Amended in Assembly March 18, 2016

California Legislature—2015–16 Regular Session

Assembly Bill No. 1931

Introduced by Assembly Member Rodriguez

February 12, 2016

An act to amend begin delete Section 1798.200 of end delete begin insert Sections 1797.184, 1798.200, 1798.201, and 1798.202 of, and to repeal Section 1799.112 of, end insert the Health and Safety Code, relating to public health.

LEGISLATIVE COUNSEL’S DIGEST

AB 1931, as amended, Rodriguez. Emergency medical services: begin delete technicians. end delete begin insert paramedics: discipline. end insert

Under existing law, the Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act, the Emergency Medical Services Authority is responsible for establishing training, scope of practice, and continuing education for emergency medical technicians and other prehospital personnel, including Emergency Medical Technician-I (EMT-I), Emergency Medical Technician-II (EMT-II), and Emergency Medical Technician Paramedic (EMT-P) designations. The act authorizes an employer of an EMT-I or EMT-II to conduct investigations and take disciplinary action against an EMT-I or EMT-II who is employed by that employer for specified conduct, and authorizes the authority to, among other things, deny, suspend, or revoke any EMT-P license for the same specified conduct. begin insert Existing law requires an EMT-P end insert begin insert ’s employer to report in writing to the local EMS agency and the authority within 30 days of specified disciplinary action being taken with regard to an EMT-P. end insert

This bill would begin delete make a technical, nonsubstantive change to that provision. end delete begin insert require the authority to develop and adopt guidelines for disciplinary orders, temporary suspensions, and conditions of probation for EMT-P licenseholders. The bill would also integrate and conform the procedures for investigating misconduct of EMT-P licenseholders with those of EMT-I and EMT-II certificate holders, including requiring notification of disciplinary action with regard to an EMT-P to be given to the local EMS agency and the authority within 3 days. end insert

begin insert

Existing law authorizes the medical director of the local EMS agency to evaluate information that comes to his or her attention that appears to constitute grounds for disciplinary action against an EMT-P and to make a recommendation to the authority for further investigation or discipline. Existing law also authorizes the temporary suspension, in specified circumstances, of an EMT-P license.

end insert begin insert

This bill would require the medical director of the local EMS agency, if he or she makes a recommendation to the authority for further investigation or discipline, to notify the EMT-P’s employer within 3 days. The bill would additionally require notification of the EMT-P’s employer when there is a temporary suspension of an EMT-P’s license.

end insert

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 1797.184 of the end insert begin insert Health and Safety Code end insert
begin insert is amended to read: end insert

1797.184.  

The authority shall develop and, after approval by
the commission pursuant to Section 1799.50, adopt all of the
following:

(a) Guidelines for disciplinary orders, temporary suspensions,
and conditions of probation for EMT-I and EMT-II certificate
holders begin insert and EMT-P licenseholders end insert that begin delete protects end delete begin insert protect end insert the public
health and safety.

(b) Regulations for the issuance of EMT-I and EMT-II
certificates by a certifying entity that begin delete protects end delete begin insert protect end insert the public
health and safety.

(c) Regulations for the recertification of EMT-I and EMT-II
certificate holders that protect the public health and safety.

(d) Regulations for disciplinary processes for EMT-I and EMT-II
applicants and certificate holders that protect the public health and
safety. These disciplinary processes shall be in accordance with
Chapter 5 (commencing with Section 11500) of Part 1 of Division
3 of Title 2 of the Government Code.

begin delete SECTION 1. end delete
begin insert SEC. 2. end insert   

Section 1798.200 of the Health and Safety Code is
amended to read:

1798.200.  

(a) (1) (A) Except as provided in paragraph (2),
an employer of an begin delete EMT-I or EMT-II end delete begin insert EMT-I, EMT-II, or EMT-P end insert
may conduct investigations, as necessary, and take disciplinary
action against an begin delete EMT-I or EMT-II end delete begin insert EMT-I, EMT-II, or EMT-P end insert
who is employed by that employer for conduct in violation of
subdivision (c). The employer shall notify the begin delete medical director of
the local EMS agency that has jurisdiction in the county in which
the alleged violation occurred end delete begin insert regulating entity end insert within three days
when an allegation has been validated as a potential violation of
subdivision (c).

(B) Each employer of an begin delete EMT-I or EMT-II employee end delete begin insert EMT-I,
EMT-II, or EMT-P end insert shall notify the begin delete medical director of the local
EMS agency that has jurisdiction in the county in which a violation
related to subdivision (c) occurred end delete begin insert regulating entity end insert within three
days after the begin delete EMT-I or EMT-II end delete begin insert EMT-I, EMT-II, or EMT-P end insert is
terminated or suspended for a disciplinary cause, the begin delete EMT-I or
EMT-II end delete begin insert EMT-I, EMT-II, or EMT-P end insert resigns following notification
of an impending investigation based upon evidence that would
indicate the existence of a disciplinary cause, or the begin delete EMT-I or
EMT-II end delete begin insert EMT-I, EMT-II, or EMT-P end insert is removed from EMT-related
duties for a disciplinary cause after the completion of the
employer’s investigation. begin insert The employer of an EMT-P shall provide
the regulating entity with all supporting documentation at the time
of notification. end insert

(C) At the conclusion of an investigation, the employer begin delete of an
EMT-I or EMT-II end delete may develop and implement, in accordance with
the guidelines for disciplinary orders, temporary suspensions, and
conditions of probation adopted pursuant to Section 1797.184, a
disciplinary plan for the begin delete EMT-I or EMT-II. end delete begin insert EMT-I, EMT-II, or
EMT-P. end insert Upon adoption of the disciplinary plan, the employer shall
submit that plan to the begin delete local EMS agency end delete begin insert regulating entity end insert within
three working days. The employer’s disciplinary plan may include
a recommendation that the begin delete medical end delete director begin delete of the local EMS
agency end delete consider taking action against the holder’s certificate begin insert or
license end insert pursuant to paragraph (3).

(2) If an begin delete EMT-I or EMT-II end delete begin insert EMT-I, EMT-II, or EMT-P end insert is not
employed by an ambulance service licensed by the Department of
the California Highway Patrol or a public safety begin delete agency end delete begin insert agency, end insert
or if that ambulance service or public safety agency chooses not
to conduct an investigation pursuant to paragraph (1) for conduct
in violation of subdivision (c), the begin delete medical end delete director begin delete of a local EMS
agency end delete shall conduct the investigations, and, upon a determination
of disciplinary cause, take disciplinary action as necessary against
the begin delete EMT-I or EMT-II. end delete begin insert EMT-I, EMT-II, or EMT-P. end insert At the
conclusion of these investigations, the begin delete medical end delete director shall
develop and implement, in accordance with the recommended
guidelines for disciplinary orders, temporary orders, and conditions
of probation adopted pursuant to Section 1797.184, a disciplinary
plan for the begin delete EMT-I or EMT-II. end delete begin insert EMT-I, EMT-II, or EMT-P. end insert The
begin delete medical end delete director’s disciplinary plan may include action against the
holder’s certificate begin insert or license end insert pursuant to paragraph (3).

(3) The begin delete medical end delete director begin delete of the local EMS agency end delete may, upon a
determination of disciplinary cause and in accordance with
regulations for disciplinary processes adopted pursuant to Section
1797.184, deny, suspend, or revoke any EMT-I or EMT-II
certificate begin insert or EMT-P license end insert issued under this division, or may
place begin delete any end delete begin insert an end insert EMT-I or EMT-II certificate holder begin insert or EMT-P
licenseholder end insert on probation, upon the finding by begin delete that medical end delete begin insert the end insert
director of the occurrence of any of the actions listed in subdivision
(c) and the occurrence of one of the following:

(A) The begin delete EMT-I or EMT-II end delete employer, after conducting an
investigation, failed to impose discipline for the conduct under
investigation, or the begin delete medical end delete director makes a determination that
the discipline imposed was not according to the guidelines for
disciplinary orders and conditions of probation and the conduct of
the EMT-I or EMT-II certificate holder begin insert or EMT-P licenseholder end insert
constitutes grounds for disciplinary action against the begin delete certificate. end delete
begin insert holder’s certificate or license. end insert

(B) Either the employer begin delete of an EMT-I or EMT-II end delete further
determines, after an investigation conducted under paragraph (1),
or the begin delete medical end delete director determines after an investigation conducted
under paragraph (2), that the conduct requires disciplinary action
against the begin delete certificate. end delete begin insert holder’s certificate or license. end insert

(4) The begin delete medical director of the local EMS agency, end delete begin insert director, end insert
after consultation with the begin delete employer of an EMT-I or EMT-II, end delete
begin insert employer, end insert may temporarily suspend, prior to a hearing, begin delete any end delete begin insert an end insert
EMT-I or EMT-II begin delete certificate or both EMT-I and EMT-II certificates end delete
begin insert certificate, an EMT-P license, or a combination thereof end insert upon a
determination that both of the following conditions have been met:

(A) The certificate holder begin insert or licenseholder end insert has engaged in acts
or omissions that constitute grounds for revocation of the EMT-I
or EMT-II begin delete certificate. end delete begin insert certificate or EMT-P license. end insert

(B) Permitting the certificate holder begin insert or licenseholder end insert to continue
to engage in the begin delete certified end delete begin insert regulated end insert activity without restriction
would pose an imminent threat to the public health or safety.

(5) If the begin delete medical end delete director begin delete of the local EMS agency end delete temporarily
suspends a begin delete certificate, end delete begin insert certificate or license, end insert the begin delete local EMS agency end delete
begin insert regulating entity end insert shall notify the certificate holder begin insert or licenseholder end insert
that his or her begin delete EMT-I or EMT-II end delete certificate begin insert or license end insert is suspended
and shall identify the reasons therefor. Within three working days
of the initiation of the suspension by the begin delete local EMS agency, the
agency end delete begin insert regulating entity, the regulating entity end insert and employer shall
jointly investigate the allegation in order for the begin delete agency end delete begin insert regulating
entity end insert to make a determination of the continuation of the temporary
suspension. All investigatory information not otherwise protected
by law held by the begin delete agency end delete begin insert regulating entity end insert and employer shall be
shared between the parties via facsimile transmission or overnight
mail relative to the decision to temporarily suspend. The begin delete local
EMS agency end delete begin insert regulating entity end insert shall decide, within 15 calendar
days, whether to serve the certificate holder begin insert or licenseholder end insert with
an accusation pursuant to Chapter 5 (commencing with Section
11500) of Part 1 of Division 3 of Title 2 of the Government Code.
If the certificate holder begin insert or licenseholder end insert files a notice of defense,
the hearing shall be held within 30 days of the begin delete local EMS agency’s end delete
begin insert regulating entity’s end insert receipt of the notice of defense. The temporary
suspension order shall be deemed vacated if the begin delete local EMS agency end delete
begin insert regulating entity end insert fails to make a final determination on the merits
within 15 days after the administrative law judge renders the
proposed decision.

(6) The begin delete medical end delete director begin delete of the local EMS agency end delete shall refer,
for investigation and discipline, any complaint received on an
begin delete EMT-I or EMT-II end delete begin insert EMT-I, EMT-II, or EMT-P end insert to the relevant
employer within three days of receipt of the complaint, pursuant
to subparagraph (A) of paragraph (1) of subdivision (a).

begin delete

(b) The authority may deny, suspend, or revoke any EMT-P
license issued under this division, or may place any EMT-P license
issued under this division, or may place any EMT-P licenseholder
on probation upon the finding by the director of the occurrence of
any of the actions listed in subdivision (c). Proceedings against
any EMT-P license or licenseholder shall be held in accordance
with Chapter 5 (commencing with Section 11500) of Part 1 of
Division 3 of Title 2 of the Government Code.

end delete begin insert

(b) For purposes of this section, the following definitions shall
apply:

end insert begin insert

(1) “Director” means either of the following:

end insert begin insert

(A) For purposes of EMT-I or EMT-II certificate holders, the
medical director of the local EMS agency that has jurisdiction in
the county in which the alleged violation occurred.

end insert begin insert

(B) For purposes of EMT-P licenseholders, the Director of the
Emergency Medical Services Authority.

end insert begin insert

(2) “Regulating entity” means either of the following:

end insert begin insert

(A) For purposes of EMT-I and EMT-II certificate holders, the
local EMS agency that has jurisdiction in the county in which the
alleged violation occurred.

end insert begin insert

(B) For purposes of EMT-P licenseholders, the EMS Authority.
When requiring a report or notification regarding an EMT-P,
“regulating entity” refers to both the local EMS agency that has
jurisdiction in the county in which the alleged violation occurred
and the EMS Authority.

end insert

(c) Any of the following actions shall be considered evidence
of a threat to the public health and safety and may result in the
denial, suspension, or revocation of a certificate or license issued
under this division, or in the placement on probation of a certificate
holder or licenseholder under this division:

(1) Fraud in the procurement of any certificate or license under
this division.

(2) Gross negligence.

(3) Repeated negligent acts.

(4) Incompetence.

(5) The commission of any fraudulent, dishonest, or corrupt act
that is substantially related to the qualifications, functions, and
duties of prehospital personnel.

(6) Conviction of any crime that is substantially related to the
qualifications, functions, and duties of prehospital personnel. The
record of conviction or a certified copy of the record shall be
conclusive evidence of the conviction.

(7) Violating or attempting to violate directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
any provision of this division or the regulations adopted by the
authority pertaining to prehospital personnel.

(8) Violating or attempting to violate any federal or state statute
or regulation that regulates narcotics, dangerous drugs, or
controlled substances.

(9) Addiction to, the excessive use of, or the misuse of, alcoholic
beverages, narcotics, dangerous drugs, or controlled substances.

(10) Functioning outside the supervision of medical control in
the field care system operating at the local level, except as
authorized by any other license or certification.

(11) Demonstration of irrational behavior or occurrence of a
physical disability to the extent that a reasonable and prudent
person would have reasonable cause to believe that the ability to
perform the duties normally expected may be impaired.

(12) Unprofessional conduct exhibited by any of the following:

(A) The mistreatment or physical abuse of any patient resulting
from force in excess of what a reasonable and prudent person
trained and acting in a similar capacity while engaged in the
performance of his or her duties would use if confronted with a
similar circumstance. Nothing in this section shall be deemed to
prohibit an EMT-I, EMT-II, or EMT-P from assisting a peace
officer, or a peace officer who is acting in the dual capacity of
peace officer and EMT-I, EMT-II, or EMT-P, from using that force
that is reasonably necessary to effect a lawful arrest or detention.

(B) The failure to maintain confidentiality of patient medical
information, except as disclosure is otherwise permitted or required
by law in Part 2.6 (commencing with Section 56) of Division 1 of
the Civil Code.

(C) The commission of any sexually related offense specified
under Section 290 of the Penal Code.

(d) The information shared among EMT-I, EMT-II, and EMT-P
employers, medical directors of local EMS agencies, the authority,
and EMT-I and EMT-II certifying entities shall be deemed to be
an investigative communication that is exempt from public
disclosure as a public record pursuant to subdivision (f) of Section
6254 of the Government Code. A formal disciplinary action against
an EMT-I, EMT-II, or EMT-P shall be considered a public record
available to the public, unless otherwise protected from disclosure
pursuant to state or federal law.

(e) For purposes of this section, “disciplinary cause” means begin insert only end insert
an begin delete act end delete begin insert action end insert that is substantially related to the qualifications,
functions, and duties of an EMT-I, EMT-II, or EMT-P and is
evidence of a threat to the public health and safety described in
subdivision (c).

begin insert

(f) The reporting requirements of subdivision (a) do not require
or authorize the release of information or records of an EMT-P
who is also a peace officer protected by Section 832.7 of the Penal
Code.

end insert begin insert

(g) Proceedings against any EMT-P licenseholder shall be held
in accordance with Chapter 5 (commencing with Section 11500)
of Part 1 of Division 3 of Title 2 of the Government Code.

end insert begin insert

(h) (1) Pursuant to subdivision (i) of Section 1798.24 of the
Civil Code, upon notification to the EMT-P, the EMS Authority
may share the results of its investigation pursuant to subdivision
(a) with the employer, a prospective employer when requested, in
writing, as part of a preemployment background check, or the
local EMS agency.

end insert begin insert

(2) An EMT-P licensee or applicant to whom the information
pertains, as set forth in subdivision (a) of Section 1798.24 of the
Civil Code, may view the contents of a closed investigation file
upon request during the EMS Authority’s regular business hours.

end insert

begin insert

begin insert SEC. 3. end insert   

end insert

begin insert Section 1798.201 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

1798.201.  

(a)  When information comes to the attention of the
medical director of the local EMS agency that an EMT-P
licenseholder has committed any act or omission that appears to
constitute grounds for disciplinary action under this division, the
medical director of the local EMS agency may evaluate the
information to determine if there is reason to believe that
disciplinary action may be necessary.

(b)  If the medical director sends a recommendation to the
authority for further investigation or discipline of the licenseholder,
the begin delete recommendation end delete begin insert end insert begin insert medical director shall also notify, within three
days, the EMT-P’s employer. The recommendation to the authority
and the notification sent to the employer end insert shall include all
documentary evidence collected by the medical director in
evaluating whether or not to make that recommendation. The
recommendation and accompanying evidence shall be deemed in
the nature of an investigative communication and be protected by
Section 6254 of the Government Code. In deciding what level of
disciplinary action is appropriate in the case, the authority shall
consult with the medical director of the local EMS agency.

begin insert

begin insert SEC. 4. end insert   

end insert

begin insert Section 1798.202 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

1798.202.  

(a)  The director of the authority or the medical
director of the local EMS agency, after consultation with the
relevant employer, may temporarily suspend, prior to hearing, begin delete any end delete
begin insert an end insert EMT-P license upon a determination that: (1) the licensee has
engaged in acts or omissions that constitute grounds for revocation
of the EMT-P license; and (2) permitting the licensee to continue
to engage in the licensed activity, or permitting the licensee to
continue in the licensed activity without restriction, would present
an imminent threat to the public health or safety. When the
suspension is initiated by the local EMS agency, subdivision (b)
shall apply. When the suspension is initiated by the director of the
authority, subdivision (c) shall apply.

(b)  The local EMS agency shall notify the licensee that his or
her EMT-P license is suspended and shall identify the reasons
therefor. Within three working days of the initiation of the
suspension by the local EMS agency, the agency shall transmit to
the begin delete authority, end delete begin insert authority and the EMT-P’s employer, end insert via facsimile
transmission or overnight mail, all documentary evidence collected
by the local EMS agency relative to the decision to temporarily
suspend. Within two working days of receipt of the local EMS
agency’s documentary evidence, the director of the authority shall
determine the need for the licensure action. Part of that
determination shall include an evaluation of the need for
continuance of the suspension during the licensure action review
process. If the director of the authority determines that the
temporary suspension order should not continue, the authority
shall immediately notify the licensee begin insert and his or her employer end insert that
the temporary suspension is lifted. If the director of the authority
determines that the temporary suspension order should continue,
the authority shall immediately notify the licensee begin insert and his or her
employer end insert of the decision to continue the temporary suspension
and shall, within 15 calendar days of receipt of the EMS agency’s
documentary evidence, serve the licensee with a temporary
suspension order and accusation pursuant to Chapter 5
(commencing with Section 11500) of Part 1 of Division 3 of Title
2 of the Government Code.

(c)  The director of the authority shall initiate a temporary
suspension with the filing of a temporary suspension order and
accusation pursuant to Chapter 5 (commencing with Section 11500)
of Part 1 of Division 3 of Title 2 of the Government Code and shall
notify the director of the local EMS agency, and the relevant
employer.

(d)  If the licensee files a notice of defense, the hearing shall be
held within 30 days of the authority’s receipt of the notice of
defense. The temporary suspension order shall be deemed vacated
if the authority fails to make a final determination on the merits
within 15 days after the administrative law judge renders the
proposed decision.

begin insert

begin insert SEC. 5. end insert   

end insert

begin insert Section 1799.112 of the end insert begin insert Health and Safety Code end insert begin insert is
repealed. end insert

begin delete

1799.112.  

(a) EMT-P employers shall report in writing to the
local EMS agency medical director and the authority and provide
all supporting documentation within 30 days of whenever any of
the following actions are taken:

(1) An EMT-P is terminated or suspended for disciplinary cause
or reason.

(2) An EMT-P resigns following notice of an impending
investigation based upon evidence indicating disciplinary cause
or reason.

(3) An EMT-P is removed from paramedic duties for
disciplinary cause or reason following the completion of an internal
investigation.

(b) The reporting requirements of subdivision (a) do not require
or authorize the release of information or records of an EMT-P
who is also a peace officer protected by Section 832.7 of the Penal
Code.

(c) For purposes of this section, “disciplinary cause or reason”
means only an action that is substantially related to the
qualifications, functions, and duties of a paramedic and is
considered evidence of a threat to the public health and safety as
identified in subdivision (c) of Section 1798.200.

(d) Pursuant to subdivision (i) of Section 1798.24 of the Civil
Code, upon notification to the paramedic, the authority may share
the results of its investigation into a paramedic’s misconduct with
the paramedic’s employer, prospective employer when requested
in writing as part of a preemployment background check, and the
local EMS agency.

(e) The information reported or disclosed in this section shall
be deemed in the nature of an investigative communication and is
exempt from disclosure as a public record by subdivision (f) of
Section 6254 of the Government Code.

(f) A paramedic applicant or licensee to whom the information
pertains may view the contents, as set forth in subdivision (a) of
Section 1798.24 of the Civil Code, of a closed investigation file
upon request during the regular business hours of the authority.

end delete