BILL NUMBER: AB 210 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 15, 2011
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
administration of the same category
type of prehospital EMS that it has continuously provided
or contracted for 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. The
bill would authorize a city or fire district to increase its
geographical area if specified conditions are met. The bill would
prohibit a local EMS agency from creating an exclusive operating area
for a type of prehospital EMS provided or contracted for by a city
or fire district that is providing continuing prehospital EMS.
(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)
(2) 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 and to act in an advisory
capacity to the county board or boards of supervisors . The
bill would require the membership of an emergency medical care
committee in each county to be representative of the EMS system
participants.
(4)
(3) By increasing the duties of local officials, this
bill would impose a state-mandated local program.
(5)
(4) 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 EMS
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
and the roles of cities and fire districts that
have provided prehospital emergency medical services
EMS at not less than the existing level since
June 1, 1980.
(d) It is the intent of the act adding this subdivision
this act 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. 2011.
(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. SEC. 2. Section 1797.201 of
the Health and Safety Code is repealed.
SEC. 4. SEC. 3. 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 continue to have authorization 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 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. 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 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 prehospital
EMS that it has not provided continuously since June 1, 1980.
1797.201. (a) A city or fire district that has continuously
provided, or contracted for, prehospital emergency medical services
(EMS) since June 1, 1980, shall have continuing authorization to
provide or contract for the administration of, with control as this
term is defined in regulation, the same type of prehospital EMS that
it has continuously provided, or contracted for, 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
written prehospital EMS agreement with a county. A city or fire
district that has previously entered into an agreement exclusively
for the purpose of agreeing to adhere to the local EMS agency's
medical control policies and procedures shall not constitute a
written prehospital EMS administration agreement under this section.
(2) The city or fire district requesting recognition enters into a
written agreement, of an unlimited term, with the local EMS agency,
in a form specified by the local EMS agency, for the purposes of this
section, addressing only the following:
(A) Medical control, pursuant to Chapter 5 (commencing with
Section 1798) including policies, protocols, emergency medical
dispatch protocols, and quality improvement.
(B) Coordination of EMS resources.
(C) Recognition of the type 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.
(E) Standards for operational control.
(F) Other terms mutually agreed upon by the contracting parties.
(b) If the city or fire district fails to enter into an agreement
with the local EMS agency, or failed to commence an appeal, by
January 1, 2014, then the city or fire district shall not perform or
contract for that type of prehospital EMS unless formally authorized
to do so by the local EMS agency in accordance with the requirements
of this division. A city or fire district that has commenced an
appeal shall continue to provide or contract for those services it
has provided as of the date of the appeal, until the appeal is
resolved. Appeals shall proceed in the following order: (i) the local
emergency medical care committee or its equivalent, (ii) the
governing body of the local EMS agency, and (iii) judicial review.
(c) If a city or fire district that meets the specifications of
this section has increased or increases its geographical area beyond
the geographical service area that it served as of June 1, 1980,
through annexation or consolidation, the following shall apply for
the newly acquired area:
(1) If the annexation or consolidation occurred prior to January
1, 2012, the annexing city, fire district, or consolidated entity
shall qualify for recognition to provide or contract for the existing
type of prehospital EMS that the annexing city, fire district, or
consolidated entity has provided or contracted for continuously since
the annexation or consolidation occurred. Notwithstanding any other
law, an annexation or consolidation shall not displace an EMS
provider with a current contract with a local EMS agency to provide a
type of EMS within an exclusive operating area.
(2) If the annexation or consolidation occurs after January 1,
2012, the annexing city, fire district, or consolidated entity shall
assume the recognition to provide or contract for the preexisting
type of prehospital EMS that had been continuously provided, or
contracted for, since June 1, 1980, by the predecessor city or fire
district for that geographical service area if there was such a city
or fire district for that geographical service area. Notwithstanding
any other law, an annexation or consolidation shall not displace an
EMS provider with a current contract with a local EMS agency to
provide a type of EMS within an exclusive operating area.
(3) This section shall not be construed to authorize any other
public agency overseeing an annexation or consolidation to make
changes to the local EMS agency's EMS plan for the provision of
prehospital EMS services.
(d) A city or fire district contracting to provide services may
enter into a written agreement for recognition to provide a type or
types of prehospital EMS with the local EMS agency pursuant to
subdivision (a), on behalf of the city or fire district that has
continuously provided or contracted for, as of June 1, 1980, a type
or types of prehospital EMS.
(e) A city or fire district that has not continuously provided or
contracted for a type of prehospital EMS since June 1, 1980, shall
not provide or contract for that type of prehospital EMS unless
formally authorized to do so by the local EMS agency in accordance
with the requirements of this division.
(f) A local EMS agency shall include all cities and fire districts
that comply with the requirements of this section in its local
emergency medical services plan.
(g) For purposes of this section, "type of prehospital EMS" shall
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.
(h) This section shall not preclude a city or fire district from
increasing the level of service it provides or contracts for within a
type of prehospital EMS for which it has continuously provided
service since June 1, 1980. For the purpose of this section, "level"
shall mean basic life support, limited advanced life support, or
advanced life support. Without limiting the foregoing, a city or fire
district that has continuously provided basic life support first
response since June 1, 1980, may upgrade to advanced life support
first response.
(i) The level of prehospital EMS provided by a city or fire
district may be reduced where the governing body of a city or fire
district, pursuant to a public hearing, determines that the reduction
is necessary. When a governing body of a city or fire district has
determined that a service-level reduction is necessary, notice shall
be provided to the local EMS agency a minimum of 90 days before the
service reduction is implemented. The local EMS agency shall conduct
a public hearing to report on the impact of the proposed service
reduction on the local EMS system.
(j) This section shall not be construed to permit a city or fire
district to add a type of prehospital EMS that it has not provided or
contracted for continuously since June 1, 1980.
(k) A local EMS agency shall not create an exclusive operating
area for a type of prehospital EMS provided or contracted for by a
city or fire district meeting the requirements of this section within
the geographical service area of the city or fire district unless
the exclusive operating area is awarded to that city or fire district
through a noncompetitive process in accordance with Section
1797.224.
(l) The continuing authorization of a city or fire district to
provide a type or types of prehospital EMS recognized pursuant to
this section shall transfer to any successor agency, including, but
not limited to, a joint powers agency, but that recognition shall be
limited to the geographical area of the predecessor agency that
continuously provided or contracted for, as of June 1, 1980, that
type or those types of prehospital EMS.
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. SEC. 4. 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. SEC. 5. 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. SEC. 6. 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 care system. The emergency medical care committee
shall submit its observations and recommendations to the county
board or boards of supervisors which it serves and shall act in
an advisory capacity to the county board or boards of supervisors
that it serves, and to the local EMS agency, on all matters
relating to emergency medical services.
SEC. 9. SEC. 7. 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. 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.
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