Section 200 - Personnel Credentials

purpose: To establish standardized criteria for determining eligibility for issuance of prehospital
emergency medical care certificates and credentials by the agency, and the parameters for
denial, restriction (at time of issuance), and revocation of prehospital emergency medical care
certificates or credentials, consistent with applicable State statute, County Ordinance, or other
applicable regulations.

A. Meeting all requirements outlined in the Santa Clara County Prehospital Care Policy Manual and California Code of Regulations is necessary for obtaining certificates or credentials.

B. Certain conditions listed in California Code of Regulations and Health & Safety Code may prevent issuance of prehospital care certificates (preclusions from issuance of prehosp certificate).

The Agency may revoke, deny issuance, or issue a restricted prehospital emergency medical
care certificate or credential upon discovering that the applicant has committed fraud of certificate, gross negligence, repeated negligent acts, incompentence, conviction of crime, violation of regulation, drug use, irrational behavior, etc.

The Agency will review all prehospital care certificate applications. Applications indicating circumstances that may prevent certificate issuance will undergo additional review, potentially including documentation review, interviews with Agency staff, and interviews with the EMS Medical Director.

a prehosp care certificate can be placed of probation, denied or revoked according to several guidelinds including but not limited to:
1. Applicant has committed any sexually related offense specified under Section
290 of the Penal Code
2. Applicant has been convicted of murder, attempted murder, or murder for hire
3. Applicant has been convicted of two of more felonies
4. Applicant is on parole or probation for any felonies

an applicant who has had their app denied or revoked shall have the right to appeal the actions

purpose: establish standardized criteria for the initial certification & certififcation renewal of EMT personnal consistent w/ applicable state stateus & the SCC EMS agency as the certifiying entity

1. Eligibility for initial certification requires meeting one of the following criteria:
- Possession of a non-expired National Registry EMT Basic card or completion of an approved EMT course within the last two years.
- Completion of an approved out-of-state EMT training course within the last two years.
- Possession of a current and valid out-of-state EMT certificate.
- Passing the National Registry of Emergency Medical Technicians-EMT Basic written and skills examination.
- Possession of a non-expired out-of-state or National Registry EMT-Intermediate Certificate.
- Possession of a current and valid California Paramedic License.

2. Must be eighteen (18) years of age or older.

3. Submit a completed Live Scan Applicant Submission Form to the California DOJ for state and federal background checks, including subsequent arrest notification reports.
- Criminal background check results will be retained by the EMS Office for six (6) months. If the application process is not completed within this time, results will be forwarded to the California Department of Justice's No-Longer-Interested list.

1. Completed EMT Certification Application including:
a. Documented proof of completion of eligibility requirements as noted in
Section II, A, 1 of this policy.
b. Payment of the established local and State fee.
c. Current CPR card, which meets American Heart Association Guidelines
at the Healthcare Provider level.
d. Two (2) current government-issued photo IDs (see Policy 617 for ID
requirements).

In addition to the Santa Clara County Prehospital Care Policy requirements, eligibility for Prehospital Certificates and Credentials includes:

1. Being currently certified as a California EMT or having been certified within the last two years.

2. Successfully completing an approved EMT refresher course or 24 hours of approved continuing education.

3. Successfully completing the EMT skills competency verification.

4. For EMTs renewing certification for the first time after July 1, 2019, providing documentation of training in:
- The use and administration of naloxone or other opioid antagonist.
- The use and administration of epinephrine by auto-injector.
- The use of a glucometer.

Process:
1. Complete the EMT Certification Application with:
a. Proof of continuing education or refresher course completion records, including the State EMS Authority Skills Verification Form.
b. Payment of local and State fees.
c. Current CPR card meeting American Heart Association guidelines at the Healthcare Provider level.
d. For certification renewal applicants from another agency, a criminal history background check verification for a state and federal search is required. Results will be maintained if actively renewing with Santa Clara County, otherwise sent to the California Department of Justice after twelve (12) months.

2. Certified EMTs must keep the EMS Agency updated with their current mailing address, notifying in writing within thirty (30) calendar days of any changes.

3. EMTs can only be certified by one certifying entity during a certification period. If certified by multiple entities, upon renewal, they must choose one certifying entity.

C. Certified EMTs must inform the EMS Agency of any changes to their mailing address within thirty days in writing.

D. EMTs can only hold certification from one certifying entity at a time. If certified by multiple entities, they must choose one upon renewal.

If an EMT certification has expired:
A. 0-6 months since expiration:
- 24 hours of approved continuing education within the past 24 months.
- State of California skills verification form.
B. 6-12 months since expiration:
- 36 hours of approved continuing education within the past 24 months.
- State of California skills verification form.
C. More than 12 months since expiration:
- 48 hours of approved continuing education within the past 24 months.
- State of California skills verification form.
- Pass National Registry EMT Basic exam within 2 years, unless already certified.
D. For first-time certification renewal starting July 1, 2019:
- Training on naloxone/opioid antagonists, epinephrine auto-injectors, and glucometers from approved providers.

A. The EMS Agency issues a temporary certificate valid for 45 days upon completing application requirements.
B. The California State EMS Authority provides a wallet-sized EMT certification card upon meeting requirements.
C. Initial certification's effective date is the issuance date.
D. Certificate issuance may be delayed if criminal issues arise during background checks; applicants are notified within 10 working days of any certification action taken.
E. Initial certification expires two years from the effective date.
F. If renewal requirements are met within six months of expiration, the new expiration is two years from the current expiration date.
G. If renewal requirements are met over six months before expiration, the new expiration is two years from the date of meeting all renewal requirements.

All EMTs employed by a Santa Clara County Prehospital Provider Agency must undergo mandatory training as directed by the EMS Medical Director, such as EMS Updates or System Orientation. EMTs failing to complete the required EMS Update by the initial deadline cannot work as EMTs within the Santa Clara County EMS System until the training is finished.

purpose: establish standardized criteria for the certification of EMT personnel by challenge that is consistent with the applicable state statutes and the EMS programs of other counties in this State

To be eligible for certification via course completion challenge examination, the candidate must meet one of the following criteria:

1. Hold a current license as a physician, registered nurse, vocational nurse, physician assistant, or licensed practical nurse in the United States.

2. Have completed an emergency medical service training program in the Armed Forces of the United States within the past two years, meeting Department of Transportation EMT Course guidelines.
Additionally, the candidate must meet the eligibility requirements outlined in Policy 200.

applicants must pass the examination by pre-established standards developed &/or approved by the SCC ELS agency

an eligible person shall be peritted to the the EMT challenge examniation once only. Failure to qulify will require an individual to complete an approved EMT course

purpose: provide certified EMT personnel local accreditation to practice authorized optional skills when working for an authorized optional scope of practice provider agency in SCC

A. Hold a current California EMT Certificate.

B. Meet eligibility requirements outlined in Policy 200 of the Prehospital Care Manual.

C. Possess a CPR card meeting American Heart Association Standards at the Healthcare Provider level.

D. Be affiliated with an approved Santa Clara County EMT Optional Scope of Practice provider agency.

E. Have no significant negative clinical or field-related incidents in the past two years.

F. Successfully complete an approved EMT-I Optional Scope of Practice training program within six months.

G. Pass the EMT Optional Scope of Practice Local Accreditation Written Examination.

H. Complete the application process within 30 days of submission.

I. Apply for accreditation no more than three times within a 12-month period.

A. submit letter from the EMT's affiliated agency requestion issuance of accreditation from the Agency

B. upon receipt of completed app & established fee, the Agency will review all docs

C. upon satisfying all accreditation requirements, the Agency will notify the provider agency of the applicant's accreditation approval

A. local accreditation shall be valid to eligible individuals who successfully complete the app requirements

B. local accreditation shall be alid concurrent with an individual's EMT certificate, but not exceed more than 2 years from date of issue

To maintain EMT-I Optional Scope of Practice accreditation in Santa Clara County:
A. EMTs must complete the annual EMS Update and any other required training designated by the Agency.
B. If an EMT fails to complete required training by the due date, they cannot practice Optional Scope skills. However, they can maintain accreditation if training is completed within 60 days after the due date, provided they are not working as an EMT during that time. Failure to complete training within 60 days results in loss of accreditation.

Loss of accreditation may occur if:
A. The EMT fails to complete required training within specified timelines.
B. The EMT loses their EMT certification.
C. Authorized by the State EMS Authority or Local Emergency Medical Services Agency (e.g., suspension, revocation).
D. Individuals who lose accreditation must complete the entire EMT Optional Scope of Practice accreditation process again if they wish to regain accreditation.

establish a mechanism for notifying the EMS agency of paramedic student placement w/in the local EMS system & ensure appropriate medical control & oversight of pramedic interns prior to practicing w/in the local jurisdiction

To become a recognized Paramedic Intern in Santa Clara County:

1. Submit a Paramedic Intern Recognition Application, signed by the intern applicant, paramedic training program, and approved preceptor(s).
2. Pay any applicable fees online.
3. Undergo a background check (DOJ and FBI Live Scan) unless already certified or accredited by Santa Clara County EMS Agency.
4. Pass the Paramedic Accreditation Examination, a part of the Local System Orientation Examination, with a minimum score of 85%. This exam can be taken up to six months prior to application.
5. Upon completion, receive a six-month identification card. Extensions beyond six months require approval from the sponsoring agency’s program manager.
6. Paramedic interns cannot practice until approved by the EMS Agency.

Appointment Scheduling and Submission:
- New applicants must schedule an appointment with the EMS Agency for identity confirmation and photo recording if necessary.
- EMS Agency personnel will only discuss internship matters in compliance with regulations and privacy laws.
- Express or on-site processing is unavailable; applicants should apply at least 30 days before the internship start date.

purpose: to grant accreditation to California Licensed Paramedics for practice within the Santa Clara County EMS System. Accreditation involves completing an orientation program prescribed by the EMS Medical Director, covering local system policies, procedures, treatment protocols, radio communications, hospital destination policies, and other system-specific features. Testing is focused solely on local policies and treatment protocols.

A. Possess a current and valid Paramedic Licensure in California.

B. Disclose any ongoing investigations, licensure censures, or required performance improvement plans upon application.

C. Be affiliated with an approved paramedic provider agency in Santa Clara County.

D. Successfully complete training in local optional scope of practice and pediatric intubation, if not previously trained and tested in this skill.

Note: Verification of pediatric intubation competency by the EMS Program Manager is required during the application process.

To maintain continuous Paramedic Accreditation:

A. Submit a Paramedic Accreditation (Renewal) Application within five months before the expiration of the current accreditation, following the renewal of the California Paramedic License.
B. Successfully complete the annual EMS Update and any other required training as directed by the EMS Medical Director.
If a paramedic fails to complete required EMS Update training by the due date, they cannot work as a paramedic. However, with approval from their department/company and concurrence from the EMS Medical Director, their accreditation may be temporarily suspended for up to 60 days if they are not actively working as a paramedic (e.g., due to injuries or leave of absence). Failure to complete the EMS Update within 60 days will lead to loss of Paramedic Accreditation, necessitating reapplication to meet all policy requirements.

Loss of Accreditation may occur due to:

1. Failure to complete required training within specified timelines.
2. Withdrawal of sponsorship by an approved provider agency.
3. Loss or suspension of the California Paramedic License.
4. Determination by the EMS Medical Director regarding failure to meet local or system-wide EMS Quality Improvement Plan requirements.
5. Individuals must reapply for accreditation if it has been discontinued.

purpose: establish criteria for approval of qualified paramedic preceptors

Applicants for paramedic accreditation in Santa Clara County must meet the following requirements:
1. Hold current licensure in California as a physician, registered nurse, physician assistant, or be an accredited Santa Clara County Paramedic.

2. Be approved by an accredited paramedic training program.

3. Have affiliation with an approved Santa Clara County Advanced Life Support (ALS) Provider.

4. Possess at least two (2) years of field experience as a paramedic in prehospital care within the last five years.

5. Have no substantiated negative clinical or field-related incidents within the last two (2) years.

6. Successfully complete a paramedic preceptor training course approved by the Agency and provide documentation of course completion.

A.The Paramedic Preceptor's responsibilities include:
1. Direct supervision, instruction, and evaluation of the intern at all times.
2. Intervening if the intern's performance is deemed detrimental or substandard.
3. Documenting the intern's progress and informing the training program accordingly.

B. The Paramedic Preceptor must report any incidents involving the intern to relevant authorities.

C. Paramedic interns operate under the supervision of the County Medical Director and Program Medical Director, not licensed paramedics.

D. The presence of paramedic interns should not alter patient care

E. If a disagreement arises, the Preceptor and other accredited paramedics will determine patient care without the intern's involvement.

purpose: provide CA licensed RNs authorization to practice as a MICN w/in SCC

A. Hold a current California Registered Nurse license.

B. Be affiliated with an approved Santa Clara County Base Hospital.

C. Have at least one year of experience in an emergency department.

D. Complete an approved MICN training program and pass the Santa Clara County MICN Examination.

E. Pass a supervised pre-accreditation base hospital contact evaluation involving at least three advanced life support patient contacts.

F. Complete at least eight hours of ride-along time with ALS field units in Santa Clara County.


App Process:
To obtain Mobile Intensive Care Nurse (MICN) accreditation in Santa Clara County, the following steps must be taken:
A. Submit a completed application and all required documents to the EMS Agency.

B. Accreditation validity aligns with the applicant's California Nurse License period.

C. MICNs are limited to applying for accreditation a maximum of three times within a twelve-month period.

MICN accreditation in Santa Clara County remains continuous provided the MICN submits evidence every two years, including:
1. Valid California Registered Nurse license.

2. Affiliation with an approved Base Hospital.

3. Completion and maintenance of specified certifications (ACLS, PALS/APLS, TNCC).

4. Completion of eight hours of EMS-related continuing education or eight hours of ride-along time with ALS field units in Santa Clara County.

5. Successful completion of any additional required education or training mandated by the Agency.

If a MICN fails to submit evidence of meeting accreditation requirements before the end of the two-year period, local accreditation will lapse. To reinstate accreditation after a lapse, all required items must be provided again.

A. The EMS Medical Director has the authority to deny, suspend, revoke, or place on probation any accreditation for justifiable reasons.

B. Actions taken regarding accreditation are separate from any notifications made to the Board of Registered Nursing. However, the Base Hospital Coordinator will be promptly informed of any inquiries, complaints, or investigations.

purpose: to establish minimum qualifications for private ambulance EMS Field Supervisors in Santa Clara County to ensure consistent management of prehospital care operations. It does not prevent employers from imposing additional standards.

EMS Field Supervisors oversee EMS field operations for private emergency medical service providers and may be deployed by the EMS Agency for ICS positions and out-of-county deployments once meeting policy requirements.

1. Have at least three years of full-time field experience in a 911 system providing ALS care.

2. Hold accreditation as a Paramedic or credential as an EMT in Santa Clara County.

3. Demonstrate a thorough understanding and adherence to Santa Clara County EMS policies and protocols by passing the EMS Field Supervisor Examination with a minimum score of 85%.

4. Be appointed by their employer and complete a supervisor training program covering personnel management, conflict resolution, crisis management, CISM, and basic investigation skills.

5. Have no disciplinary actions against certification, accreditation, or licensure in the past 24 months.

6. Complete specific training requirements, including Santa Clara County EMS Policy 214 training, FEMA Incident Command System courses, National Response Framework, NIMS Resource Management, and Fundamentals of Emergency Management courses, before serving as an EMS Field Supervisor.

To maintain credentials as an EMS Field Supervisor, one must:
A. Attend a minimum of two Agency EMS Command and Control Quality Improvement Committee meetings per year.
B. Engage in at least eight hours of Agency-approved continuing education annually for EFS credentialing.
C. Take part in at least one EMS exercise during each credentialing period.

Credentialing:
A. upon successful completon of the requirements identified in this policy, credentialing will be issued by the Agency & will have the same expiration date as the applicant's EMT certification or paramedic accreditation

B. the credential is valid only when indidual is 'on-duty'

To maintain their credential, EMS Field Supervisors must:
1. Submit a renewal application at least five months before the current credential expires.
2. Fulfill continuing education requirements.
3. Pass the EMS Field Supervisor Examination with a score of at least 85% each credentialing period.

The credential may be discontinued for the following reasons:
1. Failure to fulfill continuing education requirements.
2. Withdrawal of sponsorship by an approved Santa Clara County provider agency.
3. Loss, suspension, or other disciplinary actions regarding the individual's State of California Paramedic Licensure or EMT Certification.
4. Loss, suspension, or other disciplinary actions regarding the individual's Santa Clara County accreditation.
5. The EMS Medical Director may take action for good cause, including denial, suspension, revocation, or probation of any local credential issued under this policy.

purpose: identify minimum qualifications for the ambulance strike team (AST) & medical task force leaders in thein the SCC & to promote consistency & competencey in the mgt of prehosp care operations in-county & when requested for mutual aid.

this policy does not preclude the mployer from requiring additional standards

Before serving as an AST and Medical Task Force Leader, an individual must meet the following requirements:
1. Have at least three (3) years of experience in providing emergency medical/prehospital care services.

2. Hold a credential as a Santa Clara County EMS Field Supervisor or EMS Duty Chief.

3. Maintain paramedic licensure/accreditation in good standing with the EMS Agency.

4. Have no pending disciplinary actions against accreditation, licensure, or employment.

5. Successfully complete an AST Leader course or its equivalent.

The AST and Medical Task Force Leader's responsibilities include:

1. Ensuring the safety and condition of the team and equipment.

2. Coordinating team movement to and from the incident.

3. Supervising team deployment at the incident as directed by the incident command system.

4. Familiarizing with team operations and directing assigned units.

5. Communicating problems encountered during the incident.

6. Ensuring vehicles have adequate communication capabilities.

7. Maintaining positive public relations.

8. Determining mission details before deployment.

9. Completing and submitting necessary ICS documents.

purpose: identify that SCC aproved EMS provider agencies shall have an EMS program manage who is resp for the clinical & operational aspects of their organization related to the provision of EMS in SCC EMS system

A. Making operational and financial commitments.

B. Coordinating EMS-related responsibilities within their organization.

C. Ensuring submission of necessary records and documentation to the EMS Agency.

D. Providing clinical information from the EMS Medical Director to organization personnel.

E. Assisting employees in obtaining and maintaining certifications and accreditations.

F. Participating or assigning members to EMS Agency Stakeholder meetings.

G. Facilitating EMS Agency required training for prehospital personnel in their organization, including (bnlt) the EMS sys update & policy change

H. Assisting the EMS Agency in investigating prehospital care personnel.

I. Ensuring continuous competency of prehospital personnel and implementing performance improvement plans as needed.

J. Supporting participation in EMS Agency Field Care Audits (FCAs) and system-wide continuing education programs.

K. Participating in functional drills/exercises between provider agency personnel and other stakeholders annually.

L. Serving as the liaison between the provider agency and the EMS Agency.

M. Developing and maintaining an EMS Quality Improvement Program (EQIP).

N. Establishing and managing a field oversight program for evaluating provider agency employees, including field observations and skills training programs.

1. Minimum of three (3) years field experience in emergency medical/prehospital care services.

2. Meet CE Program Director requirements, including Fire Instructor 1A and 1B or equivalent.

3. Currently certified as an Emergency Medical Technician in California or a California Licensed Paramedic.

4. Ideally, the individual should hold a supervisor or manager position within the provider agency.

5. All prehospital providers should appoint an alternate EMS Program Manager with the same authority and qualifications as the EMS Program Manager.

prupose: to specify the requirments that EMS providers shall adhere to in demonstrating competency for high risk, low frequency skills

a skill that is performed or applied on an infrequent basis & has the potentail to cause significant hamr to a patient, if performed incorrectly.

these skills are subject to change annually at the discretion of the EMS aagency Med Drct & in collaboration with the prehosp care sys quality improvement committee

A. Competency in high-risk, low-frequency skills demonstrated using mannequins and supervised by an approved proctor.

B. EMS agencies must establish a process for ALS personnel to demonstrate skill competency at intervals approved by the EMS Agency Medical Director.

C. Follow county protocols for high-risk, low-frequency skill exercises, using approved skill testing worksheets.

D. Track training records using county-approved spreadsheets or databases and submit annually to the EMS Agency by January 15.

E. Ensure adequate training equipment and supplies.

F. Medical director may adjust frequency of training based on clinical data and professional judgment.

purpose: this policy aims to set training standards for EMS personnel in Santa Clara County beyond basic EMT Certification or Paramedic Licensure/Accreditation.

It addresses the need for training to support incident command principles and responses to various emergencies, including hazardous materials incidents and terrorism.

Compliance with federal and state laws regarding minimum training requirements, such as NIMS, ICS, and Hazardous Materials First Responder Operations, is emphasized.

All EMS personnel must complete the following training before beginning field service & must attest to having possession of each course completion certificate:

1. Intro to ICS (ICS-100)

2. intro to the Standardized Emergency Mgt Sys (SEMS)

3. FEMA Independent Study course: National Incident Mgt Sys (NIMS): an intro (IS-700 b). *if you have successfully completed IS-700a, you may wat to review the new version of the course (for credentialing purposes, the courses are equivalent)

4. successfully pass the local sys orientation exam, completed 6 months prior to application with a min passing score of 85%

5. Hazardous Materials First REsponder Operatons (FRO) course

6. Weapons of MAss DEstruction Awareness (US DHS Course AWR-160 or equivalent)

The SCC EMS Agency may randomly audit records.

EMS personnel must retain verification of attendance & completion of all education listed in any policy.

Failure to submit documentation when audited may result in certification, accreditation, or other disciplinary action