BILL ANALYSIS Ó
AB 704
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Date of Hearing: April 16, 2013
ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
Al Muratsuchi, 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 at this time.
COMMENTS :
According to the author:
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
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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.
According to the Business and Professions Committee:
1) 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 911 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
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work in a county once the paramedic is sponsored by a
local advanced life support provider/employer.
2) 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
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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
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.
This bill will take the existing consideration of military
experience for the EMT certification to the next level by
requiring regulatory development for those servicemembers not in
the U.S. Army. Those members do not receive the National
Registry card but their training is still worthy at least of
consideration toward certification and credit if found to be
appropriate by EMSA.
For paramedics, again it makes sense that EMSA should at least
consider and credit, as appropriate, the military training and
experience of paramedic license applicants. EMSA currently has a
system in place for consideration of paramedic applications from
out of state and out of country applicants. It seems reasonable
that the same or a similar system could accommodate military
trained applicants.
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 at this time.
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Analysis Prepared by : John Spangler/ V. A. / (916) 319-3550