Bill Text: CA AB2456 | 2009-2010 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Emergency medical services: regulation.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Vetoed) 2010-09-29 - Vetoed by Governor. [AB2456 Detail]

Download: California-2009-AB2456-Amended.html

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BILL NUMBER: AB 2456	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JULY 15, 2010
	AMENDED IN SENATE  JUNE 23, 2010
	AMENDED IN ASSEMBLY  MAY 28, 2010
	AMENDED IN ASSEMBLY  APRIL 22, 2010
	AMENDED IN ASSEMBLY  APRIL 5, 2010

INTRODUCED BY   Assembly Member Torrico

                        FEBRUARY 19, 2010

   An act to amend Sections 1797.184 and 1797.200 of the Health and
Safety Code, relating to emergency medical services.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2456, as amended, Torrico. Emergency medical services:
regulation.
   Existing law, the Emergency Medical Services System and the
Prehospital Emergency Medical Care Personnel Act, authorizes each
county to designate an emergency medical services (EMS) agency, for
the establishment and administration of an emergency medical services
program in the county. Existing law also establishes the Emergency
Medical Services Authority (EMSA), which, among other things, adopts
guidelines and regulations governing the provision of emergency
medical services. Violation of these provisions is a crime.
   This bill would specify that the regulations of the authority
shall include policies and procedures applicable to the functions,
certification, and licensure of all emergency medical technician
personnel, as defined, and would require the local EMS agencies to
adhere to these standards. The bill would authorize the authority to
develop and adopt a related fee schedule and fee increases to support
the authority's actual costs to promulgate the additional
regulations. The bill would provide that any policies and procedures
implemented by a local EMS agency that are not in accordance with the
standards required under the bill are subject to approval by the
Director of the EMSA, as specified, and that an EMS service provider
 or a local EMS agency  may appeal the determination made by
the director to the Emergency Medical Services Commission. By
requiring that the local entities comply with these requirements, and
by changing the definition of an existing crime, this bill would
impose a state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that with regard to certain mandates no
reimbursement is required by this act for a specified reason.
   With regard to any other mandates, this bill would provide that,
if the Commission on State Mandates determines that the bill contains
costs so mandated by the state, reimbursement for those costs shall
be made pursuant to the statutory provisions noted above.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) For the purpose of administering an effective, statewide
system of coordinated emergency medical care and statewide
recognition of certification and licensure for emergency medical
technician (EMT) personnel, the Emergency Medical Services Authority
and the Emergency Medical Services Commission must provide guidance
to the more than 32 local emergency medical services (EMS) agencies
tasked with implementing policies and procedures in all areas of
prehospital EMS, including, but not limited to, local accreditation
of optional skills, competency tests, training programs,
demonstration of skills competency, and medical control in order to
facilitate this vital coordination and efficiency.
   (b) The current statewide EMS guidelines assist in achieving
system standardization, streamlining field operations, and continuing
the authority's commitment to comprehensive planning for EMS
statewide.
   (c) The statewide EMS guidelines must be strengthened in order to
do all of the following:
   (1) Link the numerous local EMS agencies together into one
coordinated statewide EMS system.
    (2) Ensure safety, competence, and consistency to the public
statewide; consistent training, competence, and delivery of
prehospital EMS statewide; one standard for all EMT certified and
licensed personnel, regardless of where service is delivered; and
that policies are driven by research and consensus.
   (3) Support the statewide mutual aid process by providing a set
minimum level of service delivery as defined by the EMS community.
   (d) It is the intent of the Legislature to clarify the law with
respect to the authority's ability to establish guidelines for the
coordinated EMS delivery by the many essential prehospital EMS
stakeholders of this state.
  SEC. 2.  Section 1797.184 of the Health and Safety Code is amended
to read:
   1797.184.  The authority  , no later than December 31, 2011,
 shall develop and, after approval by the commission pursuant to
Section 1799.50, adopt all of the following:
   (a) Guidelines for disciplinary orders, temporary suspensions, and
conditions of probation for EMT-I and EMT-II certificate holders
that protects the public health and safety.
   (b) Regulations for the issuance of EMT-I and EMT-II certificates
by a certifying entity that protects the public health and safety.
   (c) Regulations for the recertification of EMT-I and EMT-II
certificate holders that protect the public health and safety.
   (d) Regulations for disciplinary processes for EMT-I and EMT-II
applicants and certificate holders that protect the public health and
safety. These disciplinary processes shall be in accordance with
Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of
Title 2 of the Government Code.
   (e) (1) Regulations establishing standards for policies and
procedures applicable to the functions, certification, and licensure
of EMT personnel as defined in Sections 1797.80, 1797.82, and
1797.84,  which   that provide objective
criteria for local adaptation, and  address all of the following
components:
   (A) Local accreditation.
   (B) Competency-based written and skills examinations.
   (C) Demonstration of skills competency.
   (D) Medical control for the use of the optional skills.
   (E) Approval of service providers utilizing approved optional
skills.
   (F) Additional training and maintenance of accreditation for
optional skills.
   (G) Continued competency in the optional skills, which shall be
monitored through the use of any of various methods, including, but
not limited to, organized field care audits, periodic training
sessions, structured clinical experience, or remediation plans.
   (H) Field internships.
   (I) Preceptor evaluation criteria for trainees.
   (J) Approval and evaluation of advanced EMT service providers.
   (2) The authority may develop and, after approval by the
commission pursuant to Section 1799.50, adopt a schedule of fees to
be collected from each certifying entity, and an increase in fees
pursuant to subdivision (d) of Section 1797.172, in amounts
sufficient to support the authority's actual additional costs to
promulgate regulations pursuant to paragraph (1). The fees shall be
imposed proportionally between the certifying entities, and through
EMT-P licensure fees, based on the number of EMT-Is and EMT-IIs
certified by certifying entities and the number of EMT-Ps licensed by
the authority.
  SEC. 3.  Section 1797.200 of the Health and Safety Code is amended
to read:
   1797.200.  (a) Each county may develop an emergency medical
services program. Each county developing such a program shall
designate a local EMS agency which shall be the county health
department, an agency established and operated by the county, an
entity with which the county contracts for the purposes of local
emergency medical services administration, or a joint powers agency
created for the administration of emergency medical services by
agreement between counties or cities and counties pursuant to the
provisions of Chapter 5 (commencing with Section 6500) of Division 7
of Title 1 of the Government Code.
   (b) A local EMS agency designated pursuant to subdivision (a)
shall adhere to the standards developed by the authority pursuant to
subdivision (e) of Section 1797.184 in establishing its policies and
procedures required by statute or regulation.
   (c) Upon notification to the authority by an EMS service provider
 or a local EMS agency  , any policies and procedures
implemented by a local EMS agency designated pursuant to subdivision
(a) that are not in accordance with the authority's standards
developed pursuant to subdivision (e) of Section 1797.184 are subject
to approval by the Director of the Emergency Medical Services
Authority. Approval by the director pursuant to this subdivision
shall only be granted if the policies and procedures implemented by
the local EMS agency further the purposes of this division.
   (d) An EMS service provider  or a local EMS agency  may
appeal a determination made by the director pursuant to subdivision
(c) to the Emergency Medical Services Commission. The commission in
deciding an appeal pursuant to this subdivision may sustain or
overrule the determination of the director. The commission shall
permit local implementation of the policy or procedure at issue if it
determines that the policy or procedure meets the approved standards
established pursuant to subdivision (e) of Section 1797.184 and is
consistent with the purposes of this division. The decision of the
commission is final.
  SEC. 4.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution for
certain costs that may be incurred by a local agency or school
district because, in that regard, this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
   However, if the Commission on State Mandates determines that this
act contains other costs mandated by the state, reimbursement to
local agencies and school districts for those costs shall be made
pursuant to Part 7 (commencing with Section 17500) of Division 4 of
Title 2 of the Government Code.