Inter-Departmental Correspondence

Health System



September 24, 2010


October 19, 2010







Honorable Board of Supervisors



Jean S. Fraser, Chief, Health System


Brian J. Zamora, Director, Community Health



Emergency Medical Technician Certification Fee



Adopt an Ordinance to set the San Mateo County Emergency Medical Services’ portion of the fee for Emergency Medical Technician-I certification and re-certification to $50 effective November 18, 2010.



The current County Emergency Medical Technician-I (EMT-I) certification and re-certification fee is $30, which has not been increased since 1998. In 2008 Governor Arnold Schwarzenegger signed Assembly Bill 2917, which amended Health and Safety Code, Division 2.5 to reform emergency medical services in California by increasing accountability and oversight. The bill required the Emergency Medical Services Authority to develop statewide regulations to standardize certification, re-certification, disciplinary orders, and conditions of probation for EMT-I applicants with the cost of administering such activities falling to the Local Emergency Medical Services Agencies (LEMSA) such as San Mateo County Emergency Medical Services (EMS).


Assembly Bill 2917 also authorizes the State to charge the applicant a fee sufficient to cover their operational costs, and Health and Safety Code, 1797.217 and Title 22 California Code of Regulations 100083 authorizes a LEMSA to charge an additional fee to cover the reasonable cost of administering the EMT-I certification process. The State has set their fee at $75 per certification and $37 per re-certification, effective July 1, 2010.



To cover the cost of current salary/benefit costs and other administrative expenses associated with the new regulations, EMS is requesting an increase of $20 per application. The new County fee will be $50 for both certification and re-certification. With the new State fees and increased County fee, the total fees for initial EMT-I certification will be $125, and $87 for re-certification.


The County will collect the State’s fee and transmit it to the State. The State’s portion is established through State regulation and is subject to change as State regulations are amended. It is anticipated that the State will continue to pass on increased operational costs created by new legislation related to EMT-I oversight to the LEMSAs.


EMS conducted a fee survey of other counties of similar size and location. A comparison of the proposed County fees with other Bay Area counties revealed that the proposed new fee is close to the Bay Area average.


County Counsel has reviewed and approved the ordinance as to form. All public notification requirements have been met.


This San Mateo County EMT-I fee increase contributes to the Shared Vision 2025 outcome of a Healthy Community by providing for EMT-I certification in compliance with State regulations. It is anticipated that 75% of patients with extremity injuries will report pain relief after paramedic intervention.


Performance Measure:


FY 2009-10

FY 2010-11

Percent of patients with extremity injuries reporting pain relief after paramedic intervention



* In fiscal year 2009-10 there was an increase focus on pain management in medic trainings. The long term effects of the training are uncertain.



The proposed changes to the EMT-I certification and re-certification are expected to generate new revenue of approximately $3,900. This increase was anticipated and included in the Community Health FY 2010-2011 Adopted Budget. There is no Net County Cost associated with this action.