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EMS Timeline


Development of EMS in Contra Costa Timeline
 Decades of EMS Accomplishments

Contra Costa County - Chronology of Historic Events in EMS

The emergency medical services system approach and the use of paramedic personnel to provide advanced life support care under the supervision of a base hospital physician or mobile intensive care nurse began evolving as a new model for health care delivery in the late 1960s. Contra Costa County as well as a number of other progressive counties throughout California began developing its emergency medical services system during this time. Following are milestones in the development of the EMS system in Contra Costa County:


1966-1976
1977-1986
1987-1996
1997-2006
2007- 2016

  • 1966-1976

    1976
    • Los Medanos Community College, in conjunction with Stanford University, developed first training programs for paramedics and MICNs.
    1975
    • Health Department agreed to develop an advanced life support program and to provide coordination of emergency medical services countywide based on EMCC's recommendation and with County approval. Initial EMS Program developed with Federal funding under auspices of Comprehensive Health Planning.
    • First EMS System Plan developed for Contra Costa County.

    1973
    • Emergency Medical Services Systems (EMSS) Act provides federal guidelines and funding for the development of regional EMS systems.

    1972
    • Ten ambulance zones established for provision of emergency ambulance service.

    1970
    • State Wedworth-Townsend Act enabled counties to conduct pilot projects using paramedics and mobile intensive care nurses (MICNs) to provide advanced life support services to patients in the field.
    • Ambulance Regulations added to the County Ordinance Code which included permit and ambulance registration processes.

    1968
    • Contra Costa Emergency Medical Care Committee (EMCC) appointed by County Board of Supervisors to provide oversight of emergency medical services within the County.

    1966
    • National Academy of Sciences "White Paper" entitled "Accidental Death and Disability: The Neglected Disease of Modern Society" identified deficiencies in providing emergency medical care in the country. The paper was the catalyst prompting federal leadership toward an organized approach to EMS and trauma care.
    • The 1966 Highway Safety Act further reinforced and encouraged states to set standards, regulate EMS, and implement programs designed to reduce injury.

  • 1977-1986

    1986
    • Comprehensive Trauma System Plan approved by Board of Supervisors providing for designation of a single Level II Trauma Center.
    • John Muir Medical Center designated as County's Level II Trauma Center.
    • Bay Area Trauma Registry Project initially funded by State EMSA.
    • Operational Procedures for Patient Transport by Helicopter implemented.
    • Cadillac Ambulance purchased by Regional Medical Systems (RMS) making RMS the single private emergency ambulance provider in County.
    • Competitive bidding process for emergency ambulance providers in 5 ERAs. Service contracts awarded to Regional Ambulance, Moraga Fire and San Ramon Valley Fire.
    • Base Hospital contracts established with John Muir Med Center, Mt. Diablo Med Center and Los Medanos Hospital.
    • Emergency medical dispatch program including pre-arrival instructions implemented by Contra Costa County Fire Dispatch Center.
    1985
    • EMS System Plan developed according to standards set by EMS Authority.
    • First competitive bid process for paramedic base hospital designation administered for 4 base hospital zones countywide. Contracts awarded to John Muir Med Center, Mt. Diablo Medical Center, Brookside Hospital and Los Medanos Hospital.
    • Small plane crashed into Sun Valley Mall injuring some 80 victims. Multicasualty plan implemented.
    • Emergency Medical Dispatch (EMD) standards/criteria developed; endorsed by EMCC.
    • Procedure for Emergency Department (ED) diversion implemented allowing diversion of an emergency ambulance away from an ED if number of critical patients in ED was such that additional critical patients could not be cared for adequately.
    • Brookside Hospital emergency department downgraded licensure to "Standby Emergency Services" and relinquished paramedic base hospital designation.

    1984
    • Paramedic level ambulance transport services implemented by San Ramon Valley Fire District in a joint program with John Muir Medical Center.
    • Ten ambulance zones consolidated into 5 Emergency Response Areas (ERAs). Following a competitive bid process, exclusive ambulance service contracts awarded to Cadillac Ambulance, Regional Ambulance, Moraga Fire and San Ramon Valley Fire.

    1983
    • County Health Services designated as Local EMS Agency and County Health Officer designated as EMS Medical Director by Board of Supervisors pursuant to State EMS Act.
    • Competitive bid process for emergency ambulance service contracts conducted pursuant to revised County Ambulance Ordinance. A Request for Proposal process that sought highest level of service possible without County subsidy resulted in exclusive contracts with Cadillac Ambulance, Regional Ambulance, Moraga Fire District, San Ramon Valley Fire District, and East County Ambulance.

    1982
    • Multicasualty Incident Plan approved by County Board of Supervisors providing for on-scene coordination, resource notification, and patient distribution in multicasualty events.

    1981
    • In 1981 the establishment of State law and the California EMS Authority (EMSA) provided for significant State EMS leadership in California regarding the development of EMS systems.
    • The California State Legislature enacted the "Emergency Medical Services System and Prehospital Emergency Medical Care Personnel Act (Health and Safety Code 1797, et al.)." This law specifically authorized local EMS agencies to "...plan, implement, and evaluate an emergency medical services systems...consisting of an organized pattern of readiness and response services..."
    • The Act further authorized local EMS agencies to plan, implement and monitor limited advanced life support and advanced life support programs.

    1980
    • Joint Powers Agreement for Regional emergency medical services disbanded following recommendations from Alameda and Contra Costa Counties' EMCCs.
    • Comprehensive California Emergency Medical Services System and Prehospital Emergency Medical Care Personnel Act passed. This legislation set EMS system standards, prehospital personnel training/certification standards, and provided basic standardized structure for EMS systems.
    • Provision added to the County Ambulance Ordinance, which established exclusive ambulance zones for emergency and non-emergency transport.
    • Brookside Hospital, San Pablo designated by County as third base hospital to provide medical direction for West County paramedic units.

    1977
    • First paramedics and MICNs graduated from Los Medanos Community College training programs and were certified by County Health Officer.
    • John Muir Medical Center and Mt. Diablo Medical Center designated Base Hospitals for medical control of paramedic units throughout the County. (Initial base hospital services were provided on a monthly rotation schedule.)
    • Joint Exercise of Powers Agreement between Alameda and Contra Costa Counties established an East Bay EMS Region for development of a Regional EMS program.
    • First paramedic-staffed ambulances responded in Walnut Creek (Pomeroy Ambulance in May 1977); in Moraga (Moraga Fire Protection District in June 1977); in Concord (Michael's Ambulance in January 1978); and in Richmond (Cadillac Ambulance February 1978 Labor issues delayed active participation in program until 1979).

  • 1987-1996

    1996
    • Dedicated EMS Medical Director position appointed for the EMS Agency.
    • Standards for EMS Enhanced First Responder Programs developed.
    • Request for Proposal process for emergency ambulance service (11/1/96). Contracts awarded San Ramon Fire and American Medical Response (10/28/97). Moraga Fire exempt from competitive bid process pursuant to EMS legislation.
    • Bethel Island Fire's First Responder Paramedic program implemented (10/7/96).
    • San Ramon Valley Fire Dispatch Center recognized as Center of Excellence by National Academy of Emergency Medical Dispatch.
    1995
    • The Oakland and Richmond Kaiser hospitals merged. Richmond facility received only non-critical ambulance patients due to lack of ICU capabilities.
    • Paramedic State licensing requirements implemented in place of local certification procedures.
    • Assistant EMS Medical Director position allotted to the EMS Agency.
    • The 1-800-GIVE-CPR public information program began.

    1994
    • Continuing education activities approved for EMT-Is to maintain State certification.
    • Los Medanos Community Hospital closed 4/23/94.
    • Responsibility for paramedic certification transferred from individual counties/regions to State EMSA.
    • Hospital Emergency Incident Command System (HEICS) adopted by hospitals to provide an organized approach to hospital disaster management.
    • Medical/health mutual aid response to Northridge earthquake in southern California coordinated among northern California coastal counties (Region II).
    • EMT-I training program for firefighters established by EMS Agency.
    • EMS Agency obtained State EMSA grant to study poison control center alternatives.
    • Emergency Medical Care Committee restructured to report to Health Services Director.

    1993
    • Base hospital services no longer provided by Los Medanos Hospital.
    • General Chemical Company chemical release in Richmond area triggered large-scale fire, police and EMS response. Thousands of patients requested evaluation at local medical facilities in following weeks.
    • Poison control public hotline terminated by San Francisco Poison Control Center due to funding issues. EMS Agency maintained PCC access via local 9-1-1 system.
    • San Ramon Valley Fire's Dispatch Center piloted Medical Priority's computerized ProQA Dispatch System for prehospital EMS dispatch.
    • Contra Costa County, Riverview, Orinda, Moraga and West County fire districts functionally integrated.
    • "Quality Action Team" formed to improve EMS incident review.
    • Mobile radios programmed with fire service radio channels installed in paramedic units.
    • Funding obtained by EMS Agency for Highway Injury Record Linkage Software and Firearm Injury Reporting, Surveillance and Tracking System; programs administered by Health Services Injury Prevention.
    • Board of Supervisors approved AMR contract through 7/2/95 and then through 5/2/96.

    1992
    • Fire First Responder Defibrillation Program implemented Countywide.
    • "Emergency Medical Guidelines for Law Enforcement Agencies" endorsed by EMCC/County Police Chiefs' Assoc.
    • "EMS Operational Procedures For Response to an Expanded Medical Emergency" (EME) developed/implemented.
    • "Do Not Resuscitate" policy established.
    • EMS treatment protocols for children developed and implemented.
    • John Muir Trauma Center permanently (20 years) designated as Level II trauma center following request-for-proposal review process.
    • In-Fire Service EMS Models Assessment completed.
    • Base Hospital agreements renegotiated with Mt. Diablo, John Muir and Los Medanos hospitals.
    • Medical Transmission Network or "MTN" fire/medical dispatch computer linkage project initiated.
    • Paramedic quick response vehicle (QRV) program funded by Measure H, provided by American Medical Response, and implemented in Byron/Discovery Bay area (5/1/92).
    • MEDARS radio system used for ambulance-hospital communications upgraded from 2 to 4 channels.

    1991
    • High-performance ambulance contracts initiated with Regional Ambulance, San Ramon Valley Fire, and Moraga Fire.
    • RFP competitive bid process performed to select equipment for a new First Responder Defibrillation Program. Physio Control semi-automatic defibrillators were selected.
    • Countywide system of Multicasualty Medical Caches established for use in multicasualty or disaster situations.
    • Specialized Hazardous Materials Response Protocols and training program developed and implemented.
    • Paramedic training program offered at Los Medanos Community College.
    • Veterans Administration Hospital closed.

    1990
    • CSA Em-1 became operational.
    • EMS Disaster Planning Project funded by State EMSA and administered by EMS Agency. County Health Officer designated Regional Disaster Medical Health Coordinator (RDMHC) for OES Region 2 counties.
    • San Ramon Regional Medical Center in the City of San Ramon licensed for Basic Emergency Services.

    1989
    • Countywide Benefit Assessment District for Enhanced Emergency Medical Services, County Service Area (CSA) EM-1, approved by all city councils and established by Board of Supervisors under Health Services administration.

    1988
    • "Measure H," a general election ballot advisory measure calling for the establishment of a benefit assessment for enhanced EMS services, approved by 71.6% of voters Countywide.
    • Joint Solano/Contra Costa EMS Hazardous Materials Training Project supported by 5-year funding from consent agreement between IT Corporation and State Health Services and administered by EMS Agency.
    • Pilot "first responder paramedic engine" program undertaken by Moraga Fire.

    1987
    • Formal Patient Transfer Guidelines, including an EMS Agency administered multi-disciplinary quality assurance process adopted by Board of Supervisors, and by all hospitals within the County.
    • Health Services Department Emergency Management Team, consisting of key Health Services personnel, designated to respond to County EOC or Medical/Health Operations Center in a disaster.
    • Program for reporting communicable disease exposure implemented.
    • Brookside Hospital basic emergency license restored.

  • 1997-2006

    2006
    • ReddiNet system upgraded.
    • MetiMan, an emergency care simulator purchased to provide patient simulation training for fire/ambulance personnel.
    • An electronic patient care data collection system purchased for fire first responder paramedic providers.
    • John Muir Mt. Diablo Health System renamed John Muir Health, Walnut Creek and John Muir Health, Concord.
    • Doctors San Pablo declared bankruptcy. Ambulance traffic diverted to surrounding hospitals for a 2-month period. Hospital is downsized and structure reorganized.
    • Emergency Department (ED) Diversion for ED overcrowding discontinued.
    • First responder defibrillation program implemented by Lafayette Police and San Ramon Police Departments.
    • Public safety defibrillation program implemented by Department.
    2005
    • First responder paramedic program implemented by Pinole Fire Department.
    • Five to nine-year contract for emergency ambulance services awarded American Medical Response.
    • Contra Costa EMS Fire Training Consortium established to standardize training for fire first responders and ambulance personnel Countywide.
    • First responder defibrillation program implemented by Antioch Police Department.
    • A multidisciplinary committee convened to consider a Multicasualty Plan revision.
    • Richmond Police/Fire dispatch center and AMR's dispatch center linked allowing requests for ambulances to go directly to AMR via computer versus a secondary phone call saving time in ambulance dispatch.

    2004
    • National Registry of Emergency Medical Technician's exam adopted as the approved statewide EMT-I certification exam.
    • First responder paramedic program implemented by Rodeo-Hercules Fire Protection District.
    • Comprehensive Countywide EMS quality improvement plan implemented.
    • Comprehensive plan developed for integration of paramedic first responder and ambulance services in those areas of the County covered by private ambulance services.
    • Request for Proposal process for emergency ambulance service in areas of the County served by private provider American Medical Response. Proposals submitted by AMR and StarWest ambulance.
    • EMS-related cultural disparity project conducted along with American Medical Response.
    • EMS public access defibrillation (PAD) project implemented including distribution of 42 defibrillators to government agencies and training of recipients.
    • Mass flu immunization clinics held throughout the County.
    • Trauma system and trauma center review process revised to take advantage of technology.
    • Contra Costa EMS educational conference held for prehospital personnel.
    • Impact analysis for possible closure of Doctors San Pablo.
    • First responder defibrillation program implemented by San Ramon Police Department and Mount Diablo State Park.

    2003
    • Contra Costa County Fire Dispatch accredited EMD Center of Excellence by Emergency Medical Dispatch National Academy.
    • Fitch report released on the integration of fire paramedic engines into the EMS response system.
    • Tenet's Doctors San Pablo management contract with West Contra Costa Health Care District terminated.
    • Mental health committee convened to address education, data collection and review necessary for ED physicians to resume responsibility for writing 72-hour psychiatric holds (5150s) following County Mental Health policy changes.
    • Reciprocal agreement with Alameda County implemented for Paramedic Interfacility Transfer Programs.

    2002
    • Department of Justice fingerprint background check procedure for all EMT-I certification and recertification applicants implemented.
    • East Diablo, Oakley, and Bethel Island Fire Protection Districts form East Contra Costa Fire Protection District.
    • AMR paramedic QRV established in Bethel Island replacing Bethel Island paramedic engine.
    • Paramedic engine feasibility assessment conducted by Fitch and Associates.
    • West County Dispatch Center (Richmond Police) accredited as EMD Center of Excellence by National Academy of Emergency Medical Dispatch.
    • Year 1 of 2-year State grant "Medical Education for Drug Safety" carried out by John Muir Medical Center Injury Prevention staff through the EMS Agency.
    • Paramedic Interfacility Transfer (CCT-P) Program implemented that allows specially trained paramedics to transport critical, but stable patients from hospital to hospital for specialized procedures or higher level of care.
    • Countywide post market evaluation of Medtronic-Physio-Control CR Plus defibrillator Implemented.
    • First responder defibrillation program implemented by Blackhawk Police Department.
    • EMS Aircraft policies and procedures for classification, authorization, request for, transport criteria and field operations revised.

    2001
    • EMS for Children Plan developed for Contra Costa through 2-year grant funding.
    • EMS base hospital services no longer provided by Mt. Diablo Medical Center.
    • El Cerrito paramedic engine program implemented to serve Kensington and areas in El Cerrito hills.
    • First responder defibrillation programs implemented by Kensington and Brentwood Police Departments.
    • County Trauma System Plan updated to reflect changes in California Trauma regulations/requirements.
    • Office of Justice Planning grant ($300,000) used to purchase mass decontamination, communications, and personal protective equipment for use by fire/other agencies.
    • Bioterrorism Workgroup appointed by Health Services to plan/train for response to terrorist events.
    • Regional Disaster Medical Health Response staff funded full-time by State EMSA.
    • ReddiNet system implemented providing a communications link among hospitals, medical dispatch centers and EMS Agencies in Alameda and Contra Costa Counties.
    • EMS website opened providing online access to EMS policies, protocols and other EMS-related information.

    2000
    • All Moraga-Orinda Fire EMS response vehicles staffed with paramedics.
    • Impact Evaluation Study conducted including 2 public hearings prior to the March closing of Doctors Medical Center, Pinole Campus emergency department.
    • All fire/medical dispatch centers provide fire/ambulance dispatch using Medical Priority Dispatch System.
    • EMS for Children grant obtained to develop an EMS for Children Plan.

    1999
    • Kaiser Richmond opened inpatient critical care services.
    • Oakley Fire organized as a fire protection district.
    • Multicasualty responses to a fire at Tosco's Avon Refinery; to a fire at Chevron Refinery, North Richmond; and to Richmond Health Center for noxious odor assessment.
    • Pilot bi-phasic AED project implemented.
    • Health Services Department Operations Center (DOC) activated for Y2K transition.
    • Two-year State grant for a Data Linkage and Outcome Project obtained.
    • Orinda Police Department implemented first responder defibrillation program.
    • Antioch Ambulance Company ceased all operations (7/99).
    • Contra Costa Fire began fire/medical dispatch for Pinole, Rodeo, Hercules, and Crockett-Carquinez Fire.

    1998
    • Local emergency declared by Board of Supervisors for hospital emergency/critical care resource shortages.
    • Contra Costa Regional Medical Center's new hospital opened.
    • First load of spent nuclear fuel rods transported by train through County.
    • Antioch Ambulance Service bought by Golden Empire Ambulance.
    • American Medical Response accepted subsidy reduction to fund expansion of Contra Costa Fire First Responder Paramedic Program.
    • West County Consolidated Communications Operations and Contra Costa Fire District Dispatch Center personnel trained in Emergency Medical Dispatch.
    • Multicasualty Incident (MCI) Plan revised.
    • Resource Information Management System (RIMS) installed to link OES Region II counties to statewide disaster information management system.
    • First hospital resource assessment completed.
    • Department-wide Contra Costa Health Services Emergency Plan completed.
    • Moraga Police and Orinda Police Departments implemented first responder defibrillation programs.

    1997
    • Bay Area Disaster Medical Assistance Team (DMAT) formed/sponsored by County Health Services.
    • Contra Costa Fire Protection District's First Responder Paramedic Program implemented (8/1/97). "Partners" course used to train EMT-Is to assist paramedics.
    • Multicasualty response to Concord Water World slide collapse. One death and 32 injured were triaged to area hospitals.
    • Public health nurse mutual aid provided during northern California winter storms.
    • Computerized pen-based patient care reporting implemented Countywide.
    • Emergency Medical Care Committee re-appointed by the Board of Supervisors as a Board advisory committee.
    • Statewide Poison Control Center system implemented.
    • John Muir and Mt. Diablo Medical Centers merged to form John Muir/Mt. Diablo Health System.
    • Brookside Hospital acquired by Tenet Corp. and renamed Doctors Hospital, San Pablo Campus. Doctors, Pinole became Doctors Hospital, Pinole Campus.
    • Kaisers Richmond and Martinez downgraded services. Not designated to receive ambulance patients.
    • Orinda Fire and Moraga Fire merged to form Moraga-Orinda Fire Protection District.
    • American Medical Response purchased by Laidlaw. Merged its ambulance services under the AMR name.
    • Interfacility Transfer Review process revised.

  • 2007- 2016

    2015
    • Produced 2014 Annual Performance Report recognizing stakeholder and EMS System accomplishments
    • EMSA recognizes Contra Costa countywide patient transfer of care model as a best practice February 2015.
    • Continued emergency operations supporting EMS, Public Health, Dispatch, Fire, Transport and Hospital readiness in response to Ebola.
    • Contra Costa Newsletter EMS Best Practices goes electronic.
    • Contra Costa EMS presents at first national pediatric disaster coalition conference in Scottsdale Arizona.
    • Contra Costa County Medical Reserve Corps (MRC) response honored by EMSA for excellence in providing mutual aid for the Valley Fire response.
    • Doctors Medical Center (DMC) in San Pablo permanently closes its doors April 21, 2015.
    • Conducted and completed a competitive emergency ambulance services procurement recieving a single proposal to the RFP from Contra Costa County Fire Protection District (CCCFPD) and American Medical Response (AMR) as a joint entity (the Alliance) creating a new service delivery model.
    • Final Alliance ambulance agreement approved by BOS in November 17, 2015.
    • EMS establishes working group to support health information exchange (HIE) with AMR, CCHS and First-Watch.
    • ReddiNet access expanded to Senior Nursing Facilities and non-emergency ambulance providers.
    • Contra Costa EMS STEMI System receives American Heart Association Lifeline Bronze Award for optimizing the care of heat-attack patients in May 2015.
    • New EMS Medical Director Dr. David Goldstein officially assumed his position on November 1, 2015.
    • Former EMS Medical Director Dr. Joe Barger officially honored for his leadership and service at Emergency Medical Care Committee (EMCC) December 2015.
    • Bystander CPR rate continues to improve last 4-5 years as a result of CCEMS high performance CPR initiative and expanded CPR and AED programs.
    • Contra Costa EMS revamps its emergency preparedness program preparedness program grows by four-hundred (400%) percent, with more complex exercises and training that integrates hospitals, Long Term Care facilities, and community partners.
    • Contra Costa County EMS implements Electronic Field Guidebook as a downloadable mobile application.
    • Modified first responder dispatch protocols instituted in East County supporting ambulance-only response in cases of low acuity calls as a result of fire station closures.
    • 2015-2016 LAFCO Municipal Services Review Process begun.
    • Countywide occurrences of holding ambulances longer than one (1) hour at all community hospitals increasing with increased use of emergency departments throughout the county.
    • CCEMS collaborates with CCHS and Child Injury Council to produce Contra Costa County Child Death Report 2008-2012

    2014
    • Instituted new Spinal Motion Restriction protocol and policy (January of 2014)
    • Annual trauma plan and EMS System plan updates submitted to EMS Authority
    • Contra Costa EMS presents on "EMS Stroke Systems of Care" at the annual American Association of Neuroscience Nurses (March 2014)
    • Doctor's Medical Center issues notice of intention to downgrade of emergency services on April,15, 2014
    • CCEMS System Modernization Study Final Report Issued (May 29, 2014)
    • Contra Costa EMS receives National American Heart Association Mission Lifeline EMS Bronze Award for STEMI System performance(May 2014)
    • Doctor's Medical Center San Pablo Impact Report associated with pending downgrade of services submitted to California Department of Health Services and State Emergency Services Authority (June 13, 2014)
    • Fireline Paramedic Function for Fire Paramedics Serving Outside Contra Costa Approved by EMS Medical Director (July 2014)
    • Contra Costa EMS 2009 H1N1 pediatric response featured in Department of Homeland Security/FEMA national course on Pediatric Disaster Response and Emergency Preparedness (August 2014)
    • Contra Costa EMS Napa Earthquake Mutual Aide Response August 24, 2014.
    • Emergency Ambulance Traffic to Doctor's Medical Center ends August 7, 2014.
    • CCEMS Awarded State EMS Authority Health Information Exchange (HIE) Grant to support Quality Improvement and EMS System performance reporting (August 2014).
    • Contra Costa EMS System Hospital Transfer of Care Patient Safety "Never Event" Initiative recognized as best practice by California EMS Authority. (September 2014).
    • CCEMS Awarded Homeland Security Grant for Law Enforcement AEDs (September 2014).
    • Contra Costa EMS/Public Health Local Ebola Response Begins (Oct 2014).
    • Contra Costa Emergency Medical Services and Ambulance Provider American Medical Response implements capability to transport high risk infectious disease patients: IDART (Infectious Disease Ambulance Response Team) October 2014.
    • Long time EMS Medical Director Dr. Joe Barger announces retirement and Dr. David Goldstein appointed as future EMS Medical Director (Nov 2014).
    • Contra Costa EMS participates regional medical health disaster exercises on anthrax (September thru November 2014).
    • First Public Report on Contra Costa Community Hospital Transfer of Care issued (Dec 2014).
    • Final Report Doctor's Medical Center Regional Planning Group issued (Dec 2014).

    2013
    • January 15, 2013 - Contra Costa Fire Protection District (CCFPD) closes four fire stations due to fiscal crisis affecting Clayton, Lafayette, Martinez, and Walnut Creek.
    • February 2013 - All ALS ambulance providers throughout the county using Physio-Control LifeNet System to transmit real-time 12-Lead information to hospitals for critical STEMI patients
    • February 2013 - EMS System Modernization Study begins engaging 130+ EMS stakeholders
    • April 2013 - ALS Fire first responders now able to transmit 12 leads to LifeNet System
    • June 2013 - Emergency Communications enhanced: ReddiNet, emergency communication tool becomes accessible to all county ambulance providers, community clinics and long-term care facilities. EMS receives UASI (Urban Areas Security Initiative) Grant for $98,000 for EBRCS (East Bay Regional Communications System) hospital disaster radio communications.
    • June 10-11, 2013 - Institute of Medicine presentation on June 10th-11th in Washington DC on the Alameda and Contra Costa EMS "California Neonatal and Pediatric Coalition" efforts in supporting local, regional and statewide disaster preparedness for children.
    • July 6, 2013 - Contra Costa EMS stands up mutual aid in response to Asiana Plane Crash at San Francisco Airport
    • July 2013 - CCFPD closes 5th fire station due to fiscal crisis in Pittsburg.
    • September 8, 2013 - Morgan Fire chars more than 3000 acres in Mount Diablo threatened communities of Clayton leading to evacuations of 75 homes
    • September 2013 - CA Legislature extends sunset of the Maddy Fund supporting $2.2 million, annually in uncompensated emergency care, pediatric trauma and EMS programs within Contra Costa
    • October 2013 - New Spinal Motion Restriction guideline adopted
    • November 2013 - Health Information Exchange (HIE) with Contra Costa Regional Medical Center begins using EPIC to explore EMS patient care outcomes.
    • November 20, 2013 - 110 Contra Costa Med/Health Community partners participate in statewide tabletop and functional exercise on a Foodborne Illness Outbreak
    • December 2013 - Cardiac Arrest Registry to Enhance Survival (CARES) shows Contra Costa Utstein survival rate is 25.6% & Utstein survival with bystander CPR-35.5%

    2012
    • Contra Costa Stroke System launched January 2, 2012.
    • Medical Reserve Corp recognized and approved by the Board of Supervisors January 2012.
    • Kensington designated as a HeartSafe Community on June 21, 2012.
    • July 2012, launched OUCH Mobile Testing Campaign supporting injury prevention for children of all ages in coordination with Oakland Children's, Alameda and Contra Costa Health Services and the Kohl's foundation.
    • Participated in medical/health response to Chevron Refinery fire incident on August 7, 2012 affecting 15,213 patients.
    • Published white paper on "The Importance of Fire-EMS First Medical Response" August 2012.
    • Implemented Pre-hospital "High Performance Resuscitation" protocols.
    • Taught 3,000 Mt. Diablo Unified School District ninth graders Hands Only CPR, how to use an AED and how to relieve choking as part of the CPR in Schools program.
    • Developed informational brochure for those requiring assistance in paying ambulance bill in collaboration with AMR and the Contra Costa Advisory Council on Aging.
    • Sponsored "Data Sanity" conference providing quality improvement and data review training for prehospital and hospital providers.
    • Provided Assistance to Firefighter Grant (AFG) match, using Measure H Funds, to acquire new cardiac monitors capable of field to hospital EKG transmission throughout Contra Costa County.
    • Co-sponsored with Alameda County, the first California Neonatal/Pediatric Disaster Coalition Conference supporting regional and state efforts in addressing pediatric disaster management.
    • Participated in the California Statewide Medical Health Exercise with Public Health or other system partners.
    • Established ambulance provider quarterly training and meetings supporting patient safety, disaster preparedness and EMS system coordination.

    2011
    • New EMS website launched.
    • Contra Costa EMS implements new California mandated EMT Regulation and oversight process.
    • January 2011 San Ramon Valley Cities and El Cerrito honored as first Contra Costa HeartSafe Communities.
    • March 2011 John Muir Walnut Creek Opens new Patient Care Tower.
    • Contra Costa EMS collaborates with John Muir Walnut Creek on Head Trauma Study.
    • Contra Costa EMS implements Social Media using Twitter and Facebook.
    • Transition of RDMHC and RDMHS program role to Alameda County.
    • October 2011 Contra Costa Board of Supervisors approves Stroke System Program.
    • John Muir Concord, John Muir Walnut Creek, Kaiser Walnut Creek, Kaiser Antioch, Kaiser Richmond, Doctors Medical Center San Pablo and San Ramon Regional successfully designated as Primary Stroke Receiving Centers.
    • Joined California State Stroke Registry to support implementation of Contra Costa Stroke System.
    • Celebrated third year of Contra Costa School CPR Anytime program as part of HeartSafe Communities initiative.
    • Published study to evaluate impacts of possible closure of Doctor's Medical Center San Pablo.
    • Developed county-wide Safely Surrendered Site Personnel training curriculum in collaboration with Contra Costa Health Service Maternal and Child Health Programs and County Children and Family Services.
    • Initiated enhancements to core quality improvement, patient safety and system performance indicators.
    • Implemented testing of count-wide pediatric and neonatal emergency preparedness and medical surge toolkit.
    • Initiated performance improvement process to evaluate and enhance effectiveness of countywide Multi-Casultaty Incident (MCI) Plan.
    • Acquisition of Disaster Mobile Support Unit (DMSU) for county and regional response in coordination with American Medical Response (AMR).
    • Expanded HeartSafe Community, Hands-Only CPR and Public Safety Defibrillation Programs through public/private partnerships to increase by-stander CPR and appropriate use of 911.
    • Successfully implemented 12 lead transmission program with five of six high risk heart attack (STEMI) Centers.
    • Co-sponsored regional Neonatal/Pediatric Disaster Coalition Conferences with alameda County EMS and California EMS Authority.
    • Adopted Institute of Healthcare Improvement (IHI) certificate of Quality, Patient Safety and Leadership as core curriculum for EMS personnel supporting patient care process improvement.
    • Held conference supporting national quality experts to help promote quality improvement by the use of process evaluation. (Balestracci)
    • EMS Staff participated in IHI training programs and national conferences.
    • Scholarship Program Initiated Institute of Healthcare Improvement Certificate in Quality Improvement, Patient Safety and Leadership.
    • Implemented Continuous Quality Improvement Initiatives on Pediatric Medication Safety, Bariatric Resource Awareness.
    • Contra Costa EMS leadership participated in "Lean Six Sigma Training".

    2010
    • Initiated Stroke System Planning in collaboration with newly formed Stroke System Stakeholder Advisory Group.
    • Local Implementation of State EMS Authority EMT 2010 Project, establishing a state EMT registry and standards for background checks and discipline.
    • Establishment of East Contra Costa Fire as an independent fire district.
    • Published First pocket sized Field Manual for Prehospital Providers.
    • Implemented EMS Twitter Feed.
    • Developed 9-1-1 ‘Interfacility Emergency Response" Dispatch and Prehospital protocols for high risk patient transfers.
    • Drafted first county-wide pediatric/neonatal disaster and medical surge plan and preparedness toolkit.
    • Awarded $30,000 CEMSIS trauma and EMS data grant to support statewide data sharing between EMSA and Local EMS Agencies.
    • Co-sponsored head injury study with John Muir Base Station in an effort to improve survival rates of head injury victims.
    • Participated in ACS re-accreditation of John Muir Walnut Creek as a level II Trauma Center.
    • Co-sponsored EMS for Children Regional Conference on Pediatric Disaster Preparedness in June 2010 in collaboration with Alameda EMS.
    • Successfully tested county-wide capability to accommodate a pediatric and neonatal medical surge during the November 2010 Statewide Hospital Disaster Exercise in collaboration with Contra Costa Health Services.
    • Launched 12-lead transmission pilot to reduce false positive STEMI activations.
    • Facilitated STEMI system process improvement integrating interfacility STEMI transfer between Non-STEMI centers and STEMI centers.
    • Implemented Fire Agency Zoll electronic patient care record upgrades.
    • Initiated Paramedic Fire Agency Contract Compliance process.
    • Adopted Pediatric Advanced Life Support PALS, International Trauma Life Support ITLS and Advanced Assessment and Treatment of Trauma Courses as qualifying paramedic accreditation curriculums in Contra Costa County.
    • Conducted and presented data analysis to CCHS on cardiovascular mortality in high risk populations e.g. African Americans.
    • Local implementation of American Heart Association HeartSafe Community.
    • Trained over 3,000 ninth graders in CPR at six high schools using CPR Anytime kits.
    • Supported Kaiser Walnut Creek and Doctor's San Pablo successful candidacy for statewide Pilot Cardiac Care Study.
    • Participated in successful Hospital "Magnet" designation of John Muir Medical Center Concord.
    • Contra Costa Medical Reserve Corps (CCMRC) hosted "First Person Disaster Experience" on the Haiti Disaster Response and successfully recruited 180 volunteers since CCRMC formed in May 2009.

    2009
    • Developed portal for Fire EMS Training Consortium to access Prehospital training curriculum online.
    • Sutter Delta Medical Center joined Contra Costa STEMI System on August 17, 2009.
    • Completed one full year of participation in CARES National Cardiac Arrest Registry.
    • Cyanokits placed throughout the RDMHC region.
    • RDMHC Program participation in the development and roll-out of California Disaster Health Operations Manual (CDHOM).
    • Contra Costa County Medical Reserve Corps (CCMRC) implemented as part of County's emergency planning and response system.
    • Contra Costa County Medical Reserve Corps became official May 2009.
    • Society of Chest Pain site visit participation supporting John Muir Medical Center Concord and Walnut Creek Campuses accreditation as Chest Pain Centers with PCI in July 2009.
    • Ethnic and racial data collection incorporated into prehospital care record (American Medical Response) to assess for racial disparities in EMS care delivery.
    • Quarterly facility drop time performance reporting established as part of Facilities and Critical Care Committee Activities.

    2008
    • Trial study of LUCAS chest compression system for patients in cardiac arrest implemented.
    • STEMI system launched including implementation of 12-lead EKG program in ambulances countywide and the appointment of 4 hospital receiving facilities (Doctors San Pablo; John Muir Health, Concord and Walnut Creek Campuses; and San Ramon Regional Medical Center.

    2007
    • Emergency care simulator equipment transported by AMR to fire services countywide for scheduled fire EMS training.
    • New Multicasualty Plan implemented countywide 7/1/07. 10,000 triage tags purchased and distributed to fire first responder agencies and emergency ambulance service providers.
    • Kaiser Medical Center opened in Antioch. 11/1/07
    • Fire electronic PCR implemented. 1/2/07
    • EMS provider focused quality newsletter "EMS Best Practices" initiated.
    • SWAT paramedic program proposal approved for Concord Police Department.
    • CCT-P Program treatment guidelines now coordinated with Alameda and Santa Clara County guidelines.
    • 30th Anniversary of Paramedic services in Contra Costa County.