What is a LEMSA?

The San Diego County EMS Office, a division of San Diego County Fire and the Board of Supervisors-designated local EMS agency (LEMSA), has statutory responsibilities for the region’s EMS delivery system, including quality assurance, quality improvement, and structural innovation.  

California's EMS Act authorizes each county to develop an EMS program and to designate a local EMS agency (LEMSA) that oversees the delivery of EMS within that geographic area.

California Health and Safety Code section 1797.200 requires counties to designate a LEMSA as the entity responsible for oversight of EMS within the region. A county may designate the LEMSA as the county health department, an agency established and operated by the county, a contracted entity for the purposes of local EMS administration, or a joint powers agency created to administer EMS.

Board of Supervisors Policy K-12 currently designates the County EMS Office as the County entity with primary responsibility for EMS system organization.

County EMS upholds the standards of the state’s Emergency Medical Services Authority, which includes the organization and oversight of the EMS delivery system.

The organized San Diego County EMS delivery system is comprised of the following:

  • More than 50 first responder EMS agencies 
  • 10,000 credentialed EMS professionals
  • Numerous policies, procedures, and protocols
  • 7 paramedic base hospitals
  • 23 emergency departments
  • hospital-based specialty care programs (STEMI, stroke, and trauma)
  • and responds to more than 250,000 EMS calls for service annually.

Through the EMS Medical Director, County EMS is responsible for providing policies, procedures, and protocols for EMS professionals. 

The County EMS Office:

  • Provides EMS personnel credentialing, including EMTs, Advanced EMTs, Paramedics, critical care transport personnel (ground & air), Mobile Intensive Care Nurses, and other recognitions
  • Approves training programs for prehospital personnel
  • Designates agencies and organizations participating in the countywide organized EMS delivery system
  • Designates hospital-based specialty care programs, including stroke, STEMI, and trauma systems of care
  • Collects data and monitors system activity within the LEMSIS network
  • Provides the framework for medical quality improvement activities
  • Provides EMS and other facilitative services through the EMS Duty Officer on a 7/24/365 basis
  • Provides administrative services to County Service Area 17

The LEMSA is the primary regulatory authority of the County Ambulance Ordinance, which includes ambulances and non-emergency medical transport vehicles permitting and inspections..

Ambulance Service Areas and Hospitals
LEMSA Map Legend