BILL ANALYSIS �
SB 535
Page 1
SENATE THIRD READING
SB 535 (Nielsen)
As Amended April 17, 2013
Majority vote
SENATE VOTE :37-2
HEALTH 18-0 APPROPRIATIONS 17-0
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|Ayes:|Pan, Logue, Ammiano, |Ayes:|Gatto, Harkey, Bigelow, |
| |Bonilla, Bonta, Chesbro, | |Bocanegra, Bradford, Ian |
| |Gomez, | |Calderon, Campos, |
| |Roger Hern�ndez, | |Donnelly, Eggman, Gomez, |
| |Lowenthal, Maienschein, | |Hall, Holden, Linder, |
| |Mansoor, Mitchell, | |Pan, Quirk, Wagner, Weber |
| |Nazarian, Nestande, | | |
| |V. Manuel P�rez, Wagner, | | |
| |Wieckowski, Wilk | | |
| | | | |
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SUMMARY : Revises the membership of the Commission on Emergency
Medical Services (EMS) by adding one representative from a
public agency that provides air rescue and transport to be
appointed by the Speaker of the Assembly and one air ambulance
representative appointed by the Senate Rules Committee from a
list of three names submitted by the California Association of
Air Medical Services (CAAMS).
EXISTING LAW :
1)Establishes an 18-member Commission on EMS, within the
California Health and Human Services Agency (HHSA).
Authorizes the Commission members to serve two three-year
terms and requires the Commission to meet at least on a
quarterly basis. Allows members of the Commission to receive
reimbursement for travel and other expenses, but does not
authorize the members to receive compensation for serving on
the Commission.
2)Defines the duties of the Commission to include reviewing
regulations, standards, and guidelines developed by the
California Emergency Medical Services Authority (EMSA);
advising EMSA on a data collection system; advise on emergency
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facilities and services, emergency communications, medical
equipment, personnel training, and various aspects of the EMS
system; and, to make recommendations for further development
of the EMS system.
3)Provides a process for a local emergency services agency
(LEMSA) to appeal to the Commission if there is a
determination by EMSA that a local EMS and trauma care system
plan does not effectively meet the needs of residents and is
not consistent with coordinating activities and can therefore
not be implemented.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill would have annual costs to EMSA of around
$2,000 (funded through a combination of General Fund, grants,
and fee revenue). Members of the Commission on EMS receive no
compensation, but are reimbursed for their actual necessary
travel and other expenses.
COMMENTS : According to the author, this bill is to add two more
members to the Commission on EMS which was created in HHSA,
effective January 1, 1981. One of the new members would be a
private air ambulance member and one would be a representative
from a public agency that does air rescue and transport. The
Commission currently consists of 18 members, including
physicians, paramedics, nurses, firefighters, law enforcement,
hospitals, county health officers, local EMS officials, and
ground ambulance providers. Air ambulance providers do not
currently have representation on the Commission. The author
argues that air ambulance providers throughout the state are
increasingly concerned that they are not adequately represented
on the EMS Commission. The author points out that as the
Commission reviews various regulations that affect emergency
services providers, there are times when air services are
included in these discussions. The author further argues that
because air ambulance providers are regulated by multiple
federal, state, and local agencies it is important that these
providers are able to clarify how a proposed regulation will
affect the provision of air services. According to the sponsor,
CAAMS, established in 2005, is a chapter of the Association of
Air Medical Services, an international association serving
providers of air and surface medical transport systems and is a
voluntary non-profit organization.
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According to EMSA, the Commission was originally created to
ensure that stakeholders have a voice in decisions affecting the
EMS system in California. In 1984 its original advisory and
regulatory role was expanded to allow a LEMSA to appeal
decisions made by EMSA prohibiting implementation of a proposed
local EMS and trauma care system plan. The Commission may
sustain the determination of EMSA or overrule it and permit
local implementation of the plan. The current composition has
12 gubernatorial appointees, three by the Speaker of the
Assembly, and three by the Senate Rules Committee. Under
existing law, the EMS Commission is composed of the following
appointments:
---------------------------------------------------------------
| Type |
| Representing Appointed |
|by: |
---------------------------------------------------------------
|--------------------------+------------------------------+------|
|Physician whose practice |California Chapter of the |Senate|
|is emergency medicine |American College of Emergency | |
| |Physicians | |
|--------------------------+------------------------------+------|
|Physician who is board |American Board of Emergency |Assemb|
|certified in emergency |Medicine |ly |
|medicine | | |
|--------------------------+------------------------------+------|
|Physician who is a trauma |American College of Surgeons |Assemb|
|surgeon | |ly |
|--------------------------+------------------------------+------|
|Physician |California Medical |Senate|
| |Association | |
|--------------------------+------------------------------+------|
|County Health Officer |California Conference of |Govern|
| |Local Health Officers |or |
|--------------------------+------------------------------+------|
|Registered nurse who is a |Emergency Nurses Association |Govern|
|mobile intensive care | |or |
|nurse | | |
|--------------------------+------------------------------+------|
|Paramedic or EMT-II, who |California Rescue and |Senate|
|is not a peace officer |Paramedic Association (CRPA) | |
|--------------------------+------------------------------+------|
|Private emergency |California Ambulance |Assemb|
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|services provider |Association |ly |
|--------------------------+------------------------------+------|
|Fire management |California Fire Chiefs |Govern|
| |Association |or |
|--------------------------+------------------------------+------|
|Hospital administrator |California Hospital |Govern|
| |Association |or |
|--------------------------+------------------------------+------|
|Paramedic or EMT-II who |California Peace Officers' |Govern|
|is also a full time peace |Association |or |
|officer | | |
|--------------------------+------------------------------+------|
|Public member |Rural area |Govern|
| | |or |
|--------------------------+------------------------------+------|
|Public member |Non-specific |Govern|
| | |or |
|--------------------------+------------------------------+------|
| | | |
| | | |
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---------------------------------------------------------------
| Type |
| Representing Appointed |
|by: |
---------------------------------------------------------------
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|LEMSA administrator |Emergency Medical Services |Govern|
| |Administrators' Association |or |
| |of California | |
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|Medical director of a |Emergency Medical Directors |Govern|
|LEMSA |Association of California |or |
| | | |
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|Firefighter |California State |Govern|
| |Firefighters' Association |or |
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|Employee of CAL-FIRE |California Professional |Govern|
| |Firefighters (CPF) |or |
|--------------------------+------------------------------+------|
|Employee of a city, |CPF |Govern|
|county, or special | |or |
|district providing fire | | |
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|protection | | |
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In May 2011, Governor Brown's May Revision to the proposed
2011-12 Budget included elimination of this Commission as part
of a package of savings to be achieved through department
consolidations, eliminations of boards and commissions, and
other operational efficiencies. The savings attributed to the
elimination of this Commission was $38,000 ($9,000 General
Fund). Although a number of other health-related commissions,
such as the California Medical Assistance Commission, were
eliminated, the EMS Commission was not.
CAAMS, sponsor of this bill, and other supporters such as
CALSTAR, AirMethods, REACH Air Medical Services, and PHI Air
Medical write in support that the addition of an air medical
representative and one from a public agency that provides air
rescue and transport will provide an opportunity for air medical
providers to provide their prospective when regulations are
developed and comments provided.
The Emergency Medical Services Administrators Association
(EMSAAC) writes in opposition that the current 18 member
Commission on EMS adequately represents the interests of
prehospital EMS providers including air ambulance services.
Creating two additional positions to be filled specifically by
air ambulance representatives is disproportionate to their role
within the EMS system. Air ambulance transport accounts for a
small fraction of the overall call volume of the EMS system.
EMSAAC believes the existing Commission membership which
includes seven prehospital members and six physician members is
sufficient to provide oversight and representation for the
operational and clinical aspects of air ambulance service in
California.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0001758
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