BILL NUMBER: AB 210 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 27, 2011
AMENDED IN ASSEMBLY APRIL 4, 2011
INTRODUCED BY Assembly Member Solorio
JANUARY 31, 2011
An act to amend Sections 1797.105, 1797.224,
1797.224 and 1797.270 of, to add Sections 1797.95 and
1797.225 to, and to repeal Section 1797.201 of, the Health and Safety
Code, relating to emergency medical services.
LEGISLATIVE COUNSEL'S DIGEST
AB 210, as amended, Solorio. Emergency medical services.
(1) Existing law establishes the Emergency Medical Services System
and the Prehospital Emergency Medical Care Personnel Act, which
governs local emergency medical service systems and establishes the
Emergency Medical Services Authority, which is responsible for the
coordination and integration of all state activities concerning
emergency medical services. The act requires the authority
to receive plans for the implementation of emergency medical services
and trauma care systems from local EMS agencies and authorizes a
local EMS agency to appeal a determination that a plan does not
effectively meet the needs of the persons served, among other things.
This bill would authorize a prehospital EMS provider, as defined,
to appeal the authority's determination.
(2) The act
requires a county to enter into a written agreement with a
city or fire district that contracted for, or provided, as of June 1,
1980, prehospital emergency medical services regarding the provision
of these services for the city or fire district, as specified. The
act requires, until an agreement is reached, prehospital emergency
medical services to be continued at not less than the existing level,
unless reduced by the city council or the governing body of the fire
district, as specified.
This bill would repeal these requirements.
(3)
(2) The act authorizes a local EMS agency to create one
or more exclusive operating areas in the development of a local
plan, as specified, and requires a local EMS agency that creates an
exclusive operating area in its local plan to develop and submit the
local EMS agency's competitive process for selecting providers and
determining the scope of their operations to the authority.
This bill would require a local EMS agency to grant an exclusive
operating area or authorization to provide the same prehospital
emergency medical services to a city, county, fire district, or other
governmental entity that has continuously contracted for, or
provided, these services since June 1, 1980, if this prehospital EMS
provider has not entered into an agreement with the local EMS agency
to provide prehospital emergency medical services for a city, county,
or fire district. It would require a prehospital EMS provider ,
as defined, granted an exclusive operating area or
authorization to provide prehospital emergency medical services to
enter into a written agreement with the local EMS agency by December
31, 2013. It would also require prehospital EMS providers to be
subject to the medical control of the local EMS agency and comply
with local EMS agency policies and procedures regarding
administration of the local EMS system.
(4)
(3) The EMS act authorizes the establishment of an
emergency medical care committee in each county and requires the
committee to annually review ambulance services operating within the
county, emergency medical care offered within the county, and first
aid practices in the county. The act also requires the committee to
report its observations and recommendations relative to this review
to the authority and the local EMS agency.
This bill would require the membership of an emergency medical
care committee in each county to be representative of the EMS
system participants.
(5)
(4) By increasing the duties of local officials, this
bill would impose a state-mandated local program.
(6)
(5) 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) Emergency medical services (EMS) system coordination remains
the key factor in efficiently delivering the highest level of
prehospital patient care and emergency transport.
(b) All providers and stakeholders in the EMS delivery system must
be guided by consistent, clear standards regarding their rights,
responsibilities, and duties arising out of the provision of
prehospital emergency medical care to their respective communities.
(c) Agencies responsible for developing and maintaining a local
emergency medical services plan must be guided by and responsive to
reasonable and consistent standards for evaluating and determining
the scope, manner, and types of services provided within their
respective jurisdictions, particularly when making determinations
regarding exclusive operating areas and the concomitant
rights under Section 1797.201 of the Health and Safety Code.
concomitant rights of cities and fire districts that
have provided prehospital emergency medical services at not less than
the existing level since June 1, 1980.
(d) As of January 1, 2012, all emergency medical services
personnel, regardless of local agency or private employer, are
subject to the same training, certification, and licensing standards,
and coordinate in the same manner with the base hospital in the
provision of prehospital EMS services.
(e) Cities, fire districts, private providers, and local EMS
agencies are vital partners in the delivery of prehospital EMS
services, partners that contribute to a rapid deployment of highly
trained EMS personnel.
(f) Cities and fire districts remain a fundamental partner in
assisting the county in its duty to provide emergency ambulance
services for all residents of that county.
(g) A city or fire district that retains and carries out
prehospital emergency medical service is a reflection of the will of
that jurisdiction's constituents, as it is the local taxpayers who
must pay to maintain the chosen level of service or any increase in
the level of that service.
(h) It is in the public interest to ensure that all agencies
providing prehospital EMS services do so within a coordinated EMS
system that provides clear standards for training, certification, and
licensure of personnel, as well as for medical control and clinical
oversight.
(i) Guided by findings of the courts over the past two decades,
without altering or otherwise affecting the ordinances of a city or
fire district that has historically provided prehospital emergency
medical services, it is further the intent of the Legislature to lend
greater clarity to the rights and responsibilities of a city,
county, fire district, private provider, and local EMS agency with
respect to their respective emergency response duties to their
constituents.
(j) Establishing an agreement between a city or fire district and
its respective local EMS agency to codify the existing authority of
that city or fire district to continue the administration of its own
prehospital emergency medical services as part of a coordinated EMS
system, rather than relying on the absence of an agreement, best
serves all agencies that seek to work cooperatively to provide
quality patient care at the highest level.
(k) It is imperative that those cities and fire districts
providing, as of January 1, 2012, emergency medical dispatch, first
responder, or transport services at a level not less than what they
provided continuously since June 1, 1980, be recognized through a
written agreement with the local emergency medical services agency
(LEMSA) as an authorized service provider within the local EMS
system. These services need to be acknowledged as part of any
agreement with the LEMSA. This authorization also needs to be
established in perpetuity and not be subject to a competitive bidding
process that would otherwise have an impact that reduces or
increases the recognized service area. Recognized providers need to
participate in medical control and adhere to standardized licensure,
certification, and training standards, while also serving as EMS
system participants working in a coordinated manner as part of the
EMS plan.
(d)
(l) Over 20 years of litigation magnifies the need for
further statutory guidance to ensure that the California EMS
community continues its focus on its primary mission, providing
excellent care to the citizens they serve.
SEC. 2. Section 1797.95 is added to the Health and Safety Code, to
read:
1797.95. "Prehospital EMS provider" means a city, county, fire
district, or other governmental entity or private entity that
provides first response services at the limited advanced life support
or advanced life support level or provides emergency ambulance
services or dispatches EMS resources.
SEC. 3. Section 1797.105 of the Health and
Safety Code is amended to read:
1797.105. (a) The authority shall receive plans for the
implementation of emergency medical services and trauma care systems
from local EMS agencies.
(b) After the applicable guidelines or regulations are established
by the authority, a local EMS agency may implement a local plan
developed pursuant to Section 1797.250, 1797.254, 1797.257, or
1797.258 unless the authority determines that the plan does not
effectively meet the needs of the persons served and is not
consistent with coordinating activities in the geographical area
served, or that the plan is not concordant and consistent with
applicable guidelines or regulations, or both the guidelines and
regulations, established by the authority.
(c) A local EMS agency or a prehospital EMS provider may appeal a
determination of the authority pursuant to subdivision (b) to the
commission.
(d) In an appeal pursuant to subdivision (c), the commission may
sustain the determination of the authority or overrule and permit
local implementation of a plan, and the decision of the commission is
final.
SEC. 4. SEC. 3. Section 1797.201 of
the Health and Safety Code is repealed.
SEC. 5. SEC. 4. Section 1797.224 of
the Health and Safety Code is amended to read:
1797.224. A local EMS agency may create one or more exclusive
operating areas in the development of a local plan, if a competitive
process is utilized to select the provider or providers of the
services pursuant to the plan. No competitive process is required if
the local EMS agency develops or implements a local plan that
continues the use of existing providers operating within a local EMS
area in the manner and scope in which the services have been provided
without interruption since January 1, 1981. A local EMS agency which
elects to create one or more exclusive operating areas in the
development of a local plan shall develop and submit for approval to
the authority, as part of the local EMS plan, its competitive process
for selecting providers and determining the scope of their
operations. This plan shall include provisions for a competitive
process held at periodic intervals.
SEC. 6. SEC. 5. Section 1797.225 is
added to the Health and Safety Code, to read:
1797.225. (a) A local EMS agency shall grant to a city, county,
fire district, or other governmental entity that has continuously
contracted for, or provided prehospital emergency medical services
since June 1, 1980, an exclusive operating area or authorization to
provide the same prehospital emergency medical services if this
prehospital EMS provider has not already entered into an agreement
with the local EMS agency to provide prehospital emergency medical
services for a city, county, or fire district. The prehospital EMS
provider granted an exclusive operating area or authorization to
provide prehospital emergency medical services shall enter into a
written agreement with the local EMS agency by December 31, 2013.
(b) A local EMS agency shall include all prehospital EMS providers
in its local emergency medical services plans.
(c) Prehospital EMS providers shall be subject to medical control
by the local EMS agency, including, but not limited to, pursuant to
Chapter 5 (commencing with Section 1798), and shall comply with local
EMS agency policies and procedures regarding the administration of
the local EMS system.
SEC. 7. SEC. 6. Section 1797.270 of
the Health and Safety Code is amended to read:
1797.270. An emergency medical care committee may be established
in each county in this state. The committee membership shall be
representative of the EMS system participants. Nothing in this
division should be construed to prevent two or more adjacent counties
from establishing a single committee for review of emergency medical
care in these counties.
SEC. 7. This act, which adds Section 1797.225 to,
and repeals Section 1797.201 of, the Health and Safety Code, shall
not be construed to affect, limit, or otherwise invalidate any
decision by a court of competent jurisdiction that interprets and
applies Section 1797.201 of the Health and Safety Code, as that
section read on December 31, 2011.
SEC. 8. 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.