The state of New Mexico doesn't require criminal background checks to license paramedics and other emergency medical personnel, and that worries EMS licensing manager Charles Schroeder.
Most fire departments and many private ambulance services do criminal background checks on a routine basis.
But Schroeder says he is concerned about small and volunteer fire departments and ambulance services that do not require checks.
He finds cases like that of Genaro Sandoval - Albuquerque's alleged "Arroyo Molester" - especially troublesome.
Sandoval was working as a licensed EMT for an ambulance company in Gallup when police there arrested him in 2005 for allegedly tricking three 13-year-old boys into exposing their buttocks to a camera.
Prosecutors said at the time they thought Sandoval destroyed the video while police were conducting their investigation, so a plea deal was struck.
Charges of child exploitation were dropped, and Sandoval pleaded guilty to three counts of contributing to the delinquency of a minor, all fourth-degree felonies. He was sentenced in January 2007 to three years' probation.
In February 2007, Sandoval applied to renew his EMS license and answered "no" to the question about whether he had ever been convicted of a misdemeanor or felony.
But Schroeder and the EMS Licensing Bureau had been monitoring the case after receiving an anonymous letter that included a newspaper article about Sandoval's arrest.
In August 2007, state licensing officials revoked Sandoval's EMT license.
Since there is no criminal background check system, the board would not necessarily have known about the charges when Sandoval sought to renew his license.
Since Sandoval's license was revoked, he was taken off the ambulance crew and worked as a billing clerk - until his arrest on the Albuquerque charges in late 2007.
That came about after his DNA was entered into a national database after his guilty plea in Gallup. In November 2007, investigators received notice that his DNA matched that of an unidentified attacker in the Albuquerque investigation of the "Arroyo Molester" - a man who preyed on younger boys from 2003 to 2005.
State officials who oversee EMT licensing would like to see background checks, but don't know whether the money will be there to put a system in place.
"The statute we need to put in place is one that allows us to use the DPS background system," Schroeder said. "It is a good idea."
Kyle Thornton, EMS Bureau chief, said consensus has emerged over the past five to eight years that background checks should be done as part of the EMT licensing process.
Several years ago, the Legislature required hospital employees to undergo criminal background checks, but emergency medical technicians were not included in that law.
Most fire departments in the state, like Bernalillo County and Albuquerque, conduct criminal background checks on all applicants, including firefighters transferring from other departments.
More than 20 states now deny licenses to people convicted of certain felony crimes, and the National Registry of Emergency Medical Technicians denies certification to anyone convicted of felonies involving sexual misconduct; physical or sexual abuse of children, the elderly or the infirm; and any crime involving patients.
The nonprofit national registry promotes standards for EMTs around the country.
The organization by policy bars sex offenders from being registered because "EMS practitioners ... have unsupervised, intimate, physical and emotional contact with patients at a time of maximum physical and emotional vulnerability, as well as unsupervised access to personal property."
But the state has not adopted that policy.
State regulations allow the Emergency Medical Services Licensing Commission to deny, suspend or revoke the license of anyone found having sex with a patient, or who has a conviction for a felony or misdemeanor, or a conviction of a misdemeanor involving abuse, neglect, exploitation or moral turpitude based on a court record of conviction.
Schroeder says people who admit to committing crimes in the past don't concern him as much as the ones whose criminal pasts they don't know about.
Schroeder says the first group, if approved, "have jumped through every hoop the EMS Licensing Commission required."
"I'm more concerned about the people we don't know about," he said. "We rely on the public to find out about those."
That's because the bureau and commission have no way of conducting independent background checks when issuing someone a license or when they are reissued.
Schroeder said background checks have to be authorized by statute, and they are discussing including a ban on licenses for people convicted of sex crimes.
Thornton said department officials discussed trying to get legislation introduced but didn't think they could get it passed because of the budget crunch in Santa Fe.
If there is no funding for backg round checks, the expense would fall to individuals applying for licenses. That would hurt volunteer fire departments, Thornton said, because members already pay for a lot of their equipment out of their own pockets.
There are 8,000 people licensed by the bureau and 400 EMS entities in the state ranging from the Albuquerque Fire Department to small volunteer departments.
A regulation was recently put out that requires medical rescue services to make efforts to check the backgrounds of EMS personnel.
"The problem is that it will cost money," Thornton said.
The EMS Bureau currently relies on self-reporting.
People applying for a EMT license are asked on the application whether they have ever been convicted of a misdemeanor, DUI or felony.
If the answer is "yes," the applicant must submit a personal statement regarding details of the offense; court records including judgment and sentence; documents showing probation or parole has been successfully completed; and court records showing all requirements set by the court have been satisfied.
A review is conducted by the EMS Bureau but the decision to license is made by the EMS Licensing Commission on an individual basis.
The secretary of the Department of Health appoints the commission members to threeyear staggered terms.
Appointments, by law, include one layperson; three emergency medical technicians, one from each level of licensure; and three physicians, at least two of whom must have expertise in emergency medicine. The physicians are appointed from a list proposed by the New Mexico Chapter of the American College of Emergency Physicians.
Although the law doesn't spell out who can't get a license, not everyone with a criminal record who applies gets licensed.
According to commission minutes, licenses have been denied to people who had failed to complete probation; lied about the extent of their criminal history; or failed to provide evidence of counseling and drug rehabilitation.
The state's new "ban the box" law passed this year and signed by Gov. Bill Richardson prohibits government employers from asking about convictions on application forms. But Schroeder said it doesn't apply to the licensing process so prospective EMTs are still asked.
In the Albuquerque case in which charges against Sandoval are still pending, an 11-year-old boy was walking home from school when a man offered him $30 to spray-paint "Matt sucks" under a bridge.
The boy followed the man under the bridge, where the man sexually assaulted him and videotaped the assault.
DNA taken from the boy was entered into a national database in 2005, and that case was linked to other assaults in the area.
Sandoval is in the Bernalillo County Metropolitan Detention Center awaiting trial on 25 felony charges, including criminal sexual penetration of a child under 13, kidnapping with intent of great bodily harm, aggravated assault with a deadly weapon and sexual exploitation of a child.
Plea discussions have been ongoing.
Sandoval's attorney Joseph Riggs said: "It has taken some time to work our way through the evidence in this case."