The Coastal Valleys EMS Agency (CVEMSA) operates under the statutory authority established in Division 2.5 of the California Health and Safety Code, and Title 22, Division 9 of the California Code of Regulations. Local regulation of the EMS system is effected through the County Emergency and Pre-Hospital Medical Services System Ordinances, and EMS Agency policies and procedures. By contract, Sonoma County also functions as the local EMS Agency for Mendocino County.
System Organization and Management
The California Health and Safety Code requires that each county which develops an emergency medical services program must designate a local EMS agency. Consistent with that requirement, the Coastal CVEMSA has been designated as the Local Emergency Medical Services Agency (LEMSA) for Sonoma and Mendocino Counties. The EMS Agency provides the administrative and regulatory oversight responsibilities for the local EMS system within each of these counties. The primary function of the EMS Agency is to plan, implement, and evaluate the local EMS system and the various components contained within it. This includes the licensing/permitting of ambulance provider companies, hospitals, coordination and monitoring of air and ground ambulances, certification/accreditation of pre-hospital care personnel (Emergency Medical Technicians (EMT), paramedics), policy development and implementation, medical control, quality improvement, and disaster medical response preparedness.
EMS Agency Staff
The Regional EMS Administrator is responsible for the overall operation and function of the Agency. EMS Coordinators are responsible for the operational components of each County's portion of the EMS system including oversight and review of the ambulance providers, special projects, region wide disaster medical preparedness, communications-dispatch oversight, Quality Improvement (QI)/data system, training, AED program, medical control oversight, and oversight of designated Trauma Centers. In addition to County personnel, the EMS Agency contracts with an emergency physician to function as EMS Medical Director for the regional EMS system.
Sonoma - Santa Rosa Office
195 Concourse Blvd, Suite. B
Santa Rosa, CA 95403
(707) 565-6501 office
(707) 565-6510 fax
Staffing and Training
Consistent with the California Health and Safety Code, the local EMS Agency is responsible for the approval of local EMS training programs provided by institutions and departments.
Santa Rosa Junior College, Mendocino Office of Education Regional Occupation Program (ROP) and Mendocino College are authorized by the EMS Agency to conduct basic Emergency Medical Technician (EMT) level courses. Paramedic level training is available through Santa Rosa Junior College. There are over 400 Paramedics currently licensed and accredited to practice in the Coastal Valleys EMS system.
The dispatching of Sonoma County EMS ambulance providers is coordinated through REDCOM, a Joint Powers Authority (JPA) which operates the Sonoma County EMS Dispatch Center. REDCOM provides Emergency Medical Dispatch and pre-arrival instructions to all of the County's Public Safety Answering Points (PSAP) and dispatching of field resources services to most of the ambulance providers within Sonoma County. Within Mendocino County, Cal Fire provides the primary EMS dispatch services. On-line medical direction and communications for EMS personnel in Sonoma County is provided by Santa Rosa Memorial Hospital as an approved base hospital. Three base hospitals (Ukiah Medical Center, Howard Memorial Hospital and Mendocino Coast District Hospital) provide on-line medical control in Mendocino County. All base hospitals utilize emergency room physicians for these purposes.
Disaster Medical Preparedness
All EMS Agency staff and local EMS personnel are trained in the Standardized Emergency Management System (SEMS), Incident Command System (ICS), and the National Incident Management System (NIMS) as required by law. During times of disaster, EMS Agency staff members fill a variety of positions within the respective County Emergency Operations Center (EOC) and Health Departmental Operations Center (DOC). The EMS Multi-Casualty Incident (MCI) plan is used for multi-patient incidents and disasters to coordinate prehospital care provider agencies, hospitals, the Office of Emergency Services (OES), law enforcement agencies, Cal Fire, state and county parks and recreational departments, and other emergency response organizations. Periodic drills and exercises are conducted to revise and improve this system.
At present there are 18 ambulance providers (2 air & 16 ground) and over 75 first responder agencies providing EMS services in Coastal Valleys region.
In Sonoma County all 911 ambulances any many urban fire response units are staffed at an advanced life support (ALS) level while most rural first responder services are at the basic life support (BLS) level. Nine ground ambulance provider agencies and two helicopter providers (1 air ambulance & 1 ALS Rescue) provide emergency medical transportation in Sonoma County. In July 1999, Sonoma County entered into an exclusive franchise contract with Sonoma Life Support (SLS) to provide emergency ambulance and advanced life support services to a specified portion of the county. A mix of fire department based and private ambulance providers service the remainder of the County.
Within Mendocino County, five of the ambulance services are ALS - paramedic level (4 ground and 1 EMS Air Ambulance helicopter), and three are BLS -EMT level providers (3 ground). The Ukiah Valley Fire Authority provides paramedic level first response to the county's largest urban area. All other first responder services are at a BLS level.
Oversight of the providers is provided by EMS Agency staff. The EMS Agency on a monthly basis reviews operational performance, including response times. While non-franchise providers are not obligated to the strict performance standards applied to franchisees, medical care and overall performance of these providers is monitored through the existing EMS quality improvement program.
Data Collection and Evaluation
In addition to the franchise provider's performance reports, other data regarding EMS system activity is gathered from pre-hospital care reports (PCRs) prepared by ambulance personnel for every EMS response. Information is gathered via a computerized, networked data collection system that routes and retrieves essential data which is reviewed by the Clinical Services Coordinator, Medical Director, and CQI Committees.
Public Information and Education
The EMS Agency participates in many Public Information and Education activities including CPR and AED advocacy and training through the Save Lives Sonoma and Save Lives Mendocino collaborative projects.
Hospitals and Specialty Care Centers
Hospital based emergency services are available through six Sonoma County hospitals and three Mendocino County hospitals. The EMS Agency gathers information from these hospitals to identify the specific services and level of care offered. This information is utilized to review destination policies and the EMS Point-Of-Entry plan that guide the distribution of patients within the EMS system.
Santa Rosa Memorial Hospital has been designated as a Level II trauma center (on site specialists). Pediatric trauma patients are flown to Children's Hospital of Oakland (a pediatric trauma center). Sutter Medical Center of Santa Rosa and Santa Rosa Memorial Hospital have been designated as the region's cardiac specialty care centers. All CVEMSA Regional hospital partners are committed to providing rapid Stroke care through on-site specialists or telemedicine assisted intervention. Ukiah Valley Medical Center in Mendocino County has achieved a Level `IV Trauma Center designation, highlighting the ongoing effort to improve systems of trauma care across the region.
Committees and Advisory Boards
The Agency Director answers to a Regional Advisory Committee comprised of the Health Services Directors and Health Officers from each of the member counties. The EMS Agency also uses the Emergency Medical Care Committee (EMCC) in each member county as respective representative advisory committees. These committees have been created under the authority of Health and Safety Code Section 1797.270. Membership is established and appointed by the respective Boards of Supervisors. The primary responsibility of the committees is to act in an advisory capacity to the EMS Agency and the respective Boards of Supervisors. The committees focus on review of ambulance operations, dispatch, trauma system development, CPR/First Aid training for the public and training and education issues for field personnel. Sub-committees operating under the authority of the EMCC are used to review specific areas of the EMS system operation. Information regarding meeting dates and locations of these committees can be obtained from the EMS Agency regional office in Santa Rosa or the respective county offices in Mendocino.