BILL NUMBER: AB 2917 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 2, 2008
INTRODUCED BY Assembly Member Torrico
FEBRUARY 22, 2008
An act to amend Section 1798.201 of the Health and Safety
Code, relating to emergency medical services. An act
to amend Sections 1797.101, 1797.170, and 1798.200 of, and to add
Sections 1797.61, 1797.117, 1797.118, and 1797.184 to, the Health and
Safety Code, relating to emergency medical services.
LEGISLATIVE COUNSEL'S DIGEST
AB 2917, as amended, Torrico. Emergency medical services
personnel.
Under existing law, the Emergency Medical Services System and the
Prehospital Emergency Medical Care Personnel Act, the Emergency
Medical Services Authority is responsible for establishing minimum
standards and promulgating regulations for the training and scope of
practice for emergency medical technicians-paramedic (EMT-P).
Violation of the act is a misdemeanor. Under existing law, these
standards and regulations would be applicable to local governments,
agencies, and other organizations that provide this training.
The act also provides for the certification of emergency medical
technicians through the issuance of certificates, including EMT-I and
EMT-II certificates, by local entities, known as local EMS agencies,
which are designated by counties. Existing law also permits public
safety agencies, for public safety personnel, and the State Board of
Fire Services, for fire safety personnel, to issue EMT-I
certificates. Existing law provides that the medical director of a
local EMS agency or the Emergency Medical Services Authority may
deny, suspend, or revoke certificates issued under these provisions,
or may place a certificate holder on probation, upon the occurrence
of any of specified events.
This bill would require the authority to establish and maintain a
centralized system for monitoring and tracing EMT-I and EMT-II
certification status and EMT-P licensure status to be used by local
certifying authorities. The bill would require the authority to adopt
regulations that establish standardized procedures for conducting a
background check. The bill would require every certifying authority
to verify completion of a background check.
This bill would require the authority to establish EMT-I and
EMT-II certification and disciplinary guidelines. This bill would
authorize an EMT-I or EMT-II employer to investigate and discipline
those EMT-I and EMT-II employees who commit specified acts. The bill
would also revise the grounds for which the local EMS agency may
impose additional discipline against an EMT-I or EMT-II certificate
holder.
This bill would also revise the grounds for which the authority
may discipline EMT-P licensees to include, but not be limited to,
denial of licensure by any other governmental entity, impersonating
an applicant or acting as proxy for an applicant, and making a false
statement in connection with an application.
By changing the definition of a 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 no reimbursement is required by this
act for a specified reason.
Existing law authorizes the medical director of a local emergency
medical services agency to evaluate information that an EMT-P
licenseholder has committed any act or omission that appears to
constitute grounds for disciplinary action in order to determine if
there is a reason to believe that disciplinary action may be
necessary.
This bill would, instead, require the medical director to evaluate
the information. By increasing the duties of local officials, this
bill would create 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, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
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) The health and safety of Californians often depends on the
timely response and competent care of emergency medical service (EMS)
personnel.
(b) Whether it is an automobile accident, heart attack, near
drowning, unscheduled childbirth, gunshot wound, or other life
critical incident, emergency medical technicians (EMTs) provide
vital, lifesaving, prehospital attention to the public and assist in
transporting the sick or injured to an appropriate medical facility.
(c) Maintaining consistent and accountable supervision of EMT
certificate holders requires that pertinent information about
certification be available to all EMS providers prior to the
employment of an EMT.
(d) Ensuring the safety of the public, as well as that of first
responders, requires that any entity that employs EMTs have access to
pertinent information concerning any applicant's background and
criminal history as a condition of his or her employment.
(e) Local EMS agencies have a role to play in maintaining the
consistency of department policies and in conforming to the legal
requirements necessary to provide appropriate medical oversight and
protect the public safety.
SEC. 2. Section 1797.61 is added to the
Health and Safety Code , to read:
1797.61. "Certificate status" or "license status" means the
active, expired, suspended, revoked, or placed on probation
designation applied to a certificate or license issued pursuant to
this division.
SEC. 3. Section 1797.101 of the Health
and Safety Code is amended to read:
1797.101. The Emergency Medical Services Authority shall be
headed by the Director of the Emergency Medical Services Authority
who shall be appointed by the Governor upon nomination by the
Secretary of the California Health and
Welfare Agency Human Services . The
director shall be a physician and surgeon licensed in California
pursuant to the provisions of Chapter 5 (commencing with Section
2000) of Division 2 of the Business and Professions Code, and who has
substantial experience in the practice of emergency medicine.
SEC. 4. Section 1797.117 is added to the
Health and Safety Code , to read:
1797.117. (a) The authority shall establish and maintain a
centralized registry system for the monitoring and tracking of each
EMT-I and EMT-II certificate status and each EMT-P license status.
This centralized registry system shall be used by the local
certifying authorities as part of the certification process and shall
be available for public information on EMT-I and EMT-II certificate
and EMT-P license status.
(b) The centralized registry system shall contain, but not be
limited to, the full name of every individual who has been issued an
EMT-I or EMT-II certificate or EMT-P license, the name of the entity
that issued the certificate or license, the certificate or license
number, the date of issuance of the license or certificate, the
license or certificate status, and the date when a background check
was completed.
(c) The authority shall, in order to reduce duplication and
unnecessary administrative costs, adopt regulations that establish
standardized procedures for conducting a background check that
require an Federal Bureau of Investigation and Department of Justice
criminal history and the use of the subsequent arrest service
described in Section 1165.2 of the Penal Code.
SEC. 5. Section 1797.118 is added to the
Health and Safety Code , to read:
1797.118. (a) Every certifying authority shall verify that a
background check pursuant to regulations adopted pursuant to Section
1797.117 has been completed on each individual who is issued an EMT-I
or EMT-II certificate.
(b) Every certifying authority shall submit to the authority
certification data required pursuant to Section 1797.117.
(c) Each local EMS agency shall submit certificate status updates
to the authority within three working days after a final
determination is made regarding a certification disciplinary action
taken by the medical director that results in a change in an EMT-I or
EMT-II certificate status.
SEC. 6. Section 1797.170 of the Health
and Safety Code is amended to read:
1797.170. (a) The authority shall establish minimum
standards develop and promulgate
, after approval by the commission pursuant to Section
1799.50, adopt regulations for the training and scope of
practice for EMT-I certification .
(b) Any individual certified as an EMT-I pursuant to this act
shall be recognized as an EMT-I on a statewide basis, and
recertification shall be based on statewide standards. Effective July
1, 1990, any individual certified as an EMT-I pursuant to this act
shall complete a course of training on the nature of sudden infant
death syndrome which is developed by the California SIDS program in
the State Department of Public Health Services
in consultation with experts in the field of sudden infant
death syndrome.
SEC. 7. Section 1797.184 is added to the
Health and Safety Code , to read:
1797.184. The authority shall develop and, after the approval of
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 authority 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 or EMT-II
certificate holders that protect the public health and safety.
SEC. 8. Section 1798.200 of the Health
and Safety Code is amended to read:
1798.200. (a) The (1)
(A) Except as provided in paragraph (2),
an employer of an EMT-I or EMT-II may conduct investigations, as
necessary, and take disciplinary action against an EMT-I or EMT-II
who is employed by that employer for conduct in violation of
subdivision (c).
(B) Each EMT-I or EMT-II employer shall
provide a written report, along with supporting documentation, to
the medical director of the local EMS agency that has jurisdiction
over the employer within 30 days after the EMT-I or EMT-II
is terminated or suspended for a disciplinary cause, the EMT-I or
EMT-II resigns following notification of an impending investigation
based upon evidence that would indicate the existence of a
disciplinary cause, or the EMT-I or EMT-II is removed from
EMT-related duties for a disciplinary cause after the completion of
the employer's investigation.
(C) At the conclusion of an
investigation, the employer of an EMT-I or EMT-II may develop and
implement, in accordance with the guidelines for disciplinary orders,
temporary suspensions, and conditions of probation adopted pursuant
to Section 1797.184, a disciplinary plan for the EMT-I or EMT-II.
Upon adoption of the disciplinary plan, the employer shall submit
that plan to the local EMS agency within three working days. The
employer's disciplinary plan may include a recommendation that the
medical director of the local EMS agency consider taking
action against the holder's certificate pursuant to paragraph (3).
(2) The medical director of a local EMS agency may conduct
investigations as necessary, and take disciplinary action against an
EMT-I or EMT-II who is not working as an EMT-I or EMT-II or whose
employer chooses not to conduct an investigation pursuant to
paragraph (1) for conduct in violation of subdivision (c). At the
conclusion of these investigations, the medical director may develop
and implement, in accordance with the recommended guidelines for
disciplinary orders, temporary orders, and conditions of probation
adopted pursuant to Section 1797.184, a disciplinary plan for the
EMT-I or EMT-II. The medical director's disciplinary plan may include
action against the holder's certificate pursuant to paragraph (3).
(3) The medical director of the
local EMS agency may, in accordance with Chapter 6
(commencing with Section 100206) of Division 9 of Title 22 of the
California Code of Regulations, regulations for
disciplinary processes adopted pursuant to Section 1797.184,
deny, suspend, or revoke any EMT-I or EMT-II certificate issued under
this division, or may place any EMT-I or EMT-II certificate holder
on probation, upon the finding by that medical director of the
occurrence of any of the actions listed in subdivision (c) .
The authority shall ensure that the local EMS agency's disciplinary
policies and procedures are, at a minimum, as effective in protecting
the due process rights of any EMT-I or EMT-II certificate holder as
those in Chapter 5 (commencing with Section 11500) of Part 1 of
Division 3 of Title 2 of the Government Code. and the
occurrence of one of the following:
(A) The EMT-I or EMT-II employer, after conducting an
investigation, failed to impose discipline for the conduct under
investigation, or the medical director makes a determination that the
discipline imposed was not according to the guidelines for
disciplinary orders and conditions of probation and the conduct of
the EMT-I or EMT-II certificate holder constitutes grounds for
disciplinary action against the certificate.
(B) Either the employer of an EMT-I or EMT-II further determines,
after an investigation conducted under paragraph (1), or the medical
director determines after an investigation conducted under paragraph
(2), that the conduct requires disciplinary action against the
certificate.
(4) The medical director of the local EMS agency, after
consultation and agreement with the employer of an EMT-I or EMT-II,
may temporarily suspend, prior to hearing, any EMT-I or EMT-II
certificate or both EMT-I and EMT-II certificates upon a
determination that the certificate holder has engaged in acts or
omissions that constitute grounds for revocation of the EMT-I or
EMT-II certificate if permitting the certificate holder to continue
to engage in the EMT-I or EMT-II activities presents an imminent
threat to the public health or safety.
(b) The authority may deny, suspend, or revoke any EMT-P license
issued under this division, or may place any EMT-P license issued
under this division, or may place any EMT-P licenseholder on
probation upon the finding by the director of the occurrence of any
of the actions listed in subdivision (c). Proceedings against any
EMT-P license or licenseholder shall be held in accordance with
Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of
Title 2 of the Government Code.
(c) Any of the following actions shall be considered evidence of a
threat to the public health and safety and may result in the denial,
suspension, or revocation of a certificate or license issued under
this division, or in the placement on probation of a certificate or
licenseholder under this division:
(1) Fraud in the procurement of any certificate or license under
this division.
(2) Gross negligence.
(3) Repeated negligent acts.
(4) Incompetence.
(5) The commission of any fraudulent, dishonest, or corrupt act
which is substantially related to the qualifications, functions, and
duties of prehospital personnel.
(2) Denial of licensure, revocation, suspension, or other
disciplinary action against an EMT license or certificate by another
state or territory of the United States, by any other government
agency, or by another California licensing entity. A certified copy
of the decision or judgment shall be conclusive evidence of that
action.
(3) Impersonating an applicant or acting as proxy for an applicant
in any examination or continuing education required under this
division for the issuance of a certificate or license.
(4) Incompetence or gross negligence in carrying out usual
certified or licensed EMT functions.
(5) Making or giving any false statement or information in
connection with the application for issuance of a certificate or
license.
(6) Conviction of any crime which is substantially related to the
qualifications, functions, and duties of prehospital personnel. The
record of conviction or a certified copy of the record shall be
conclusive evidence of the conviction.
(7) Violating or attempting to violate directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
any provision of this division or the regulations adopted by the
authority pertaining to prehospital personnel.
(8) Violating or attempting to violate any federal or state
statute or regulation which regulates narcotics, dangerous drugs, or
controlled substances.
(9) Addiction to the excessive use of, or the misuse of, alcoholic
beverages, narcotics, dangerous drugs, or controlled substances.
(8) Impersonating another certified EMT-I or EMT-II or licensed
EMT-P.
(9) Permitting or allowing another person to use his or her EMT-I
or EMT-II certificate or EMT-P license for the purpose of providing
emergency medical services.
(10) Functioning outside the supervision of medical control in the
field care system operating at the local level, except as authorized
by any other license or certification.
(11) Demonstration of irrational behavior or occurrence of a
physical disability to the extent that a reasonable and prudent
person would have reasonable cause to believe that the ability to
perform the duties normally expected may be impaired.
(12)
(11) Unprofessional conduct exhibited by any of the
following:
(A) The mistreatment or physical abuse of any patient resulting
from force in excess of what a reasonable and prudent person trained
and acting in a similar capacity while engaged in the performance of
his or her duties would use if confronted with a similar
circumstance. Nothing in this section shall be deemed to prohibit an
EMT-I, EMT-II, or EMT-P from assisting a peace officer, or a peace
officer who is acting in the dual capacity of peace officer and
EMT-I, EMT-II, or EMT-P, from using that force that is reasonably
necessary to effect a lawful arrest or detention.
(B) The failure to maintain confidentiality of patient medical
information, except as disclosure is otherwise permitted or required
by law in Sections 56 to 56.6, inclusive, of the Civil Code.
(C) The commission of any sexually related offense specified under
Section 290 of the Penal Code.
(D) Obtaining or possessing in violation of the law, or, except as
directed by a licensed physician and surgeon, dentist, or
podiatrist, administering to himself or herself, or furnishing or
administering to another, any controlled substance as defined in
Division 10 (commencing with Section 11000) of this code or any
dangerous drug or dangerous device as defined in Section 4022 of the
Business and Professions Code.
(E) Use of any controlled substance as defined in Division 10
(commencing with Section 11000) of this code or any dangerous drug or
dangerous device as defined in Section 4022 of the Business and
Professions Code, or alcoholic beverages, to an extent or manner
dangerous or injurious to himself or herself, any other person, or
the public, or to the extent that the use impairs his or her ability
to conduct with safety to the public the practice authorized by his
or her certification or license.
(F) Conviction of a criminal offense involving the prescription,
consumption, or self-administration of any of the substances
described in subparagraphs (D) and (E), or the possession of, or
falsification of a prescription record pertaining to, the substances
described in subparagraph (D), in which event the record of the
conviction is conclusive evidence thereof.
(G) Being committed or confined by a court of competent
jurisdiction for intemperate use of, or addiction to, the use of any
of the substances described in subparagraphs (D) and (E), in which
event the court order of commitment or confinement is prima facie
evidence of that commitment or confinement.
(H) Falsifying, or making grossly incorrect, grossly inconsistent,
or unintelligible entries in any hospital, patient, or other record
pertaining to controlled substances or dangerous drugs or devices.
(d) The report requirement of this section shall not be construed
to require or authorize the release of information or records of an
EMT-I or EMT-II who is also a peace officer described in Section 3301
of the Government Code or a firefighter described in Section 3251 of
the Government Code or to require or authorize the release of
records described in Section 832.7 of the Penal Code. The information
within this report shall be deemed to be an investigative
communication that is exempt from public disclosure as a public
record pursuant to subdivision (f) of Section 6254 of the Government
Code.
(e) For purposes of this section "disciplinary cause" means an act
that is substantially related to the qualifications, functions, and
duties of an EMT-I or EMT-II and is evidence of a threat to the
public health and safety described in subdivision (c).
SEC. 9. This act shall not be construed to limit
or otherwise impair the medical control of the medical director of a
local EMS agency granted pursuant to Section 1798 of the Health and
Safety Code.
SEC. 10. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because 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.
SECTION 1. Section 1798.201 of the Health and
Safety Code is amended to read:
1798.201. (a) When information comes to the attention of the
medical director of the local EMS agency that an EMT-P licenseholder
has committed any act or omission that appears to constitute grounds
for disciplinary action under this division, the medical director of
the local EMS agency shall evaluate the information to determine if
there is reason to believe that disciplinary action may be necessary.
(b) If the medical director sends a recommendation to the
authority for further investigation or discipline of the
licenseholder, the recommendation shall include all documentary
evidence collected by the medical director in evaluating whether or
not to make that recommendation. The recommendation and accompanying
evidence shall be deemed in the nature of an investigative
communication and be protected by Section 6254 of the Government
Code. In deciding what level of disciplinary action is appropriate in
the case, the authority shall consult with the medical director of
the local EMS agency.
SEC. 2. If the Commission on State Mandates
determines that this act contains 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.