BILL NUMBER: AB 210 AMENDED
BILL TEXT
AMENDED IN SENATE JULY 12, 2011
AMENDED IN SENATE JUNE 29, 2011
AMENDED IN ASSEMBLY JUNE 1, 2011
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 1797.85, 1797.224, 1797.270, 1797.274,
and 1797.276 of, and to repeal and add 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 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 continue the authorization of a city or fire
district that had continuously contracted for or provided prehospital
emergency medical services (EMS) since June 1, 1980, to contract for
or provide, with operational control, the same category of
prehospital EMS that it has continuously provided during that time,
within the geographical service area that it continuously served
during that time, if the city or fire district makes a formal written
request to the local EMS agency prior to January 1, 2014, and if
specified conditions are met. The bill would revise the definition of
exclusive operating area for this purpose to delete providers of
limited advanced life support on advanced life support.
(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 authorize a local EMS agency to grant one or more
exclusive operating areas for emergency ambulance services,
interfacility transport, or both, in the development of the local
plan.
(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, instead, require the committee to review the
county's emergency medical care system. The bill would
require the membership of an emergency medical care committee in each
county to be representative of the EMS system participants.
(4) By increasing the duties of local officials, this bill would
impose a state-mandated local program.
(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 medical transport.
(b) All prehospital EMS providers 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 services to their respective
communities.
(c) Local EMS 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, as set forth in
Sections 1797.85 and 1797.224, and the 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) It is the intent of the act adding this subdivision to
preserve the rights of cities and fire districts as set forth in
Section 1797.201, as that section read on December 31, 2011, and the
authority of the local EMS agencies to grant exclusive operating
areas pursuant to Section 1797.224 as that section read on December
31, 2011, and to align those rights and authority.
(e) Cities, fire districts, private providers, and local EMS
agencies are vital partners in the delivery of prehospital EMS,
partners that contribute to a rapid deployment of highly trained EMS
personnel.
(f) It is in the public interest to ensure that all agencies
providing prehospital EMS do so within a coordinated EMS system that
provides clear standards for training, certification, and licensure
of personnel, as well as for administration, medical control, and
clinical oversight.
SEC. 2. Section 1797.85 of the Health and Safety Code is amended
to read:
1797.85. "Exclusive operating area" means an EMS area or subarea
defined by the emergency medical services plan for which a local EMS
agency, upon the recommendation of a county, restricts operations to
one or more emergency ambulance services.
SEC. 3. Section 1797.201 of the Health and Safety Code is
repealed.
SEC. 4. Section 1797.201 is added to the Health and Safety Code,
to read:
1797.201. (a) A city or fire district that has continuously
contracted for or provided prehospital emergency medical services
(EMS) since June 1, 1980, shall have continuing
continue to have authorization to contract for or provide,
with operational control, the same category of prehospital EMS that
is it has continuously provided during
that time, within the geographical service area that it has
continuously served during that time, if the city or fire
district makes a formal written request for recognition to the local
EMS agency prior to January 1, 2014, and if the following conditions
are met:
(1) The city or fire district has not previously entered into a
prehospital EMS administration agreement. A
For purposes of this section, a "prehospital EMS administration
agreement" means an agreement entered into between a city or fire
district and a local EMS agency in which the city or fire district
agreed to have their prehospital EMS administered by the local EMS
agency. An agreement, other than an agreement described in this
paragraph, previously entered into between a local EMS agency and a
city or fire district where the city or fire district agreed to
adhere to that local EMS agency's medical control policies and
procedures shall not constitute a prehospital EMS administration
agreement.
(2) The city or fire district enters into a written agreement with
the local EMS agency, in a form specified by the local EMS agency,
addressing only the following:
(A) Medical control , including policies, protocols,
emergency medical dispatch protocols, and quality improvement.
(B) Coordination of EMS resources.
(C) Recognition of the category of prehospital EMS that the city
or fire district is authorized to perform.
(D) Designation of the geographical service area for which
authorization is granted.
(b) If the city or fire district fails to enter into an agreement
with the local EMS agency by January 1, 2014, or has failed to
commence an appeal, then the city or fire district shall not perform
or contract for that category of prehospital EMS unless formally
authorized to do so by the local EMS agency in accordance with the
requirements of this division. Appeals shall proceed in the following
order: local Emergency Medical Care Committee or its equivalent, the
governing body of the local EMS agency, and then judicial review.
The standard of review on the appeal shall be de novo.
(c) A city or fire district that has not continuously performed,
or contracted for, a specific category of prehospital EMS
since June 1, 1980, shall not perform or contract for that category
or of prehospital EMS unless formally
authorized to do so by the local EMS agency in accordance with the
requirements of this division.
(d) A local EMS agency shall include all prehospital EMS providers
who comply with the requirements of this division in its local
emergency medical services plan.
(e) For purposes of this division, "category of prehospital EMS"
shall include only only include one or
more of the following:
(1) First response, which means the delivery of prehospital EMS
without patient transport.
(2) Dispatch, which means dispatch of a provider's own or
contracted prehospital EMS resources.
(3) 911 ambulance transport service, which means ambulance service
provided in response to a 911 call or, as determined by the local
EMS agency, an emergency call to a 7 digit number.
(4) Interfacility ambulance service, which means ambulance
transport, other than 911 ambulance service, between health
facilities or between a patient's residence and a health facility.
(f) All prehospital EMS providers shall be subject to medical
control by the local EMS agency, including, but not limited to, those
pursuant to Chapter 5 (commencing with Section 1798), and shall
comply with local EMS agency policies and procedures regarding the
delivery of prehospital emergency medical services.
(g) Nothing in this section shall preclude a prehospital EMS
provider from increasing the level of service it provides within a
category of prehospital EMS for which it has continuously
provided service since June 1, 1980.
(h) Nothing in this section shall be construed as permitting a
prehospital EMS provider from adding a new category of
service prehospital EMS that it has not provided
continuously since June 1, 1980.
SEC. 5. 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 for emergency ambulance services or interfacility
transport, or both, 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 , as
determined by the local EMS agency.
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. Section 1797.274 of the Health and Safety Code is amended
to read:
1797.274. The emergency medical care committee shall, at least
annually, review the county's emergency medical care
system.
SEC. 8. Section 1797.276 of the Health and Safety Code is amended
to read:
1797.276. Every emergency medical care committee shall, at least
annually, report to the authority, and the local EMS agency its
observations and recommendations relative to its review of the county'
s emergency medical system. The emergency medical care
care committee shall submit its observations and recommendations to
the county board or boards of supervisors which it serves and to the
local EMS agency, on all matters relating to emergency medical
services.
SEC. 9. This act, which repeals and adds 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 Division 2.5 (commencing
with Section 1797) of the Health and Safety Code, as that division
read on December 31, 2011.
SEC. 10. 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.