San Diego County Emergency Medical Services Office
All-Hazard Health Services Capacity Management Plan - Level 5 (Baseline Surveillance)
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All-Hazard Health Services Capacity Management Plan - System Stress Tools
Below are system stress tools that are used based on the All-Hazard Health Services Capacity Management Plan Level.
- Active System Stress Tools
- 4:1 Patient to EMS Professional Ratio at EDs
- Ambulance Strike Team
- Agencies and hospitals may request ASTs, or other resources, through the MHOAC at their expense
- EMS Transfer to ED Waiting Area Option
- Deactivated System Stress Tools
- 9-1-1 Response Mode Alteration
- Abbreviated Radio Report Option
- Assess and Refer Option
- DoD Beneficiary Destination Directive
- EMS Treatment Considerations
- Non-Patient Passenger Restrictions
- EMT Transport Option Following On Scene Paramedic Treatment
- Patient Masking Recommendation
- Health Services Capacity Task Force Plan Level Staffing Augmentation
- County-contracted Ambulance Operational Areas within HSCTF Plan Level staffing augmentation should contact their County Contracting Officer's Representative (COR)
- Active System Stress Tools
Latest News
Recognizing EMS Week 2025
May 19, 2025, 8:00 AM PST
2025 marks the 51st anniversary of EMS Week. This year's theme is EMS WEEK: We Care. For Everyone.
EMS Week recognizes and honors EMS providers for their commitment and tireless efforts to safeguard the health, safety, and well-being of our communities.
We thank all San Diego County EMS providers for their service, courage, and all you do to contribute to our shared mission of saving lives.
Request for Information Opportunity
May 19, 2025, 8:00 AM PST
The County of San Diego, Emergency Medical Services Office is
seeking
information about Online Medical Direction for EMS
Providers. This Request for Information will close on June 2, 2025 at
5:00 PM PST.
The Request for Information (RFI) has been posted on the County of San Diego, Purchasing and Contracting BUYNET e-Commerce system. If your firm is interested, it is highly suggested that you register on the BUYNET system. The link is: https://sdbuynet.sandiegocounty.gov/.
Please use commodity code number 85100000 (Comprehensive Health Services) and/or 85120000 (Medical Practice) to ensure you have access to the RFI and receive automatic e-mails as soon as any communication is posted.
All communication regarding this RFI should be directed to Jack Leedham via the “Discussions” functionality in BuyNet, or via email at jackt.leedham@sdcounty.ca.gov.
2025-2026 EMS Office Fee Updates
May 19, 2025, 8:00 AM PST
Changes effective July 1, 2025.
| Fee Category | Amount |
| EMT/Advanced EMT Initial, Transfer, or Reinstatement Certification | $275 ($75 state fee plus $200 county fee) |
| EMT/Advanced EMT Renewal Certification | $237 ($37 state fee plus $200 county fee) |
| Paramedic Accreditation* | $200 county fee |
| Mobile Intensive Care Nurse Authorization* | $200 county fee |
| EMT or Advanced EMT Replacement Card | No fee (conditions apply) |
| EMT Out of County Status | No fee (conditions apply) |
| Other Healthcare Professional (Paramedic Intern, RN, etc.) | No fee (conditions apply) |
| Ambulance / CCT Provider Permit
Application | $11,300 (annual) |
| Permitted Vehicle Inspection | $385 (per inspection) |
| Air Ambulance Permit | $5,500 (annual, per aircraft) |
| CE Provider Approval | $4,100 (every 4 years) |
| Base Hospital Designation | $61,000 (annual) |
| Trauma Center Designation | $66,000 (annual) |
*Paramedic accreditation and MICN authorization renewals have no fee as long as the credential is current/has not expired.
2025-2026 Protocol and Policy Updates
May 1, 2025, 1:54 PM PST
We are pleased to announce the San Diego County EMS 2025-2026 protocols and policies are posted on the Prehospital Policies and Protocols webpage.
All protocol and policy updates take effect on July 1, 2025.
Please see the Protocol Packet, Protocol Presentation, and Protocol Changelog for more information about the updates.
EMS Medical Director's Guidance on Measles
April 22, 2025, 2:29 PM PST
In response to the ongoing 2025 measles outbreak in the United States, the San Diego County EMS Office has released the "EMS Medical Director’s Guidance on Measles for EMS Professionals" memo.
This guidance underscores the essential role of EMS professionals in combating the spread of this highly contagious disease. Additionaly, the memo highlights key actions to take before, during, and after a potential measles exposure. We encourage all EMS professionals and stakeholders to review this comprehensive document to ensure the safety of both patients and healthcare clinicians in San Diego County.
Ambulance Ordinance Update
December 29, 2024, 5:00 PM PST
Did you know the County of San Diego sets rules for ambulances, air ambulances, and non-emergency medical transportation providers to follow through an Ambulance Ordinance?
A lot has changed in our local EMS delivery system since the rules were last updated, so the Ambulance Ordinance is undergoing revisions to align with current best practices and medical transportation standards. As part of this process, we would like to hear from the community to help better understand their experience with the ambulance system and identify areas for potential improvement.
You can find more information about this project on the Engage San Diego County Ambulance Ordinance page.
Update Following San Diego County EMS Board of Supervisors Presentation
August 29, 2024, 3:00 PM PST
On Tuesday, August 27th, the San Diego County EMS Office presented an update to the Board of Supervisors regarding the Comprehensive Evaluations of the Base Station Hospital System and the Trauma Catchment Area Designations reports.
After the Board meeting, the County EMS Administrator and County EMS Medical Director provided stakeholders with information about next steps in the process. County EMS' priority focus areas include access to real-time medical direction, quality assurance and clinical impovement processes, and comprehensive, countywide EMS system coordination.
County EMS is committed to modernizing the EMS delivery system to enhance patient-centered, equitable EMS care for all San Diego County residents and visitors. We look forward to collaborating with all the various stakeholders in San Diego County throughout these next steps.
Base Station Hospital System & Trauma Center Catchment Area Designations: Final Report Posted
May 30, 2024, 12:00 PM PST
The County of San Diego EMS Office (CoSD EMS) is pleased to announce that Public Consulting Group (PCG) has concluded their Comprehensive Evaluation of the Base Station Hospital System and Trauma Center Catchment Area Designations.
The Comprehensive Evaluation of the Base Station Hospital System Report and the Trauma Center Catchment Area Designations Report have been posted on the County of San Diego's Engage webpage.
Following the report publication, public comments about the report will be accepted through June 30, 2024.
Prior to presenting the reports to the Board of Supervisors, CoSD
EMS and PCG have scheduled two virtual Zoom meetings on
June 5 and June 6 to allow stakeholders to:
- Learn about the study process
- Review the report's findings
- Hear about next steps
- Ask the consultant group questions
We invite all EMS system stakeholders, healthcare community members, and the public to participate.
Dates, times, and links for the virtual sessions can be found on the County EMS Engage webpage.
New Online Reporting Platform for APS Referrals
December 22, 2023, 9:21 AM PST
Aging & Independence Services (AIS) has transitioned to a new online reporting platform for APS referrals. To report suspected elder or dependent adult abuse or self-neglect, use the new link below:
You do not need a username and password to use the new online system. In addition, a SOC 341 form is no longer required if you use the online referral option above. Referrals can still be made by calling the AIS Call Center at 800-339-4661. The Mandatory Reporting page has also been updated.
"Emergency Department Impact Status Scorecard" Pilot Program
November 29, 2023, 1:15 PM PST
In collaboration with hospital leaders and the Hospital Association of San Diego and Imperial Counties, the San Diego County EMS Office deployed an "Emergency Department (ED) Impact Status Scorecard." The ED Impact Status Scorecard is a novel system stress indicator allowing hospitals to communicate real-time facility capacity. This system facilitates the ongoing partnership between hospitals, EMS professionals, and County EMS. The successful pilot program, initiated May 2023, has been expanded for use across the entire San Diego County hospital system.
View the details here: ED Impact Status Scorecard Pilot Program Expansion
EMS Mobile App is Now Available
The San Diego County EMS Office is pleased to announce our new EMS Mobile App!
The app is now available to the community: EMS Mobile App
The EMS Mobile App is a browser-based application and works on any device with an internet connection and web browser. The app allows users to easily search through all protocols and policies using keywords. In addition, users can bookmark specific protocols and policies to quickly access them at any time.
The EMS Mobile App also has a references section with important resources for our hospital and prehospital healthcare professionals.
Patient-Centered Care Modification from Paramedic to EMT Transport from Scene to Hospital
After the deactivation of
the tool that allowed EMTs to transport eligible patients following
on-scene paramedic treatment during high system stress periods, the
San Diego County EMS Office received requests from EMS prehospital
and hospital professionals for clarification on the authorized use
of EMS Policy S-412. The EMS Medical Director has issued a memo
titled "Patient-Centered Care
Modification from Paramedic to EMT Transport from Scene to
Hospital" to provide guidance and clarification on this policy.
EMS Cardiac Monitor Data Retention Community Consensus Guidance
A community workgroup was formed as part of the San Diego County EMS Office quality assurance/quality improvement (QA/QI) program. The workgroup has developed a consensus guidance document to provide communitywide standards in EMS cardiac monitor data management.
This guidance is intended to enhance the QA/QI process by ensuring standardization in EMS cardiac monitor data integration and retention. The EMS Medical Director has released an EMS Cardiac Monitor Data Retention Community Consensus Guidance memo with more information.
Treatment on the EMS Gurney Community Consensus Guidance
A community workgroup has developed a consensus guidance document to provide focused, patient-centered guidance for hospital treatments that may be performed prior to patient Transfer of Care.
This guidance is intended to bring clarity to interventions that are reasonable to perform during this time interval to facilitate a smoother patient handover process. The EMS Medical Director has released a Treatment on the EMS Gurney Community Consensus Guidance memo with more information.
Recommendation for COVID and Flu Vaccinations
With concern for the surge in COVID cases this fall, it is important for all of us to be up to date on our vaccinations. The harsh influenza season in the Southern Hemisphere suggests we may experience a severe flu season concurrent with this potential surge in COVID cases.
The EMS Medical Director strongly recommends COVID and flu vaccinations and has released a strong recommendation for COVID and flu vaccinations memo with more information.
Xylazine Alert for EMS
Please see the Xylazine Alert for EMS Professionals from the EMS Medical Director.
Additional information may be found at this National Institute of Drug Abuse page and this Drug Enforcement Administration info sheet.
Behavioral Health Program for First Responders
The Fire Captain Ryan Mitchell behavioral health support program is a free, confidential 24/7 peer-supported referral hotline.
This program aims to increase awareness about local mental health
resources and decrease the stigma and barriers associated with First
Responders seeking behavioral health
support services.
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