BILL NUMBER: AB 941 ENROLLED
BILL TEXT
PASSED THE SENATE SEPTEMBER 11, 2007
PASSED THE ASSEMBLY SEPTEMBER 12, 2007
AMENDED IN SENATE SEPTEMBER 7, 2007
AMENDED IN SENATE SEPTEMBER 5, 2007
AMENDED IN SENATE AUGUST 23, 2007
AMENDED IN SENATE JULY 3, 2007
AMENDED IN SENATE JUNE 11, 2007
AMENDED IN SENATE JUNE 4, 2007
AMENDED IN ASSEMBLY APRIL 30, 2007
AMENDED IN ASSEMBLY APRIL 17, 2007
AMENDED IN ASSEMBLY APRIL 11, 2007
INTRODUCED BY Assembly Member Torrico
(Principal coauthors: Senators Ashburn and Ridley-Thomas)
(Coauthor: Assembly Member Aghazarian)
FEBRUARY 22, 2007
An act to amend Sections 1797.170, 1797.171, and 1798.200 of, and
to add Section 1797.117 to, the Health and Safety Code, relating to
emergency medical services and declaring the urgency thereof, to take
effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 941, Torrico. Emergency medical technicians: certificates:
discipline.
Existing law, the Emergency Medical Services System and the
Prehospital Emergency Medical Care Personnel Act, provides for the
certification of emergency medical technicians through the issuance
of certificates, including EMT-I and EMT-II certificates, by local
entities, known as local EMS agencies, which are designated by
counties. Existing law also permits public safety agencies, for
public safety personnel, and the State Board of Fire Services, for
fire safety personnel, to issue EMT-I certificates. Existing law
provides that the medical director of a local EMS agency or the
Emergency Medical Services Authority may deny, suspend, or revoke
certificates issued under these provisions, or may place a
certificate holder on probation, upon finding the occurrence of any
of specified events.
This bill, if certain conditions are met, would require the
authority to maintain a centralized system for monitoring and tracing
EMT-I and EMT-II certification status and EMT-P licensure status to
be used by employers and local EMS agencies as part of the background
check process. The bill would require EMS providers to verify that a
background check is completed on all EMT-I and EMT-II holders and to
submit certification data.
This bill would require the authority to establish EMT-I and
EMT-II certification and disciplinary guidelines. This bill would
require an EMS provider who employs an EMT-I or EMT-II to investigate
and, as necessary, discipline those EMT-I and EMT-II employees who
commit specified acts. The bill would also revise the grounds for
which the local EMS agency may impose additional discipline against
an EMT-I or EMT-II certificate holder.
This bill would also revise the grounds for which the authority
may discipline EMT-P licensees to include, but not be limited to,
denial of licensure by any other government entity, impersonating an
applicant or acting as proxy for an applicant, and making a false
statement in connection with an application.
By changing these enforcement requirements of local agencies, this
bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
This bill would declare that it is to take effect immediately as
an urgency statute.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) The health and safety of Californians often depends on the
timely response and competent care of emergency medical service (EMS)
personnel.
(b) Whether it is an automobile accident, heart attack, near
drowning, unscheduled childbirth, gunshot wound, or other life
critical incident, emergency medical technicians (EMTs) provide
vital, lifesaving, prehospital attention to the public, and assist in
transporting the sick or injured to an appropriate medical facility.
(c) Maintaining consistent and accountable supervision of EMT
certificate holders requires that pertinent information about
certification be available to all EMS providers prior to the
employment of an EMT.
(d) Ensuring the safety of the public as well as that of first
responders requires that any entity that employs EMTs have access to
pertinent information concerning any applicant's background and
criminal history as a condition of his or her employment.
(e) Local EMS agencies have a role to play in maintaining the
consistency of department policies and their conformance with the
legal requirements necessary to provide appropriate medical oversight
and protect the public safety.
SEC. 2. Section 1797.117 is added to the Health and Safety Code,
to read:
1797.117. (a) The Emergency Medical Services Authority shall
maintain a centralized registry system for the monitoring and
tracking of EMT-I and EMT-II certification status and EMT-P licensure
status, to be used by the local emergency medical services agencies
and employers of EMT personnel as part of the certification process.
To the extent that additional funds are needed for this purpose,
implementation of this subdivision shall be contingent upon a
specific appropriation provided for this purpose in the annual Budget
Act.
(b) The centralized registry system shall contain the full name of
the EMT-I, EMT-II, or EMT-P, the agency that issued the certificate
or, in the case of an EMT-P the license number, the date of issuance
of the license or certificate, the licensure or certification status,
and when a background check was completed as a condition of
licensure, certification, or employment.
(c) The authority shall develop and, after approval of the
commission pursuant to Section 1799.50, adopt regulations to
implement this section to include, but not be limited to, penalty
provisions for failure of a local EMS agency to report certification
status changes according to the timelines established under this
section and failure of an EMS service provider to report disciplinary
actions to a local EMS agency according to the timelines established
under Section 1798.200.
(d) For the purposes of this section the following definitions
shall apply:
(1) "Certification status" means the current status of an EMT-I or
EMT-II certificate or EMT-P license as active, inactive (not
renewed), suspended, or revoked.
(2) "Background check" means a standard procedure developed by the
authority and, after approval by the commission pursuant to Section
1799.50, adopted that shall include a Federal Bureau of Investigation
and Department of Justice criminal history.
(e) Every authorized EMS provider shall verify that a background
check is completed on each EMT-I and EMT-II certificate holder and
shall submit the certification data as set forth in this section.
(f) Each local EMS agency shall submit certification status
updates to the authority within three working days after a final
determination is made regarding a certification disciplinary action
taken by the medical director that results in a change in an EMT-I or
EMT-II certification status.
SEC. 3. Section 1797.170 of the Health and Safety Code is amended
to read:
1797.170. (a) The authority shall establish minimum standards and
shall adopt regulations for the training and scope of practice for
EMT-I.
(b) The authority shall develop and, after the approval of the
commission pursuant to Section 1799.50, adopt all of the following:
(1) Recommended guidelines for disciplinary orders, temporary
suspensions, and conditions of probation for EMT-I certificate
holders.
(2) Recommended guidelines for the issuance of EMT-I certificates
by a local EMS agency or other certifying authority.
(3) Recommended guidelines for the recertification of EMT-I
certificate holders, including, but not limited to, the requirement
that an applicant apply for recertification through one of the
following:
(A) If his or her employer is a certifying agency, through his or
her employer.
(B) If his or her employer is not a certifying agency, through a
certifying agency within the county of employment.
(C) If not currently employed, through a certifying agency within
his or her county of residence.
(4) Recommended guidelines for disciplinary hearings for EMT-I
certificate holders which shall include, but not be limited to,
procedures and time restrictions for all of the following:
(A) Notifications, including a notification by an EMS service
provider to the relevant local EMS agency when a disciplinary
investigation has been opened regarding conduct in violation of
subdivision (c) of Section 1798.200.
(B) Written accusations.
(C) Requests for discovery.
(D) Hearings conducted by an independent, impartial panel.
(c) Any individual certified as an EMT-I pursuant to this act
shall be recognized as an EMT-I on a statewide basis, and
recertification shall be based on statewide standards. Effective July
1, 1990, any individual certified as an EMT-I pursuant to this act
shall complete a course of training on the nature of sudden infant
death syndrome which is developed by the California SIDS program in
the State Department of Public Health in consultation with experts in
the field of sudden infant death syndrome.
SEC. 4. Section 1797.171 of the Health and Safety Code is amended
to read:
1797.171. (a) The authority shall develop, and after approval of
the commission pursuant to Section 1799.50, shall adopt, minimum
standards for the training and scope of practice for EMT-II.
(b) The authority shall develop and, after the approval of the
commission pursuant to Section 1799.50, adopt all of the following:
(1) Recommended guidelines for disciplinary orders, temporary
suspensions, and conditions of probation for EMT-II certificate
holders.
(2) Recommended guidelines for the issuance of EMT-II certificates
by a local EMS agency or other certifying authority.
(3) Recommended guidelines for the recertification of EMT-II
certificate holders, including, but not limited to, the requirement
that an applicant apply for recertification through one of the
following:
(A) If his or her employer is a certifying agency, through his or
her employer.
(B) If his or her employer is not a certifying agency, through a
certifying agency within the county of employment.
(C) If not currently employed, through a certifying agency within
his or her county of residence.
(4) Recommended guidelines for disciplinary hearings for EMT-II
certificate holders which shall include, but not be limited to,
procedures and time restrictions for all of the following:
(A) Notifications, including a notification by an EMS service
provider to the relevant local EMS agency when a disciplinary
investigation has been opened regarding conduct in violation of
subdivision (c) of Section 1798.200.
(B) Written accusations.
(C) Requests for discovery.
(D) Hearings conducted by an independent, impartial panel.
(c) An EMT-II shall complete a course of training on the nature of
sudden infant death syndrome in accordance with subdivision (c) of
Section 1797.170.
(d) (1) In rural or remote areas of the state where patient
transport times are particularly long and where local resources are
inadequate to support an EMT-P program for EMS responses, the
director may approve additions to the scope of practice of EMT-IIs
serving the local system, if requested by the medical director of the
local EMS agency, and if the EMT-II has received training equivalent
to that of an EMT-P. The approval of the director, in consultation
with a committee of local EMS medical directors named by the
Emergency Medical Directors Association of California, is required
prior to implementation of any addition to a local optional scope of
practice for EMT-IIs proposed by the medical director of a local EMS
agency. No drug or procedure that is not part of the basic EMT-P
scope of practice, including, but not limited to, any approved local
options, shall be added to any EMT-II scope of practice pursuant to
this subdivision.
(2) Approval of additions to the scope of practices pursuant to
this subdivision may be given only for EMT-II programs in effect on
January 1, 1994.
SEC. 5. Section 1798.200 of the Health and Safety Code is amended
to read:
1798.200. (a) (1) (A) Except as set forth in paragraph (2), an
authorized EMS provider shall conduct investigations, as necessary,
and take disciplinary action against an EMT-I or EMT-II who is
employed by the EMS provider for conduct in violation of subdivision
(c).
(B) At the conclusion of the investigation the EMS provider may
develop and implement, in accordance with the recommended guidelines
for disciplinary orders and conditions of probation adopted pursuant
to Sections 1797.170 and 1797.171, a disciplinary plan for the EMT-I
or EMT-II.
(C) Upon adoption of the disciplinary plan, the EMS provider shall
inform the local EMS agency within three working days of its
findings and the disciplinary action taken.
(D) The EMS provider's disciplinary plan may include a
recommendation that the medical director of the local EMS agency
consider taking action against the holder's certificate pursuant to
paragraph (3).
(2) If the EMT-I or EMT-II is not employed by an authorized EMS
provider, any investigation or disciplinary action shall be conducted
by the medical director of the local EMS agency.
(3) (A) The medical director of the local EMS agency may, in
accordance with recommended guidelines for disciplinary hearings
adopted by the authority pursuant to Sections 1797.170 and 1797.171,
deny, suspend, or revoke any the EMT-I or EMT-II certificate issued
under this division, or may place any EMT-I or EMT-II certificate
holder on probation, upon the finding by that medical director of the
occurrence of any of the actions listed in subdivision (c) and one
of the following:
(i) That the EMS service provider recommended certification action
pursuant to subparagraph (D) of paragraph (1).
(ii) That the EMS service provider failed to impose discipline for
the act or omission, or the medical director makes a determination
that the discipline imposed was not sufficient and the act or
omission engaged in by the EMT-I or EMT-II certificate holder
constitutes grounds for further disciplinary action against the
certification.
(iii) A determination pursuant to an investigation conducted under
paragraph (2) that the act or omission requires disciplinary action
against the certification.
(B) Any information reported or disclosed by an employer pursuant
to this subdivision shall be deemed to be an investigatory
communication and shall be exempt from disclosure pursuant to the
California Public Records Act (Chapter 3.5 (commencing with Section
6250) of Division 7 of Title 1 of the Government Code).
(4) Notwithstanding any provision of law to the contrary, the
local EMS agency may elect to refer to the authority, the task of
performing the local EMS agency's duties under paragraph (3). If the
local EMS agency makes this election, it shall inform the authority
and the EMS providers in its area, and thereafter the authority shall
perform the duties of the local EMS agency pursuant to paragraph (3)
within the local EMS agency's area.
(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.
(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 or
licenseholder under this division:
(1) Fraud in the procurement of any certificate or license under
this division.
(2) Denial of licensure, revocation, suspension, or other
disciplinary action against an EMT license or certification by
another state or territory of the United States, by any other
government agency, or by another California licensing entity. A
certified copy of the decision or judgment shall be conclusive
evidence of that action.
(3) Impersonating an applicant or acting as proxy for an applicant
in any examination or continuing education required under this
division for the issuance of a certificate or license.
(4) Incompetence or gross negligence in carrying out usual
certified or licensed EMT functions.
(5) Making or giving any false statement or information in
connection with the application for issuance of a certificate or
license.
(6) Conviction of any crime which 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) Impersonating another certified or licensed practitioner, or
permitting or allowing another person to use his or her certificate
or license for the purpose of providing emergency medical services.
(9) 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.
(10) 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 Sections 56 to 56.6, inclusive, of the Civil Code.
(C) The commission of any sexually related offense specified under
Section 290 of the Penal Code.
(D) Obtaining or possessing in violation of the law, or, except as
directed by a licensed physician and surgeon, dentist, or
podiatrist, administer to himself or herself, or furnish or
administer to another, any controlled substance as defined in
Division 10 (commencing with Section 11000) of this code or any
dangerous drug or dangerous device as defined in Section 4022 of the
Business and Professions Code.
(E) Use of any controlled substance as defined in Division 10
(commencing with Section 11000) of this code or any dangerous drug or
dangerous device as defined in Section 4022 of the Business and
Professions Code, or alcoholic beverages, to an extent or manner
dangerous or injurious to himself or herself, any other person, or
the public, or to the extent that the use impairs his or her ability
to conduct with safety to the public the practice authorized by his
or her certification.
(F) Conviction of a criminal offense involving the prescription,
consumption, or self-administration of any of the substances
described in subparagraphs (D) and (E), or the possession of, or
falsification of a prescription record pertaining to, the substances
described in subparagraph (D), in which event the record of the
conviction is conclusive evidence thereof.
(G) Being committed or confined by a court of competent
jurisdiction for intemperate use of or addiction to the use of any of
the substances described in subparagraphs (D) and (E), in which
event the court order of commitment or confinement is prima facie
evidence of that commitment or confinement.
(H) Falsifying, or making grossly incorrect, grossly inconsistent,
or unintelligible entries in any hospital, patient, or other record
pertaining to substances described in subparagraph (D).
SEC. 6. This act shall not be construed to limit or otherwise
impair the medical control of the medical director of a local EMS
agency granted pursuant to Section 1798 of the Health and Safety
Code.
SEC. 7. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
SEC. 8. This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect. The facts constituting the necessity are:
In order to administer the Emergency Medical System in a manner
that more fully protects the public health, at the earliest possible
time, it is necessary for this act to take effect immediately.