An overview

Many certified EMTs have expressed concerns and doubts about the Professional Standards Enforcement Process utilized by the Health Services's Emergency Medical Services & Systems Section in carrying out its statutory duties. Those concerns and doubts, when examined, appear in large part to have their basis in a lack of information about the people, the process, and the safeguards built in for the protection of all parties involved in the process.

LEGAL AUTHORITY FOR THE PROCESS

The Legislature has provided certain protections to the public. Entry level competence is the aim of the certification testing and recertification processes. The quality of care provided by an EMT is the responsibility of an authorized medical director. By delegating to the Health Services the authority to establish minimum standards for certification and recertification, the Legislature has attempted to make sure that responding EMTs possess the necessary skills and knowledge to carry out their duties.

SOURCES OF INFORMATION

			ORS 162.075 (Falsification of a sworn document)
			ORS 682.135 & ORS 682.991 (Procuring certification by fraud or deception)
			ORS 682.175 (Confidentiality of information, denial/suspension or revocation of license)
			ORS 676.160 to 676.180 (complaints against health professionals; processing, confidentiality)
			OAR 333-265-140 (Maintaining EMT Continuing Education Records)
			OAR 333-265-150 (EMT Continuing Education Records Audit)
			OAR 333-265-160 (Responsibility to Notify the Division)

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Complaints and Allegations

Where a certified EMT engages in misconduct, this information may be reported to Health Services by co-workers, medical director, receiving hospitals, or members of the general public. Information is received by telephone, in person, or in writing.

EMTs, and others, are obligated to report occurrences of these types to Health Services.

ORS 682.175(4) requires the reporting, by EMTs, ambulance operators, medical director, hospital personnel, etc., of information which appears to show that an EMT is incompetent, guilty of unprofessional or dishonorable conduct, or may be incapable of safely performing the duties of an EMT.

EMTs should be aware that reports to Health Services are capable of beginning a very powerful process. Accordingly, EMTs should attempt to resolve problems first through internal organizational mechanisms, with the involvement of the medical director if necessary, prior to initiating a report to Health Services. A disturbing number of complaints arise from unhappy co-workers, vindictive spouses and political opponents, in an effort to inconvenience, discredit, or otherwise injure an EMT. EMTs are constantly in the public eye, and should remember that when they engage in conduct which may give rise to public concern.


ORS 682.175(6) provides protection to individuals who report actual or suspected EMT misconduct, so long as the report is made without malice. Where baseless allegations are made with malice, these protections will not apply, and the person making a malicious report may be liable in civil damages to the EMT accused.

Health Services is diligent in its attempts to distinguish legitimate complaints from those lodged based on a personal vendetta or other improper reason. Although a number of complaints have been received from untrustworthy reporters, Health Services' investigators make every effort to screen and resolve complaints of this nature as quickly as possible. An EMT who makes a knowingly false or malicious report to Health Services may be subject to discipline for unprofessional conduct.


The investigative process begins when information is received by the Health Services, from whatever source, which if true would be evidence that:

• a real and present threat to the public health and safety exists; or
• an individual has violated EMS statutes or administrative rules; or
• an individual is disqualified from holding EMT certification at one or all levels.

Health Services will investigate all allegations of wrongdoing, regardless of the source. However, where the credibility of the information is suspect, investigative staff will conduct a preliminary investigation to establish the foundation for a decision to pursue or not to pursue further investigation.

A complaint, allegation of wrongdoing, or other information need not be in writing for Health Services to take action based on it. However, where possible, Health Services endeavors to have complainants place their statements in writing, in order to establish a firm starting point for an investigation.

Certification and Recertification Documents

Certification and recertification applications contain questions about potential statutory disqualifiers. EMTs are obligated, under penalty of perjury, to provide truthful answers to the questions asked. The fact that an EMT answers "yes" to a question about disqualifiers does not mean that an EMT will not be certified. It simply means that further discussion between Health Services and the applicant is indicated.

A Word About Continuing Education Documentation

The area of continuing education (CE) documentation has proved to be particularly troublesome for some EMTs. The Division considers the submission of false, incomplete or altered CE documentation to be a very serious matter, and will move to discipline (as untrustworthy or professionally not qualified) an EMT who submits falsified CE documentation. More information can be found at *OAR 333-265-140 (Maintaining EMT Continuing Education Records).

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Investigations

ORS 682.175(3) provides Health Services with the authority to conduct investigations of the fitness of individuals to hold EMT certification, and of any allegations of wrongdoing (incompetence, violation of statutes or regulations, etc.) by EMTs. Investigations are conducted by assigned staff members of Health Services, who are trained and certified to carry out these duties.

Pre-certification Investigations: Where an individual answers affirmatively with respect to one or more questions dealing with disqualifying factors, Health Services will conduct a preliminary investigation into the matter. This may include, but is not limited to, written or telephone contact with the applicant to ascertain whether in fact a problem presently exists or has already been resolved.

Full Background Investigations Health Services will evaluate information received to determine if that information, if true, would establish the existence of a threat to public health and safety, that an EMS statute or administrative rule has been violated, or that an individual is disqualified from holding certification.

If the answer to one of these questions is YES, Health Services' investigative staff will conduct a complete investigation of the allegations. Please note that the decision to further investigate does not mean that Health Services believes an EMT to be "guilty" of some violation. At this stage, the Health Services posture remains, "if the allegation is true, then further action is required." The investigation will determine whether or not the allegation is or is not true.

If the answer to all of these questions are NO, Health Services will decline to pursue the matter, close the investigative file. If the decision is that further investigation is warranted, Health Services' investigators will conduct an appropriate investigation. Any other violations discovered in the course of the investigation will be pursued and will be included in the final determination of action to be taken.

Other Investigations: Where complaints of wrongdoing, violations, etc., are received by Health Services, or where wrongdoing is uncovered in the ordinary course of business, Health Services will conduct an appropriate level of investigation.

Probation The process is not as rigid as the above description may suggest. Health Services is vested by the Legislature with broad discretion to act in the public interest. Health Services attempts to exercise this judgment with a high degree of compassion for the individual EMT.

Health Services may also choose to permit an EMT who is subject to discipline to enter into a probationary agreement in lieu of other disciplinary measures. Where an EMT admits the facts of a complaint which might subject him or her to suspension, revocation, or denial of certification, and Health Services determines that the interests of the public are better served by permitting the EMT to continue to function under heightened supervision, Health Servicesmay offer this alternative.

Enforcement of Terms of Probation Once probation is imposed, Health Services is responsible for monitoring the EMT's compliance with the terms and provisions of probation. Monitoring may include unannounced urinalysis (where the EMT has a recent history of involvement with unlawful drugs), appearances before the Subcommittee on EMT Certification and Discipline, close scrutiny by the EMT's supervising physician, or other measures.

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