Like any other medical professional, you owe a given standard of care towards your patients as a paramedic. Violating this standard may harm your career. Any complaint against you is taken very seriously since it implies you had put a life in danger.
If you have been accused of professional misconduct, you will have to go through a disciplinary process to determine whether the allegations are true. And like in the criminal process, paramedics, too, face the consequences if it is determined that they have committed a violation, only that here they face disciplinary action and not punishment.
The Disciplinary Process in Detail
In California, paramedic licenses are regulated by the EMSA (Emergency Medical Services Authority). The EMSA has strict policies concerning the disciplining of paramedics or those seeking to be one. The disciplinary guidelines are found under the California HSC (Health & Safety Code). HSC 1798.200 sets forth the professional misconducts that lead to a paramedic facing disciplinary action, including:
- Fraud
- Incompetence
- Gross negligence
- Repeated negligence acts
- Conviction of an offense such as DUI, vandalism, domestic violence, theft, etc
- Drug or alcohol addiction
- Unprofessional behavior indicated by any of these:
- Physically abusing or mistreating any patient resulting from the use of excessive force of what a sensible paramedic would do given the same circumstances (using reasonable force to help a peace officer make an arrest isn’t prohibited)
- Committing a sexual offense under PC 290
- Failing to maintain the confidentiality of a patient’s medical info unless if the disclosure is required or allowed by law
- Demonstrating irrational conduct or developing a physical disability to the point that a prudent person would have reasonable cause to believe your capability of performing the expected duties might be impaired
- Performing outside the approved scope of practice
- Violating state or federal regulation or law on narcotics, controlled substances, or dangerous drugs
If this agency believes you’re guilty of any of the above misconduct, it will likely take disciplinary action against you. They include paramedic license suspension/revocation, denial of a license, probation, etc. Even EMSA placing you on probation is serious since the probation comes with strict terms and conditions that’ll significantly dampen your job prospects.
Luckily, before the EMSA permanently imposes its disciplinary action, you must be given a chance to challenge the proposed disciplinary action. This process is intricate, and you want to have a skilled professional license defense lawyer by your side helping you handle it.
For instance, the process starts with investigation or the EMSA issuing you with a formal complaint (a Statement or Accusation), which you, preferably through your lawyer, have to respond to as quickly as possible in the form of a Notice of Defense.
After that, your case is scheduled for an administrative hearing at one of California’s administrative hearings offices located in Los Angeles, San Diego, Sacramento, and Oakland. An administrative hearing is an intricate legal proceeding that involves discovery, witness testimony, unique rules of evidence outlined under the California Administrative Procedures Act, and subpoenas.
1. Complaints or Criminal Charge Against You
The disciplinary process kicks off by a person filing a complaint against you to EMSA. Any complaint against a paramedic is filed using a Paramedic Investigation Request Form. Anyone can file a complaint against you, including your co-worker, insurer, employer, physician, patient, nurse, family member, etc. The agency will inform you once the complaint is made.
Even though the Paramedic Request Form requires that you certify that the info in it is true, complete, and correct to the best of your knowledge, there’s no requirement that you sign it under penalty of perjury. The information the form contains is transmitted to the chief investigator in the EMSA Enforcement unit, then entrusted to an investigator for follow-up.
2. Investigations and Interviews
It is only understandable that you will start panicking right after you’re notified that a person has brought an accusation against you. Some paramedics won’t do anything to defend themselves against the allegations. They instead leave the agency to make their decision, sure that it is the end of their career.
This is far from the truth. The fact of the matter is that not every complaint filed with the EMSA is career-ending. After a complaint has been filed, the agency will investigate to establish whether it meets the agency’s jurisdiction requirement and whether you deserve to face disciplinary action. It could send investigators to your place of work to assess how you do our duties. The investigators might also exhaustively interrogate the complainant and your employers.
They may also question you regarding the supposed violation. Please don’t respond to these questions without consulting an experienced license defense lawyer. If possible, you can have your attorney by your side during questioning. If the agency requests a written response from you, reach out to your attorney to help you avoid self-incrimination.
The investigation aims at finding out whether the complaint filed against you is true or not. At times, there might be little proof to substantiate you were unethical in your duties. In this case, the EMSA won’t continue with the disciplinary process. Should you retain an expert professional license defense lawyer much earlier, they might stop the investigation process altogether by persuading the EMSA that the complaint against you is unfounded.
3. Formal Complaint (Statement of Issues or Accusation)
At times there’s no investigation against you. The very first time to learn that the EMSA is taking disciplinary action against you is when it sends a notice known as a Statement of Issues or Accusation in your mail. You have to respond to the Accusation within ten days of receiving it should you wish to challenge the EMSA’s disciplinary decision. You respond to it by filing a Notice of Defense. Failure to do so on time will likely lead to the EMSA imposing disciplinary action without notifying you further, and you may lose your legal right to appeal the decision. But if you do, the EMSA has to allow you to undergo a hearing, which is presided over by an Administrative Law Judge (ALJ).
4. Administrative Hearing
As we mentioned, the administrative hearing takes place at the Office of Administrative Hearing (OAH). Usually, the accused paramedic receives a notice inviting them to attend the hearing. Here, the plaintiff will present their case before the hearing officer. After which, you’ll be given a chance to defend yourself. You have various legal rights at this stage. For instance, you have the right to:
- Request access to discovery— If the EMSA has kicked off disciplinary proceedings against you, you are entitled to discovery. Discovery refers to all the reports, information, documents, witness statements, and investigations that the agency gathered to use against you. You have to ask for it within the stipulated time limits. In case the agency doesn’t avail the discovery to you after requesting it, you could bring a motion to the ALJ compelling them to do so.
- Request subpoenas— you are entitled to request the ALJ to subpoena all the records and witnesses during the hearing. The subpoena form and instructions for submitting it to the ALJ for signature are available on the OAH website.
- Prepare well for the case— you’ll also be allowed to prepare the witnesses who will testify against you and all the proof you will present during the hearing. You ought to present the evidence concisely, thoroughly, and in a well-organized manner. You have to come with copies of the evidence you plan to present to give to the ALJ and the EMSA.
This is a formal hearing conducted in a courtroom set up before an ALJ. Whereas the usual rules of evidence and court rules apply, they’re a bit relaxed. You need to be prepared to make objections and respond to questions, the proper process for offering evidence and testimony, and general court procedures. The EMSA has to prove by clear, convincing proof that you did violate the HSC.
After all the arguments have been presented, the ALJ determines whether you indeed committed the supposed violation. If they are convinced that you did, they will impose disciplinary action. The various disciplinary action you could face include:
A Citation Accompanied by a Fine
Based on the nature of your violation and facts surrounding the case, the fine ranges anywhere between $250 and $2,500. You have to pay it within sixty days of the EMSA’s notice of the fine being imposed. But your lawyer may be able to negotiate so that you can take up to a year to make the payment. They can do this by presenting proof of your financial hardship, if applicable.
A citation goes on the EMSA website’s public record, which means prospective employers can view it. Therefore, you want to challenge it even if it is the lowest form of disciplinary action.
Probation for You and Your License
If you are on probation, your career will depend on 100% understanding and compliance will all probationary conditions the agency imposes. Your attorney can negotiate the probationary terms and conditions if they are harsh. They can work to lower them to more lenient ones. Additionally, if you don’t know what the agency requires of you as far as probation terms are concerned and what will happen if you violate them, you want to consult with your attorney. Your lawyer may also be able to reduce the probation period.
A Revocation, Suspension, or Denial of Your Paramedic License
License revocation, suspension, or denial is the severest disciplinary action the EMSA can impose. However, even here, your attorney can challenge the suspension period and have it reduced if it cannot be prevented altogether. If the suspension period ends, your lawyer can walk you through the reinstatement process.
If the accusation against you involves drug or alcohol abuse, license suspension can be stayed pending your completion of an approved alcohol or drug program. After which, the license will be placed on probation for three to five years. This may not be the best course of action, but it’s better than completely losing the license.
No Disciplinary Action Taken
If the ALJ rules that there’s no sufficient evidence to support the allegations against you, you won’t face any disciplinary action. You’ll receive an email or letter of ‘no action imposed; from your employer. But the EMSA medical director might choose to send you a warning due to complaints on your professional misconduct while in your line of duty. Receiving a warning isn’t bad, but it could be an aggravating factor when the EMSA seeks to suspend or revoke your license in the future should there be another similar accusation. The EMSA medical director might opt to issue a warning when:
- There’s insufficient evidence to substantiate the supposed unprofessional conduct allegations.
- The proposed evidence or disciplinary action was approved, but you didn’t require to face any disciplinary action at the time.
Guidelines for Probation, Revocation, Suspension, or Denial
The EMSA has guidelines for disciplinary action, including factors it considers before imposing a given disciplinary action. These factors are:
- Severity and nature of the professional misconduct or criminal offense,
- Potential or actual harm to the public,
- Previous disciplinary record,
- Possible or actual harm to patients,
- Prior remediation and warnings,
- Aggravating evidence,
- Variety or number of present violations,
- Proof of rehabilitation,
- Mitigating factors,
- General criminal record,
- Adherence to terms and conditions of probation and criminal sentencing,
- Any expungement proceedings per PC 1203.4, and
- The elapsed period since the commission of the criminal offense or professional misconduct
The guidelines also outline standard disciplinary action for given crimes or professional misconduct and probationary terms and conditions. The EMSA also has separate guidelines for denial of a paramedic license.
Per the Administrative Procedure Act, the ALJ has to give his/her propose disciplinary action within 30 days after the hearing. He/she relies on the EMSA’s decisions and guidelines before making his/her final decision concerning the allegations against you. The EMSA serves the ultimate proposed disciplinary action plan to you while considering the mitigating factors your attorney raised. Based on the evidence the lawyer presents, the EMSA’S medial director may opt to:
- Reduce or mitigate the originally-proposed disciplinary action plan
- Direct that your license be reinstated entirely
- Make technical or minor alterations to the initially-proposed disciplinary action plan before adopting the ALJ’s decision.
- Reject the ALJ’s proposed decision on the grounds of lack of sufficient proof and order that additional evidence be added to the case
The EMSA medical director has up to 100 days to make the ultimate decision concerning your petition. His/her final decision becomes public as soon as he/she makes it, and both you and your lawyer will be issued with a copy of the decision through certified means like a letter or email. The medical director’s ultimate decision then becomes effective after 30 days from the date you and your lawyer receive a copy of it.
5. Appealing the Disciplinary Action Against You
If you lose at the hearing stage and are not content with the outcome, you might want to exhaust all avenues to seek justice. The one step you can take is appealing the ALJ/EMSA’s decision to impose disciplinary action against you in the Superior Court of California by filing a Writ of Mandamus. Your attorney can help you file this appeal within thirty days from the date the disciplinary action was imposed.
The Writ of Mandamus is used to contest the administrative hearing outcome, particularly if there were omissions/errors the EMSA or ALJ made. If you don’t obtain a favorable outcome at this stage, your lawyer can proceed to the California Court of Appeals and appeal the superior court’s decision. You could also move to the Supreme Court of California if you aren’t satisfied with the court of appeal’s decision.
6. Petition for Penalty Relief
If you end up unsatisfied after exhausting all avenues of appeal, you could file a petition seeking penalty relief, including license reinstatement. Your lawyer can help petition the Medical Board of California (MBC) to reinstate an already suspended or revoked paramedic license, punishment reduction, and early termination of the imposed probation period.
Contact a Paramedic License Defense Attorney Near Me
Undoubtedly, violating the EMSA policies or being convicted of an offense poses a significant risk to your career as a licensed paramedic. Some charges or allegations could arise unintentionally and unconsciously while in the line of duty. The EMSA’s notice about the allegations, weighty nature of the facts surrounding the supposed unprofessional behavior, and the disciplinary process you will have to undergo shouldn’t worry you if you have a skilled professional license defense lawyer by your side.
At the Legal Guardian, we have handled the paramedic disciplinary process with tremendous success for our clients facing charges in Long Beach, California. For several years, we have acted as counsel for dozens of paramedics in procedures like this. If you’re a licensed paramedic or seeking to acquire your paramedic license, and the EMSA wants to take disciplinary action against you, contact us right away at 888-293-0396 for a cost-free consultation. Your career may depend on it.
