BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2917
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           Date of Hearing:   April 23, 2008

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mark Leno, Chair

                    AB 2917 (Torrico) - As Amended:  April 2, 2008

          Policy Committee:                              Health Vote:16-1

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill revises the emergency medical technicians (EMT)  
          certification process and disciplinary authority of state and  
          local emergency medical services agencies (LEMSA). Specifically,  
          this bill:

          1)Requires the California Emergency Medical Services Agency  
            (EMSA) to establish and maintain a centralized registry for  
            monitoring EMT certification and adopt related regulations. 

          2)Requires LEMSA to use the registry as a part of the  
            certification process and provide information to the public. 

          3)Requires EMSA to adopt regulations that standardize criminal  
            background check processes and rely on California Department  
            of Justice (DOJ) data and Federal Bureau of Investigation  
            (FBI) data. Requires LEMSA to verify resulting background  
            checks. 

          4)Requires EMSA to adopt regulations pertaining to: 

             a)   Disciplinary processes including suspensions and  
               probation. 
             b)   Issuance of certification and recertification 
           
           5)Authorizes LEMSA to investigate disciplinary issues and  
            establishes related processes.  

           6)Significantly expands the reasons an EMT may have a  
            certification or license denied, suspended, or revoked.   

          FISCAL EFFECT  








                                                                  AB 2917
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          1)EMSA fee-supported special fund start-up costs of $1.6 million  
            in 2009-10 and fee-supported annual costs of $700,000 to  
            $800,000 in 2010-11 and $600,000 in 2011-12 to establish  
            policies and processes, promulgate regulations, and create the  
            registry. 

          2)On-going annual costs may be significantly less, assuming the  
            registry runs smoothly. 












































                                                                  AB 2917
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           COMMENTS  

           1)Rationale  . This bill, sponsored by the California Health and  
            Human Services Agency, addresses a range of significant issues  
            with regard to the status and discipline of EMT statewide. The  
            bill creates statewide processes related to background checks  
            and increases data about these checks and disciplinary  
            processes and outcomes. In addition, this bill clarifies  
            authority at the state and local levels with regard to these  
            issues.  

          This bill is similar to AB 941 (Torrico), in 2007, which was  
            vetoed due to concerns about penalties, investigation  
            timelines, and local authority to conduct investigations. 

           2)Increased Scrutiny Identified Concerns  . In recent years a  
            series of articles and investigations by the Sacramento Bee  
            and the Los Angeles times have highlighted inconsistent and  
            disconcerting EMT disciplinary enforcement. The result has  
            been EMT with various and significant criminal backgrounds  
            acquiring and/or maintaining licenses. Criminal infractions  
            have included child sexual abuse, domestic violence, patient  
            neglect, and narcotic convictions. 
           
          3)Background Checks  .  Statewide, there are 61 EMT certifying  
            authorities:  31 LEMSA and 30 public safety agencies. Only 17  
            of the 31 LEMSAs require DOJ background checks. Data about the  
            public safety agency checks has not been collected.  According  
            to DOJ rules, the certifying agencies that require criminal  
            background checks cannot share the criminal history  
            information with each other when an EMT applies to work in  
            another jurisdiction.  The DOJ rules require an EMT to be  
            fingerprinted again in the new jurisdiction, increasing the  
            time and cost for EMT to be certified.
           
          4)Lack of state-level licensing and registry  .  California is the  
            only state that does not certify EMT at the state level.  In  
            addition, EMT are the only allied health professionals in  
            California who are not state-licensed and the state lacks a  
            statewide registry on EMT licensure. When other states need to  
            verify a California EMT or certificate, it is very difficult  
            for them to determine which of the 61 certifying agencies to  
            contact for verification information.  The EMT is often not  
            able to identify their certifying agency.









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           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081