Medical Control Authorities

A Medical Control Authority (MCA) is an organization designated by the department for the purpose of supervising and coordinating an emergency medical services (EMS) system, as prescribed, adopted, and enforced through department-approved protocols for a particular geographic region.

MCA Responsibilities 
MCA Role in the MI-EMSIS 
Michigan Protocols (Updated: 10/1/14) 
Michigan Emergency Protocols 
MCA Directory
MCA Events (Updated: 4/9/14) 
MCA News (Updated: 12/2012)
Declaratory Rulings, Alerts, & Clarifications 
Forms & Publications

MCA Responsibilities

  • The supervision and coordination of the EMS system;
  • Adopting an organizational structure of their choice, but must have an advisory body;
  • Appointing a medical director who is board certified in emergency medicine or who practices emergency medicine and is current in Advanced Cardiac Life Support (ACLS) and Advanced Trauma Life Support (ATLS);
  • Establishing written protocols for the practice of life support agencies and EMS personnel;
  • Circulating draft protocols to all significantly affected persons for review and submitting to the department for approval;
  • Ensuring physicians, hospital staff, and providers are educated on protocols;
  • Adhering to protocols

MCA Role in the MI-EMSIS

The Office of Legal Affairs within the Michigan Department of Community Health has developed the following document to provide clarification with respect to confidentiality/privacy issues as it pertains to the data collection/retention process:

MDCH Authorities and Obligations (9/2009) 

To assist in addressing the confidentiality/privacy issues that have been raised, the EMS and Trauma Systems Section is requiring that each MCA develop and submit a protocol, for approval, on how data will be used, maintained, and how the data will remain confidential.  The Department has developed a state protocol (Patient Care Record, Electronic Documentation, and EMS Information System) to fulfill this need and has added it to the "System Protocols" section of the State Protocols.  The MCA must adopt this protocol at a minimum.  If you choose to add additional language, a deviation form must be completed along with the protocol, for review and approval.

As the EMS and Trauma Systems Section is very committed to ensuring data confidentiality, access by the Medical Control Authorities to their Life Support Agency data has been removed effective IMMEDIATELY.  To have access restored, the Medical Control Authority must complete the following:

*Submit, at a minimum, the state protocol for "Patient Care Record, Electronic Documentation, and EMS Information System" (located under System Protocols);

*Submit a signed Data Use and Non-Disclosure Agreement;

*Submit a signed User Agreement for each individual who is given access to the Michigan EMS Information System (MI-EMSIS)

November 2009 Memo to MCA's regarding MI-EMSIS 

If your MCA has not yet been set up for MI-EMSIS, or if you have any questions regarding MI-EMSIS, please contact Kevin Putman, EMS State Data Manager at:

Kevin Putman, MSA, EMT-P, I/C
Michigan EMS Data Manager

Western Michigan University School of Medicine
1000 Oakland Drive, D60G
Kalamazoo, MI 49008-8060
Office: (269) 337-4291
Fax: (269) 337-6475

Michigan Protocols

Each MCA is required to establish written protocols as defined in Section 20919 of the Public Health Code.  Protocols adopted by the MCA and approved by the department have the force and effect of law.  Licensed life support agencies and individuals are accountable to the MCA in the provision of emergency medical services as defined in protocols.  Each participating and non-participating hospital within a MCA region shall follow all standards, policies, procedures, and protocols established by the MCA as approved by the Department.  Each MCA shall submit to the department current protocols for department review and approval.  Department approval shall be on a 3 year cycle as defined by the department.

The department has updated the State Protocols by developing the following:

  • Medical First Responder Adult and Pediatric Treatment Protocols;
  • Emergency Medical Technician & Specialist Adult and Pediatric Treatment Protocols;
  • Paramedic Adult and Pediatric Treatment Protocols

Medical Control Authorities are required to submit new protocols by June 1, 2010 and every 3 years thereafter, that at a minimum meet the state protocols.  If they want to make an addendum to the state protocols, the MCA's must follow the process of completing the appropriate forms, and submitting requests to the department for review and approval.

To preview and download the Michigan Protocols, you will need Adobe Acrobat Reader.  If you do not have this program, it can be downloaded from the Adobe website at: 

Note: The protocols may take several minutes to download as they are very large files. 

Michigan Protocols (Revised: 1/31/13)
Michigan Protocols (Narrative ONLY) (Revised: 1/31/13)
Adult Cardiac Treatment Protocol - Tachycardia 2-8 (Revised: 8/15/13)
Do Not Resuscitate Procedure Protocol 5-9 (Revised: 3/25/14)
Adult Treatment Protocol - General Crush Injury 5-34 (Revised: 10/1/14)
Adult Treatment Protocol - Excited Delirium 1-22 (Revised: 10/1/14)
Adult Treatment Protocol - Obstetrical Emergencies 1-12 (Revised 7/18/14)
Adult Treatment Protocol - Spinal Injury Assessment 1-20 (Revised: 7/18/14)
Pediatric Treatment Protocol - Pediatric Medication Emergency Dosing & Intervention Cards 3-14 (Revised: 9/25/14)
Pediatric Treatment Protocol - Pediatric Assessment & Treatment 3-3 (Revised: 9/25/14)
Pediatric Treatment Protocol - Pediatric Newborn Assessment, Treatment, & Resuscitation 3-9 (Revised: 7/18/14)
System Protocol - High Risk Delivery Transport Guidelines (Optional) 6-38 (Revised: 9/25/14)
General Procedures Protocol - Refusal of Care - Adult & Minor 5-26 (Revised: 7/18/14)
General Procedures Protocol - Spinal Precautions 5-27 (Revised: 7/18/14)

6/8/12 Memo: Updated Michigan Protocols
12/6/12 Memo: Updated Michigan Protocols
8/20/13 Memo: Updated Adult Cardiac Treatment Protocol - Tachycardia 2-8
4/1/14 Memo: Updated Do Not Resuscitate Procedure Protocol 5-9
10/16/14 Memo: Updated Michigan Protocols

Other Forms and Templates:
MCA Request for Addendum to Michigan Protocols Form  (Word Format) (Revised: 4/2012)
Instructions for Submitting Protocols for Review  (Word Format) (Revised: 4/2010) 
Required Drug List  (Revised: 4/2010)

BYLAWS Template (Revised: 6/7/2012)

Michigan Emergency Protocols

Administrative Rule 325.22206, Rule 207(5) allows for a Medical Control Authority to
 establish an emergency protocol necessary to preserve the health or safety of individuals within its region in response to a present medical emergency or disaster in accordance with section 20919 (3)(e) of the code.

MCAs should submit emergency protocols as soon as possible, either by fax (517) 241-9458 or send electronically to Maria Willoughby-Byrwa at to implement.   Emergency protocols are in effect for 60 days, unless otherwise approved by the Department.

MCA Events:

Highlights from 2014 Medical Control Seminar
(Adobe PDF)

*MCA Orientation (Marvin Helmker, EMS Manager, EMT-P, I/C)
*MCA Update (Marvin Helmker, EMS Manager, EMT-P, I/C)
*MCA Protocol Updates (Maria Willoughby-Byrwa, EMT-P, I/C)
*MCA Protocol Submission Process (Maria Willoughby-Byrwa, EMT-P, I/C)
*EMS for Children Initiatives (Maria Willoughby-Byrwa, EMT-P, I/C)

*EMS System Overview (William Fales, MD, FACEP)
*EMS Quality Improvement (Macomb County Medical Control Authority)
*Innovations & Best Practices for Public Health & Medical Preparedness & Response (Edward Gabriel, MPA, EMT-P, CEM, CBCP)
*Michigan's High-Performance CPR Initiative (Vincent Schwartz, EMT-P, I/C)
*Bringing Science to the Pit Crew: High-Functioning EMS CPR Teams (Douglas Kupas, MD, EMT-P)
*Trauma Systems & their Development (Wayne Vander Kolk, MD, FACS)
*Operationalizing CQI in your Skills Verification Program (Antonio Bonfiglio, MD, FACEP)
*Michigan's Trauma System (Eileen Worden, Trauma Manager)
*Spinal Injury Assessment Protocol & Spinal Precautions Procedure: New Michigan Protocols (Robert Domeier, MD)
*PSRO Case Studies: Critical Thinking
*Creating a Culture of Safety in EMS: for Providers & Patients (Douglas Kupas, MD, EMT-P)

Highlights from 2013 Medical Control Seminar (Adobe PDF)

*MCA Orientation (Robin Shivley)

*MCA Update (Robin Shivley)
*Legal Update: Defining Michigan Statutes (Robin Shivley)
*IRB Special Studies (Robin Shivley)
*MCA Strengths & Weaknesses: 2012 Evaluation Survey (Maria Willoughby-Byrwa)

*Cardiac Arrest Review 2012 (Robert Domeier, MD)
*Part 1: Strategies to Improve Cardiac Arrest Survival (Robert Neumar, MD, PhD)
*Part 2: Strategies to Improve Cardiac Arrest Survival (Robert Neumar, MD, PhD)
*Part 3: Strategies to Improve Cardiac Arrest Survival (Robert Neumar, MD, PhD)
*Part 4: Strategies to Improve Cardiac Arrest Survival (Robert Neumar, MD, PhD)
*Statewide Quality Improvement in EMS: The MI-MEDIC Project (William Fales, MD, FACEP)
*Michigan MCI Burn Plan: Assembling the Team (William Fales, MD, FACEP)
*Pediatric Prehospital Medication Errors (John D. Hoyle, Jr. MD, FACEP, FAAP)
*EMS: Endless Medication Shortages? (Deb Wagner, PharmD, FASHP)
*Management of Medication Shortages (Damon Obiden)
*Medication Shortage Management Policy (Kent County MCA)
*Operationalizing Michigan's Trauma System: A Year of Progress (Eileen Worden)

Highlights from 2012 Medical Control Seminar (Adobe PDF)

*Medical Director Course - Module 1: EMS Overview

*Medical Director Course - Module 2: EMS Systems
*Medical Director Course - Module 3: Roles & Responsibilities
*MCA Yesterday & Today
*MCA Future Directions
*MCA Update

*Community Paramedic
*Patient Advocacy - HVA's Case Manager Program
*MDCH Data and Protocols 2012 - Early Version
*MDCH Data and Protocols 2012 - Late Version
*Scarce Resource Allocation
*Rampart Study
*Operationalizing Michigan's Trauma System
*MDCH - EMS Legal Update

Highlights from 2011 Medical Control Seminar (Adobe PDF)

*Statewide Trauma System - Part 1 (Michelle Mora)

*Statewide Trauma System - Part 2 (Michelle Mora)
*Regionalization of Emergency Care (Robin Shivley)
*Pediatric Study - Prehospital Medication Errors (Dr. Hoyle)
*MCA Evaluation Tool - Presentation / Tool (Robin Shivley)
*Disaster Preparedness Update (Dr. Edwards)
*EMS & Trauma Systems Section Update (Robin Shivley) 

Highlights from 2010 Medical Control Seminar (Adobe PDF)

*Medical Director Course - Introduction (Dr. Fales, Dr. Edwards, & Robin Shivley)

*Medical Director Course - Module 1: EMS Overview 
*Medical Director Course - Module 2: EMS Systems 
*Medical Director Course - Module 3: Roles & Responsibilities 

*The Expanding Role of Medical Control Directors (Dr. Edwards, Dr. Domeier, & Michelle Mora)
*The Expanded Roles of EMS & Medical Oversight 

*Changes in EMS Communications (Brent Williams)
*Why Data & CQI are so Important (Dr. Lammers)
*Quality Improvement (Dr. Fales & Kevin Putman)
*EMS Issues that Impact MCA's (Robin Shivley)

Highlights from 2009 Medical Control Seminar (Adobe PDF) 

MCA Roles & Responsibilities 
Michigan EMS System Overview (Part 1) 
Michigan EMS System Overview (Part 2) 
Understanding the Protocol Process 

MCA News

Contaminated Medication

In light of the recent incident involving contaminated medication causing Fungal Meningitis, the Department has issued a memo to ALL Medical Control Authorities and ALS agencies regarding the impact it may have on drugs being carried by our Advanced services. 

At this time, the Department is requesting that all ALS agencies inventory their drug boxes to determine if any of the listed medications were manufactured or distributed by The New England Compounding Center (NECC).  If medications are found, please be sure to remove these drugs from your boxes and work with your pharmacy to have them exchanged and secured.

12/20/12 CDC Clinician Guidance
12/3/12 CDC Health Update: Additional Contamination Identified
10/11/12 Department Memo to ALL MCAs and ALS Agencies
FDA Statement and Updates on the Fungal Meningitis Outbreak

Forms & Publications



Data Use and Non-Disclosure Agreement (MI-EMSIS) (Revised: 10/2009) (Microsoft Word) 
User Agreement (MI-EMSIS) (Revised: 10/2009) (Microsoft Word)  
Request for Addendum to Michigan Protocols Form DCH-1464 (Revised: 4/2012) (Microsoft Word)
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