Amended in Assembly April 25, 2016

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 Sections 1797.184, 1798.200, 1798.201, and 1798.202 of, and to repeal Section 1799.112 of, the Health and Safety Code, relating to public health.

LEGISLATIVE COUNSEL’S DIGEST

AB 1931, as amended, Rodriguez. Emergency medical services: paramedics: discipline.

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. Existing law requires an EMT-P’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.

This bill would 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.

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.

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.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

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

SECTION 1.  

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

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 and EMT-P licenseholders that protect the public health
and safety.

(b) Regulations for the issuance of EMT-I and EMT-II
certificates by a certifying entity that protect 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.

SEC. 2.  

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 EMT-I, EMT-II, or EMT-P may conduct
investigations, as necessary, and take disciplinary action against
an EMT-I, EMT-II, or EMT-P who is employed by that employer
for conduct in violation of subdivision (c). The employer shall
notify the regulating entity within three days when an allegation
has been validated as a potential violation of subdivision (c).

(B) Each employer of an EMT-I, EMT-II, or EMT-P shall notify
the regulating entity within three days after the EMT-I, EMT-II,
or EMT-P is terminated or suspended for a disciplinary cause, the
EMT-I, EMT-II, or EMT-P resigns following notification of an
impending investigation based upon evidence that would indicate
the existence of a disciplinary cause, or the EMT-I, EMT-II, or
EMT-P is removed from EMT-related duties for a disciplinary
cause after the completion of the employer’s investigation. The
employer of an EMT-P shall provide the regulating entity with all
supporting documentation at the time of notification.

(C) At the conclusion of an investigation, the employer 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 EMT-I, EMT-II, or EMT-P. Upon adoption of the
disciplinary plan, the employer shall submit that plan to the
regulating entity within three working days. The employer’s
disciplinary plan may include a recommendation that the director
consider taking action against the holder’s certificate or license
pursuant to paragraph (3).

(2) If an EMT-I, EMT-II, or EMT-P is not employed by an
ambulance service licensed by the Department of the California
Highway Patrol or a public safety agency, 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 director shall conduct the investigations, and,
upon a determination of disciplinary cause, take disciplinary action
as necessary against the EMT-I, EMT-II, or EMT-P. At the
conclusion of these investigations, the 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
EMT-I, EMT-II, or EMT-P. The director’s disciplinary plan may
include action against the holder’s certificate or license pursuant
to paragraph (3).

(3) The director 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 or EMT-P license issued under
this division, or may place an EMT-I or EMT-II certificate holder
or EMT-P licenseholder on probation, upon the finding by the
director of the occurrence of any of the actions listed in subdivision
(c) and the occurrence of one of the following:

(A) The employer, after conducting an investigation, failed to
impose discipline for the conduct under investigation, or the
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 or EMT-P licenseholder constitutes grounds for
disciplinary action against the holder’s certificate or license.

(B) Either the employer further determines, after an investigation
conducted under paragraph (1), or the director determines after an
investigation conducted under paragraph (2), that the conduct
requires disciplinary action against the holder’s certificate or
license.

(4) The director, after consultation with the employer, may
temporarily suspend, prior to a hearing, an EMT-I or EMT-II
certificate, an EMT-P license, or a combination thereof upon a
determination that both of the following conditions have been met:

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

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

(5) If the director temporarily suspends a certificate or license,
the regulating entity shall notify the certificate holder or
licenseholder that his or her certificate or license is suspended and
shall identify the reasons therefor. Within three working days of
the initiation of the suspension by the regulating entity, the
regulating entity and employer shall jointly investigate the
allegation in order for the regulating entity to make a determination
of the continuation of the temporary suspension. All investigatory
information not otherwise protected by law held by the regulating
entity and employer shall be shared between the parties via
facsimile transmission or overnight mail relative to the decision
to temporarily suspend. The regulating entity shall decide, within
15 calendar days, whether to serve the certificate holder or
licenseholder 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 or licenseholder
files a notice of defense, the hearing shall be held within 30 days
of the regulating entity’s receipt of the notice of defense. The
temporary suspension order shall be deemed vacated if the
regulating entity fails to make a final determination on the merits
within 15 days after the administrative law judge renders the
proposed decision.

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

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

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

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

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

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

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

(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
only an action 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).

(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.

(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.

(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.

(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.

SEC. 3.  

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

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 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 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.

SEC. 4.  

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

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, an
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 authority and the EMT-P’s employer, 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
and his or her employer 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 and his or her employer 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.

SEC. 5.  

Section 1799.112 of the Health and Safety Code is
repealed.