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  AUGUST 4, 2010
	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
  review  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  
that is notified of a policy or procedure that is not in compliance
is required to stop implementation of the policy and  
procedure or submit a revised policy or procedure that complies with
the regulations developed by the authority to the director within 90
days of notification.   The bill would allow the authority
to assess penalties on a local EMS agency that fails to respond to a
notification of noncompliance  . 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  Commission on  Emergency
Medical Services Authority and the Emergency Medical Services
 Commission  must provide guidance to the more than
 32   31  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   a single 
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   predetermined  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  and enforce
 guidelines for the coordinated  EMS delivery 
 delivery of EMS  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,
  July 1, 2012,  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  
Advanced EMT  certificate holders that protects the public
health and safety.
   (b) Regulations for the issuance of EMT-I and  EMT-II
  Advanced EMT  certificates by a certifying entity
that protects the public health and safety.
   (c) Regulations for the recertification of EMT-I and 
EMT-II   Advanced EMT  certificate holders that
protect the public health and safety.
   (d) Regulations for disciplinary processes for EMT-I and 
EMT-II   Advanced EMT  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, 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   Advanced EMTs  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

    (c)     Any policies and procedures adopted
or approved  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   subdivision (a)  are subject to
 approval   review  by the Director of the
Emergency Medical Services Authority  at the discretion of the
director or upon notification by a relevant employer or a local EMS
agency  . Approval  of policies and procedures  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  and are in accordance with the
regulations developed by the authority  . 
   (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.  
   (d) A local EMS agency that is notified by the authority that a
policy or procedure is not in compliance with the regulations
developed by the authority shall stop implementing that policy or
procedure or shall submit a revised policy or procedure that complies
with the regulations developed by the authority to the director
within 90 days of notification.  
   (e) The authority may assess penalties on a local EMS agency that
fails to respond to a notification as required pursuant to
subdivision (d). 
  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.