BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 704|
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THIRD READING
Bill No: AB 704
Author: Blumenfield (D) and Fong (D)
Amended: 7/1/13 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 7/03/13
AYES: Hernandez, Anderson, Beall, De León, DeSaulnier, Monning,
Nielsen, Pavley, Wolk
SENATE APPROPRIATIONS COMMITTEE : 5-0, 8/12/13
AYES: De León, Gaines, Hill, Lara, Steinberg
NO VOTE RECORDED: Walters, Padilla
ASSEMBLY FLOOR : 75-0, 5/9/13 (Consent) - See last page for vote
SUBJECT : Emergency medical services: military experience
SOURCE : Author
DIGEST : This bill requires the Emergency Medical Services
Authority (EMSA) to develop and adopt regulations to accept the
education, training and practical experience that an applicant
received as a member of the armed forces toward the
qualifications and requirements for certification as an EMT-I or
EMT-II, or licensure as an EMT-P.
ANALYSIS :
Existing law:
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1.Establishes EMSA within the California Health and Human
Services Agency, and requires the director of EMSA to be a
physician appointed by the Governor.
2.Requires EMSA, among other things, to develop planning and
implementation guidelines for emergency medical services
systems which address specified components, including manpower
and training, communications, transportation, system
organization and management, data collection and evaluation,
and disaster response.
3.Establishes the EMS Commission within the California Health
and Human Services Agency, composed of 18 members appointed by
the Governor, the Speaker of the Assembly, and the Senate
Committee on Rules to represent specified entities,
professions and associations.
4.Requires the EMS Commission to review and approve regulations,
standards and guidelines to be developed by EMSA for
implementation of the EMS System and the Pre-hospital
Emergency Medical Care Personnel Act.
5.Defines "Emergency Medical Technician-I" or "EMT-I" as an
individual trained in all facets of basic life support, as
specified. Defines an "Emergency Medical Technician-II,"
"EMT-II," "Advanced Emergency Medical Technician," or
"Advanced EMT" as an EMT-I with additional training in limited
advanced life support according to specified standards. Both
EMT-Is and EMT-IIs are certified at the local level.
6.Defines "Emergency Medical Technician-Paramedic," "EMT-P,"
"paramedic" or "mobile intensive care paramedic" means an
individual whose scope of practice includes the ability to
provide advanced life support, as specified, including
administering specified medications. EMT-Ps are licensed and
regulated at the state level through EMSA.
This bill:
1.Requires EMSA to develop, and after approval by the EMS
Commission, adopt regulations to accept, upon presentation of
satisfactory evidence by an applicant for certification as an
EMT-I or EMT-II, or licensure as an EMT-P, the education,
training and practical experience completed by an applicant as
a member of the United States Armed Forces, the United States
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Military Reserve, the National Guard of any state, or the
Naval Militia of any state toward the qualifications and
requirements for certification or licensure.
2.Requires EMSA, in developing the above regulations related to
requirements for certification as an EMT-II, to deem an
applicant for EMT-II certification with military experience
equivalent to EMT-I certification as certified as an EMT-I
unless EMSA determines that the education, training or
practical experience is not sufficiently comparable to
existing standards.
3.Prohibits EMSA, in developing the above regulations related to
requirements for licensure as an EMT-P, from requiring an
applicant for EMT-P licensure with military experience
equivalent to relevant course work to complete duplicative
requirements unless EMSA determines that the education,
training, or practical experience is not sufficiently
comparable to existing standards.
Background
Report on military health personnel. In 2008, the UCSF Center
for Health Professions published a report entitled, "US Military
and California Health Personnel: Select Comparisons." As this
report noted, California faces workforce shortages and
geographic mal-distribution in many of the health care
professions and that one potential pool of health care workers
includes former military personnel returning from active duty or
retiring with years available for service in the civilian labor
force.
The report stated that several differences exist between the
military and civilian sectors regarding how health care workers
are educated, trained, certified and regulated. These
differences can sometimes make it all but impossible for an
individual to make a smooth transition from the military to a
comparable civilian position. In many instances, civilian
health education programs and state professional boards'
licensing criteria do not always give full credit for the health
care provider education, training and experience one may have
received in the military. Because of the state-based authority
to set health care professions' scopes of practice, the practice
acts vary from state to state for some professions. The U.S.
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military is exempt from this system and has developed its own
occupations and training programs based on need. This results
in occupations and skill sets that do not match up exactly.
Current EMT regulations . Current regulations allow military
education, training and experience to serve as credit towards
EMT licensure. All levels of EMT licensure (EMT-I, EMT-II, and
EMT-P) allow medical training units of a branch of the Armed
Forces or Coast Guard to serve as eligible EMT training
programs. However, an individual may obtain certification as an
EMT-1 if he/she can provide documented evidence of successful
completion of an emergency medical services training program of
the Armed Forces within the preceding two years that meets
national EMS Education Standards. This does not apply to EMT-2
or EMT-P level licensure.
Prior Legislation
AB 1588 (Atkins, Chapter 742, Statutes of 2012) requires boards
under the Department of Consumer Affairs (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.
AB 1976 (Logue, 2012) would have required healing arts boards
within DCA, as well as professional licensure programs within
the Department of Public Health, to accept military training
towards licensure requirements, as applicable, and requires
boards that accredit schools to ensure schools have procedures
in place to accept military training. AB 1976 was held on the
Assembly Appropriations suspense file.
AB 1932 (Gorell, 2012) would have required healing arts boards
within DCA to issue a written report to the California
Department of Veterans Affairs detailing the methods of
evaluating the education, training, and experience obtained in
military service and whether that education, training and
experience is applicable to the boards' requirements for
licensure. AB 1932 was passed by the Assembly, but was not
referred to a Senate policy committee.
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
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meeting licensure requirements, if the military education,
training, and experience are applicable to the profession.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee, ongoing costs
of about $100,000 for EMSA to develop and adopt regulations and
to assist with ongoing certification and licensing of emergency
medical technicians by the Authority and local governments
(Emergency Medical Services Personnel Fund and EMT Certification
Fund).
SUPPORT : (Verified 8/14/13)
American Federation of State, County and Municipal Employees,
AFL-CIO
Association of California Healthcare Districts
California Association of County Veterans Service Officers
California State Firefighters' Association
United States Department of Defense Liaison Office
Vietnam Veterans of America - California State Council
ARGUMENTS IN SUPPORT : The United States Department of Defense
State Liaison Office states that, one of its highest priority
issues this year is working with states to facilitate service
members receiving credit for military education, training, and
experience when applying for a state licensure when
transitioning out of the military. The California Association
of County Veterans Service Officers and the Vietnam Veterans of
American - California State Council agree that California should
recognize veterans' skills and training received while serving
in the armed forces and allow these skills to be transferrable
to certification or licensure in similar civilian positions.
The California State Firefighters' Association states that one
out of every five veterans becomes unemployed upon their return
home, and that a large portion of unemployed veterans were
medics in the service. The American Federation of State, County
and Municipal Employees states that it supports this bill
because it provides multiple career pathways for this important
field, as well as assists veterans with transitioning into
civilian life more easily. The Association of California
Healthcare Districts writes that the majority of California's
health care districts are located in rural areas, and many have
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a difficult time recruiting qualified individuals into their
workforce.
ASSEMBLY FLOOR : 75-0, 5/9/13
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,
Buchanan, Ian Calderon, Campos, Chau, Chávez, Chesbro, Conway,
Cooley, Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier,
Beth Gaines, Garcia, Gatto, Gomez, Gordon, Gorell, Gray,
Grove, Hagman, Hall, Harkey, Roger Hernández, Jones,
Jones-Sawyer, Levine, Linder, Lowenthal, Maienschein, Mansoor,
Medina, Melendez, Mitchell, Morrell, Mullin, Muratsuchi,
Nazarian, Nestande, Olsen, Pan, Patterson, Perea, V. Manuel
Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner, Stone,
Ting, Torres, Wagner, Weber, Wieckowski, Wilk, Williams,
Yamada, John A. Pérez
NO VOTE RECORDED: Donnelly, Holden, Logue, Waldron, Vacancy
JL:ej 8/14/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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