It depends how the vehicle is ordered. I believe specific states allow emergency vehicles exemptions for California emissions; including those that require it for new cars otherwise. Fairly confident Ford sells them both ways.
You may want to consult an attorney or your local Google-fu if you're feeling lucky. If you're considering a non-California emissions equipped PIU, check local laws if your state requires California emissions on new cars and what the exemptions are for new vs. used vehicles. In New York, last I looked you can bring in a used non-CA emissions vehicle under certain circumstances.