About: EMS Agency Role and Authority

Authority and Medical Direction

Under California Health and Safety Code sections 1797.200–1797.220, the County designates a local EMS agency to plan, implement, and evaluate its EMS system. The EMS Agency exercises this authority through locally adopted policies, procedures, contracts, system plans, and medical standards.

The EMS Medical Director provides medical control over prehospital emergency care. This includes approving patient-treatment protocols, medical policies, medication and equipment standards, destination guidelines, and requirements for EMS personnel and provider organizations.

EMS System Planning and Administration

The Agency develops and maintains the County’s EMS system plan and coordinates the organizations responsible for receiving 9-1-1 calls, dispatching resources, providing care, transporting patients, and receiving patients at hospitals.

System planning includes evaluating service needs, coordinating resources, administering agreements, establishing operational requirements, and ensuring that providers comply with applicable laws, regulations, policies, contracts, and performance standards. The Agency also works with local and regional partners to address emerging healthcare needs and improve access to emergency care.

9-1-1 Access, Dispatch, and Communications

The Agency establishes medical-dispatch and communications standards that help ensure emergency calls are appropriately prioritized and the necessary resources are sent. This includes coordination among public-safety answering points, fire and ambulance dispatch centers, field personnel, hospitals, and other system partners.

Communications policies support the exchange of information from the initial 9-1-1 call through patient treatment, transportation, hospital notification, and transfer of care.

First Response and Ambulance Transportation

Fire departments, ambulance providers, and other authorized agencies provide field response and transportation services under the Agency’s policies and medical direction. The Agency establishes requirements for ambulance operations, response performance, clinical capabilities, staffing, equipment, patient transportation, and hospital destinations.

The Agency also monitors the performance of contracted and permitted providers and coordinates ambulance resources during periods of high demand, major incidents, and disasters.

EMS Personnel, Certification, and Training

The Agency certifies and renews emergency medical technicians and accredits paramedics to practice within San Mateo County. It also establishes local orientation, training, continuing-education, and competency requirements where authorized by law.

The Agency monitors compliance with certification, accreditation, clinical-performance, and professional-conduct standards. It works with training programs, provider agencies, medical directors, and other partners to maintain a qualified and prepared EMS workforce.

Hospitals and Specialty Systems of Care

The Agency coordinates with receiving hospitals to support the timely transfer of patients from field personnel to hospital care. It establishes patient-destination policies based on clinical need, hospital capability, system conditions, and the availability of specialized services.

The Agency also coordinates specialty systems of care for patients with time-sensitive conditions, including trauma, stroke, heart attack, and pediatric emergencies. These systems are designed to identify serious conditions early, begin appropriate treatment in the field, notify the receiving hospital, and transport the patient to an appropriate facility.

Data, Performance Monitoring, and Quality Improvement

The Agency collects and analyzes EMS data to evaluate clinical care, response performance, patient transportation, hospital destinations, ambulance patient offload times, and patient outcomes. This information helps identify trends, measure compliance, and guide improvements throughout the system.

Continuous quality improvement may include case review, clinical audits, performance reporting, provider feedback, protocol evaluation, and corrective-action planning. The goal is to improve patient safety, clinical effectiveness, operational reliability, and accountability.

Public Information and Community Programs

The Agency provides information to patients, healthcare professionals, EMS personnel, and the public about the EMS system and available services. It also supports community programs related to emergency recognition, injury prevention, public-access defibrillation, naloxone, and other initiatives that can improve survival and reduce preventable harm.

Patients, providers, and members of the public may submit questions, concerns, compliments, or feedback regarding the EMS system. The Agency reviews these matters as part of its regulatory and quality-improvement responsibilities.

Emergency Preparedness and Disaster Medical Response

The EMS Agency has a central role in coordinating medical and health emergency preparedness. Through the Medical Health Operational Area Coordinator (MHOAC) Program, Health Care Coalition, Medical Reserve Corps, and other partnerships, the Agency helps prepare the County’s healthcare system for emergencies and disasters.

During an incident, responsibilities may include coordinating hospitals and healthcare organizations, requesting medical resources, supporting patient distribution and medical transportation, obtaining mutual aid, sharing situational information, and coordinating with public health, emergency management, and regional and state agencies.

Through medical direction, regulation, planning, coordination, and performance oversight, the San Mateo County EMS Agency works to ensure that patients receive timely, safe, effective, and coordinated emergency care—from the initial 9-1-1 call through arrival at the most appropriate healthcare facility.