Local Optional Scope of Practice

Local Optional Scope of Practice (LOSOP), as defined in California Health and Safety Code §1797.172(b) and referenced in California Code of Regulations, Title 22, §100091.02(2)(a), gives local EMS agencies (LEMSAs) the flexibility to meet the unique emergency medical needs of their communities. Through LOSOP, a LEMSA can request approval for EMS clinicians to use additional medications or perform specialized skills that go beyond the standard statewide scope of practice. Each proposal is carefully reviewed by the California Emergency Medical Services Authority (EMSA) and the Emergency Medical Services Medical Directors Association of California's (EMDAC) Scope of Practice Committee to ensure safety, quality, and consistency in patient care. Once approved by the EMSA Director, a LOSOP can be authorized and implemented by a LEMSA Medical Director for up to three years before renewal is required.

Approved LOSOPs

The San Diego County EMS Office has approval for the following LOSOPs:

Description Type Status Approval Date Expiration Date EMSA Approval Letter
Amyl Nitrite Renewal Active 06/01/2023 09/01/2026 View
Buprenorphine* Renewal Active 11/20/2025 12/31/2028 View
Hydroxocobalamin Renewal Active 06/01/2023 09/01/2026 View
Sodium Thiosulfate Renewal Active 06/01/2023 09/01/2026 View
Unified Scope for Qualified Transport Providers Renewal Active 02/28/2025 02/29/2028 View
International Border Interfacility Transfer* Initial Inactive 07/24/2024 07/31/2027 View
Vaccination Administration (S-190)* Initial Active 10/14/2025 10/31/2028 View

* EMS agencies must obtain LEMSA approval prior to implementation

All LOSOPs and trial studies throughout the state can be found here: Scope Of Practice | EMSA (ca.gov)