The California Emergency Medical Services Authority (EMSA) has proposed a comprehensive update to regulations governing the administration of local emergency medical services (EMS) systems. The package addresses a wide range of issues, including local EMS planning and state approval, exclusive operating areas and ambulance procurements, provider authorization, data and reporting requirements, and the administration of rights retained by certain cities and fire districts under Health and Safety Code section 1797.201. While portions of the proposal are intended to clarify and standardize existing requirements, the package would also establish significant new statewide procedures and expand EMSA oversight of local EMS governance and operations.
RCRC is undergoing a review of the regulatory package, focusing specifically on provisions that could erode local control, impose substantial new administrative and documentation requirements on counties and local EMS agencies, and affect longstanding local arrangements and statutory rights. Among other issues, the proposed regulations would establish new procedures for determining section 1797.201 rights, increase state oversight of local EMS plans and ambulance procurements, and require local agencies to review and potentially revise existing policies and practices for consistency with the new regulations. The proposal also anticipates nondiscretionary, unfunded implementation costs for local agencies.
Regulatory documents are available here (scroll down the webpage to open the “Regulations Currently Open for Comment” section). Comments on the proposed regulations are due December 11, 2026.
RCRC encourages counties to review the proposal carefully and consider providing feedback regarding potential impacts to local authority, costs, and EMS system administration. For questions, contact RCRC Senior Policy Advocates Sarah Dukett or Leigh Kammerich.