BILL ANALYSIS Ó
AB 704
Page 1
Date of Hearing: April 9, 2013
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Richard S. Gordon, Chair
AB 704 (Blumenfield) - As Introduced: February 21, 2013
SUBJECT : Emergency medical services: military experience.
SUMMARY : Requires the Emergency Medical Services Authority
(EMSA) to adopt regulations by January 1, 2015 to accept the
military education, training, and practical experience of
applicants, as specified, towards certification as an Emergency
Medical Technician (EMT)-I and EMT-II, and towards licensure as
an EMT-Paramedic (EMT-P). Specifically, this bill :
1)Requires the EMSA to develop and adopt regulations by January
1, 2015, to accept, upon presentation of satisfactory
evidence, the military education, training, and experience for
applicants as a member of the United States (U.S.) Armed
Forces, the U.S. Military Reserve, the National Guard of any
state, or the Naval Militia of any state, towards meeting
requirements for the EMT-I certificate, the EMT-II
certificate, and the EMT-P license.
2)Requires the EMSA, in developing the regulations, to deem an
applicant for EMT-II certification with military experience
equivalent to EMT-I certification requirements as
EMT-I-certified, unless the EMSA determines that the military
education, training, or practical experience is not
sufficiently comparable to existing standards.
3)Prohibits the EMSA, in developing the regulations, from
requiring an applicant for EMT-P licensure with military
experience equivalent to relevant coursework to complete
duplicative requirements, unless the EMSA determines that the
military education, training, or practical experience is not
sufficiently comparable to existing standards.
EXISTING LAW :
1)Requires the EMSA to develop and adopt regulations and minimum
standards for the training and scope of practice of an EMT-I,
EMT-II, and EMT-P. (Health and Safety Code [HSC] Sections
1797.170, 1797.171, 1797.172)
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2)Authorizes an individual applying for EMT certification to
challenge EMT course completion requirements if the individual
provides evidence that the following occurred in the preceding
two years:
a) Completed an emergency medical service training program
of the U.S. Armed Forces which meets the specified United
States Department of Transportation EMT-Basic National
Standards Curriculum; or,
b) Was active in a pre-hospital emergency medical
classification of the U.S. Armed Services which does not
have formal certification requirements. (CCR 100078)
3)Creates the following definitions:
a) "Emergency Medical Technician-I" or "EMT-I" to mean an
individual trained in all facets of basic life support
according to prescribed standards. (HSC 1797.80 and CCR
100063).
b) "Emergency Medical Technician-II," "EMT-II," "Advanced
Emergency Medical Technician," or "Advanced EMT" means an
EMT-I with additional training in limited advanced life
support according to prescribed standards. (HSC 1797.82 and
CCR 100063)
c) "Emergency Medical Technician Paramedic," "EMT P,"
"paramedic" or "mobile intensive care paramedic" means an
individual whose scope of practice to provide advanced life
support is according to prescribed standards. (HSC 1797.84
and CCR, Title 22, Division 9, Chapter 4, Section 100145)
FISCAL EFFECT : Unknown
COMMENTS :
1)Purpose of This Bill . This bill would require EMSA to adopt
regulations requiring local EMS agencies to accept documented
military education, training, and experience towards the
issuance of EMT certifications and paramedic licenses in
California. While current law provides a process for
considering military experience in meeting certain EMT
requirements, each local EMS agency has broad discretion to
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waive training requirements on a case-by-case basis. This
bill aims to establish a uniform statewide policy for
accepting military education, training, and experience towards
EMT certification and paramedic licenses in order to spare
veteran applicants the uncertainty and the potential time and
expense of completing duplicative EMT training requirements.
This bill is author sponsored.
2)Author's Statement . According to the author's office, "Upon
exiting military service, our nation's recent veterans face a
higher unemployment rate than their civilian counterparts.
Many veterans are unable to transfer their military training
and experience into marketable job skills for civilian
careers. This should not be a problem for veterans who served
as medics given the high-quality education and experience they
obtained in the military. Unfortunately, California does not
offer credit for this specialized background towards civilian
licensure.
"Veterans with medical training make up the second largest
specialty in the military and cannot transfer their training
and experience towards EMT [certification] or paramedic
licensure, despite similarities in the training and experience
of comparable positions, such as a combat medic. As a result,
these veterans must retake courses which they have already
taken, costing them additional time and money.
"AB 704 will allow these veterans to use their training and
experiences to be credited towards paramedic licensure, and
streamline veterans with equivalent experience to fill
much-needed jobs in the healthcare field."
3)Federal report on streamlining licensure for military medics .
In February 2013, the Executive Office of the President of the
United States issued a report entitled, "The Fast Track to
Civilian Employment: Streamlining Credentialing and Licensing
for Service Members, Veterans, and their Spouses" (the "EOP
report"). The report highlights how veterans have
difficulties translating their military experience into
civilian certification and licensure, and exhorts states to
capitalize on the public resources spent training servicemen
and women. The EOP report argues that the need for action is
immediate, as more veterans are expected to return to the U.S.
with the ongoing withdrawal of troops from Afghanistan. There
is also increasing civilian demand for these skills, as the
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report states that "In 2012, there were slightly more than
75,000 Active Duty, Guard, and Reserve members in healthcare
support occupations, and last year nearly 10,000 separated
from the military. The [U.S.] Department of Labor estimates
that, by 2020, the demand for EMTs/Paramedics will increase
33%."
The report further contends that "Military education,
training, and experience are not always recognized by state
licensing agencies or by the organizations that administer the
related certifications or exams, making it difficult for
service members and veterans to qualify for the credentials
they need for professional positions. Challenges include the
absence of common standards for service credentialing
programs, inconsistent state laws, and a lack of understanding
about how military training and experience translates into
licensing and academic credits."
4)EMT Certification and Paramedic Licensure . There are
currently 60,000 EMTs and 19,000 paramedics in California.
The EMS system and EMTs are the "first responders", usually
activated by a 9-1-1 call, who stabilize and transport
individuals to a medical facility for treatment.
This bill applies to two types of EMT certifications (EMT-I
and EMT-II) and one type of paramedic license (commonly
referred to as EMT-P). There are some notable differences
between the certifications and the license:
a) In California, EMT-I and EMT-IIs are certified by one of
the 32 local (single- or multi-county) EMS agencies. The
local EMS agency reviews an applicant's documentation,
including his or her course completion record, out-of-state
certification, and National Registry card, to determine
whether or not he or she meets state and local
requirements. Local EMS agencies have broad discretion in
accepting or denying an EMT applicant, and in determining
whether or not it will accept military experience towards
certification.
b) EMT-Ps (or paramedic licenses), are issued by the EMSA
and then accredited by a local EMS agency to work in a
county once the paramedic is sponsored by a local advanced
life support provider/employer.
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5)Acceptance of military experience towards EMT certification .
Currently, there are two pathways for veterans to count
military experience towards EMT certification:
a) National Registry of EMTs . The National Registry of
EMTs is a nationwide certification agency with uniform
standards for training and examination of personnel
delivering emergency ambulance services. An individual
must complete an approved U.S. Department of Transportation
(U.S. DOT) training program, be cardiopulmonary
resuscitation (CPR)-certified, and pass a practical and
skills examination in order to receive a National Registry
card.
The National Registry of EMTs provides certification in
four EMT classifications: Basic, Intermediate-85,
Intermediate-99, and Paramedic. California offers EMT
certification by endorsement to out-of-state applicants
holding a National Registry card and seeking certification
in the state. This provision would therefore apply to
military members who hold a National Registry card.
Currently, the U.S. Army is the only branch of the U.S.
Armed Forces that requires all of its military medics to
obtain a National Registry card. According to the EOP
report, "?medics in the Army are required to pass the EMT
national certification at the conclusion of their technical
training in the health sciences and maintain the
certification while they remain in that military
occupational specialty. Air Force medics may take the exam
but are not required to pass it."
b) Waiver from training requirements . Existing state
regulations allow a military veteran applying for EMT
certification within two years of leaving military service
to seek a waiver from training requirements. A local EMS
agency would review the applicant's military transcripts to
determine whether the military coursework is equivalent to
the accepted standard of the U.S. DOT training course. If
the local EMS agency determines that the military
experience is equivalent, the applicant is exempt from
taking an approved U.S. DOT training course.
Unless an individual holds a current National Registry
EMT-Basic card, the applicant must take a written and
skills examination and possible additional training
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specified by the local EMS agency. Therefore, a military
veteran from any branch of the U.S. Armed Forces other than
the Army may still need to complete additional training and
examination requirements as determined by the local EMS
agency.
Currently, there are no laws or regulations requiring EMSA
to accept military education, training, or experience for
the paramedic license.
6)Effects of this bill . Because of the broad discretion that
local EMS agencies have to accept or decline military
experience towards certification, veterans face the
possibility of having the same experience credited
differently, depending on the county in which they are
applying. This bill would help dispel that uncertainty by
requiring the EMSA to promulgate regulations to treat military
experience uniformly, while not precluding a local EMS agency
from requiring additional training as necessary to meet local
standards.
Furthermore, by allowing former service members to convert
their military education, experience, and training into credit
towards EMT certification and paramedic licensure, veterans
can immediately begin seeking employment and earning an income
instead of expending further time and money to complete an EMT
training course that they may not need.
7)Arguments in support . According to the Association of
California Healthcare Districts (ACHD), "AB 704 requires the
EMSA to develop and adopt regulations to accept the training
and practical experience completed by an applicant with
military experience towards the qualifications and
requirements for an EMT certification, an advanced EMT
certification, or an EMT paramedic licensure, as specified.
"ACHD represents public District hospitals, skilled nursing
facilities, and clinics all across California. Millions of
Californians rely on these public health facilities and
programs for vital health care services. The majority of
these facilities are the sole provider of healthcare services
in their communities.
"The majority of California's Healthcare Districts are located
in rural areas, and many have a difficult time recruiting
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qualified individuals into their workforce. By increasing the
prospective workforce, Healthcare Districts will be able to
offer their communities increased patient care. ACHD supports
long-term solutions to increase the potential workforce for
healthcare professionals within all areas of California to
ease workforce shortages."
8)Related Legislation . AB 213 (Logue) of 2013 would require a
healing arts board under the Department of Consumer Affairs
(DCA) and the State Department of Public Health to accept
military education, training, and experience towards licensure
requirements if that education, training, or experience is
equivalent to the standards of the licensing board or
department. AB 213 is pending in the Assembly Business,
Professions and Consumer Protection Committee.
AB 555 (Salas) of 2013 would require a licensing board under
DCA to consider, and allow a board to accept, an applicant's
military training to meet licensure requirements, if
applicable to the requirements for the particular business,
occupation, or profession regulated by the board. AB 555
would allow a licensing board to consult with the Department
of Veterans Affairs and the Military Department when
evaluating the applicability of military training towards
licensure requirements. AB 555 is pending in the Assembly
Business, Professions and Consumer Protection Committee.
AB 851 (Logue) of 2013 would require the Dental Board of
California (DBC) to accept military education, training, and
experience towards licensure requirements if that education,
training, or experience is equivalent to the standards of the
DBC. AB 851 is pending in the Assembly Business, Professions
and Consumer Protection Committee.
AB 1057 (Medina) of 2013 would require every licensing board
under DCA to inquire in every license application if the
applicant is serving in, or has previously served in, the
military. AB 1057 is pending in the Assembly Appropriations
Committee.
9)Previous Legislation . AB 1588 (Atkins), Chapter 742, Statutes
of 2012, requires boards under DCA to waive professional
license renewal fees, continuing education requirements, and
other renewal requirements as determined by the licensing
board, for any licensee or registrant called to active duty.
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AB 1904 (Block), Chapter 399, Statutes of 2012, requires a
board under DCA to issue an expedited license to the spouse or
domestic partner of a military member on active duty.
SB 1405 (De León), Chapter 411, Statutes of 2012, allows,
beginning January 1, 2014, certified public accountants,
public accountants and public accounting firms to have their
permits placed on military inactive status if the permit
holder is engaged in, and provides sufficient evidence of,
active duty as a member of the California National Guard or
the U.S. Armed Forces, as specified.
SB 1646 (Rogers), Chapter 987, Statutes of 1994, requires
licensing boards under DCA to promulgate regulations to
evaluate and credit military education, training, and
experience in meeting licensure requirements, if the military
education, training, and experience are applicable to the
profession.
10)Double-referred . This bill is double-referred to the
Assembly Veterans Affairs Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
Association of California Healthcare Districts
California Association of County Veterans Service Officers
California Professional Firefighters
California State Firefighters' Association, Inc.
Vietnam Veterans of America, California State Council
Opposition
None on file.
Analysis Prepared by : Joanna Gin / B.,P. & C.P. / (916)
319-3301