1797.195
. (a) Notwithstanding any other provision of law to the
contrary, an EMT-I, EMT-II, or EMT-P may provide emergency medical
care pursuant to this section in the emergency department of a
hospital that meets the definition of small and rural hospital
pursuant to Section 1188.855, except that in the case of a hospital
meeting the definition contained in Section 1188.855 the population
of the incorporated place or census designated place where the
hospital is located shall not have increased to more than 20,000
since 1980, and all of the following conditions are met:
(1) The EMT-I, EMT-II, or EMT-P is on duty as a prehospital
emergency medical care provider.
(2) The EMT-I, EMT-II, or EMT-P shall function under direct
supervision as defined in hospital protocols that have been issued
pursuant to paragraph (3), and only where the physician and surgeon
or the registered nurse determines that the emergency department is
faced with a patient crisis, and that the services of the EMT-I,
EMT-II, or EMT-P are necessary to temporarily meet the health care
needs of the patients in the emergency department.
(3) The utilization of an EMT-I, EMT-II, or EMT-P in the emergency
department is done pursuant to hospital protocols that have been
developed by the hospital's nursing staff, the physician and surgeon
medical director of the emergency department, and the administration
of the hospital, with the approval of the medical staff, and that
shall include at least all of the following:
(A) A requirement that the EMT-I, EMT-II, or EMT-P successfully
complete a hospital training program on the protocols and procedures
of the hospital emergency department. The program shall include, but
not be limited to, features of the protocols for which the EMT-I,
EMT-II, or EMT-P has not previously received training and a
postprogram evaluation.
(B) A requirement that the EMT-I, EMT-II, or EMT-P annually
demonstrates and documents to the hospital competency in the
emergency department procedures.
(C) The emergency medical care to be provided in the emergency
department by the EMT-I, EMT-II, or EMT-P shall be set forth or
referenced in the protocols and shall be limited to that which is
otherwise authorized by their certification or licensure as defined
in statute or regulation. The protocols shall not include patient
assessment in this setting, except when the assessment is directly
related to the specific task the EMT-I, EMT-II, and EMT-P is
performing.
(D) A process for continuity of patient care when the EMT-I,
EMT-II, or EMT-P is called to an off-site emergency situation.
(E) Procedures for the supervision of the EMT-I, EMT-II, or EMT-P.
(4) The protocols for utilization of an EMT-I, EMT-II, or EMT-P in
the emergency department are developed in consultation with the
medical director of the local EMS agency and the emergency medical
care committee, if a committee has been formed.
(5) A written contract shall be in effect relative to the services
provided pursuant to this section, between the ambulance company and
the hospital, where the EMT-I, EMT-II, or EMT-P is employed by an
ambulance company that is not owned by the hospital.
(b) When services of emergency personnel are called upon pursuant
to this section, responsibility for the medical direction of the
EMT-I, EMT-II, or EMT-P rests with the hospital, pursuant to the
hospital protocols as set forth in paragraph (3) of subdivision (a).
(c) Although this section authorizes the provision of services in
an emergency department of certain small and rural hospitals, nothing
in this section is intended to expand or restrict the types of
services or care to be provided by EMT-I, EMT-II, or EMT-P pursuant
to this article.