Division 9, Chapter 1.5, and Santa Clara County EMS policy.

C. Only individuals with public safety first aid training are permitted to operate under this policy as part of the Santa Clara County EMS system.

A. Public Safety First Aid Providers must complete training and demonstrate competency in various skills through an approved program.

B. Authorized skills include CPR, AED use, evaluation of the ill and injured, shock treatment, airway and breathing support techniques, recovery position, spinal immobilization, splinting, eye irrigation, oral glucose assistance, administration of epinephrine and naloxone, emergency childbirth assistance, hemorrhage control, chest seals, decontamination, care for amputated body parts, and basic wound care.

C. These skills are limited to those explicitly authorized in the policy and regulations.

purpose: define the approval process for agencies or organizations that utilize EMTs to provide AED services to the public

A. Agencies or organizations intending to authorize EMTs to use AEDs must submit a program proposal to the Santa Clara County EMS Agency for approval.

BThe program proposal should outline policies on AED operation, maintenance, deployment, and ordering of equipment:
1. It should detail initial and ongoing training requirements for EMTs, including hands-on manipulation of AEDs and proper AED/CPR procedures for unconscious patients.
2. A continuous quality improvement plan is required, ensuring EMTs demonstrate competency every two years or as determined by the EMS quality improvement plan. Communication protocols with the EMS Agency regarding AED use should also be included.
3. The proposal must specify the method of collecting data and submitting an annual report to the EMS Agency, including statistics on CPR before emergency medical care, defibrillatory shocks administered, and the initial rhythm of witnessed cardiac arrests.- It must include a plan for collecting and submitting data to the EMS Agency annually.

C. Approved providers must adhere to EMS Agency policies outlined in the Santa Clara County Prehospital Care Manual and other related guidelines.

D. Failure to comply with the requirements may result in the revocation or suspension of the program's approval.