BILL ANALYSIS Ó
AB 1931
Page 1
Date of Hearing: April 19, 2016
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
AB 1931
(Rodriguez) - As Amended March 18, 2016
SUBJECT: Emergency medical services: paramedics: discipline.
SUMMARY: Conforms guidelines for investigations and discipline
of misconduct by Emergency Medical Technician-Paramedic license
holders (EMT-Ps) to current requirements for Emergency Medical
Technician-I and II (EMT-I and EMT-II) certificate holders.
Specifically, this bill:
1)Requires the Emergency Medical Services Authority (EMSA) to
develop and adopt guidelines for disciplinary orders,
temporary suspensions, and conditions of probation for EMT-P
license holders.
2)Integrates and conforms the procedures for investigating
misconduct of EMT-P license holders with those of EMT-I and
EMT-II certificate holders, including requiring notification
of disciplinary action with regard to an EMT-P by the EMT-P's
employer to be given to the local emergency medical services
agency (LEMSA) and the EMSA within three days.
3)Requires the medical director of the LEMSA, if he or she makes
a recommendation to the EMSA for further investigation or
AB 1931
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discipline, to notify the EMT-P's employer within three days.
4)Requires notification of the EMT-P's employer when there is a
temporary suspension of an EMT-P's license.
EXISTING LAW:
1)Establishes EMSA, which is responsible for establishing
training, scope of practice, and continuing education for
emergency medical technicians and other prehospital personnel,
including EMT-I, EMT-II, and EMT-P designations.
2)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 EMSA to deny, suspend, or revoke any
EMT-P license for the same specified conduct.
3)Requires an EMT-P's employer to report in writing to the LEMSA
and EMSA within 30 days of specified disciplinary action being
taken with regard to an EMT-P.
4)Authorizes the medical director of the LEMSA 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 EMSA for further investigation
or discipline.
5)Authorizes the temporary suspension, in specified
circumstances, of an EMT-P license.
AB 1931
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FISCAL EFFECT: This bill has not been analyzed by a fiscal
committee.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, this bill is
needed so that any EMT-P discipline imposed is timely,
decisive, and appropriate, while also reflecting fair
corrective action for those who violate the standards of
professional conduct and endanger public safety. The author
states that when an EMT-P makes a mistake, he or she should be
corrected, and when an EMT-P is found guilty of misconduct,
the punishment should fit the crime -- subject to a
standardized, fairly applied, and timely process. The current
disciplinary system is not fair, timely, or efficient.
Although not a state law requirement, all professional
firefighters are trained as EMTs and most, as a condition of
employment, are paramedics (EMT-Ps). While the state issues
licenses to EMT-Ps, multiple agencies and levels of government
-- from a fire department employer and LEMSA to the state EMSA
and its Emergency Medical Services (EMS) Commission -- retain
the authority to investigate the actions of an EMT-P and
impose discipline without an effective system of coordination
or communication with each other during the course of the
investigation or when imposing such discipline. As a result,
discipline may be imposed on a paramedic license holder by one
oversight agency without regard for any appropriately
administered discipline already imposed by another oversight
agency. The coordinated system made applicable to EMT-Is and
EMT-IIs nearly a decade ago does not apply to EMT-Ps. This
bill enacts a disciplinary oversight system for California's
EMT-Ps that parallels the system currently applicable to
EMT-Is and EMT-IIs. The author concludes, in doing so, this
bill promotes and maintains a statewide coordinated EMS
delivery system guided by consistent and clear standards and,
by coordinating resources, saves money.
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2)BACKGROUND. EMSA is charged with providing leadership in
developing and implementing EMS systems throughout California
and setting standards for the training and scope of practice
of various levels of EMS personnel. EMSA is mandated by
statute to develop and implement regulations that set training
standards and the scope of practice for emergency medical
personnel, including EMT-I, EMT-II, and EMT-P. EMSA provides
statewide coordination and leadership for the planning,
development, and implementation of LEMSA systems. California
has 33 LEMSAs and seven regional EMS systems comprised of
small, rural, less-populated counties.
3)SUPPORT. California Professional Firefighters (CPF), the
sponsor of this bill, argues that this bill promotes and
maintains a statewide coordinated EMS delivery system, one
that is not only guided by clear standards, but is also
consistent with policy that is applicable to other EMS
personnel, as approved by the Legislature and Governor in
2007. This bill provides efficiency in both investigations
and imposition of disciplinary action as well as cost saving
benefits to employers and EMSA. CPF states that communities
are entitled to transparency and an assurance that
firefighters are dedicated to patient care. LUNA local 792
and the Orange County Professional Firefighters Association,
Local 3631note that multiple agencies have authority to
investigate actions and impose discipline on EMT-Ps and that
coordination of these activities will better ensure the health
and safety of the public.
4)OPPOSE UNLESS AMENDED. The EMS Administrators Association
(EMSAAC) opposes this bill unless amended. EMSAAC is
concerned that this bill makes two significant changes to
existing process that would have significant negative effects
on LEMSAs and the ability of LEMSA medical directors to hold
EMS personnel accountable for their actions. EMSAAC has
proposed amendments to address their concerns.
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5)PREVIOUS LEGISLATION. AB 2917 (Torrico), Chapter 274,
Statutes of 2008, requires EMSA to establish and maintain a
statewide registry of the status of EMT licenses and
certificates, to be used by certifying entities and to develop
standards, guidelines, and regulations for certification of
EMT-I and EMT-2. AB 2907 also establishes guidelines for EMT
investigation and discipline.
6)AMENDMENTS. The author proposes the following amendments, all
on page 6 of the bill, to meet the concerns of EMSAAC:
a) On line 13-14, delete "in the county in which the
alleged violation occurred"
b) On line 19-20, delete "in the county in which the
alleged violation occurred"
c) On line 24, delete "in the county in which the alleged
violation occurred"
REGISTERED SUPPORT / OPPOSITION:
Support
California Professional Firefighters (sponsor)
California State Firefighters Association
AB 1931
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LIUNA Local 792
Orange County Professional Firefighters Association, Local 3631
Opposition
None on file.
Analysis Prepared by:John Gilman / HEALTH / (916) 319-2097