BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 941|
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THIRD READING
Bill No: AB 941
Author: Torrico (D), et al
Amended: 9/5/07 in Senate
Vote: 21
PRIOR VOTES NOT RELEVANT
SUBJECT : Emergency medical technicians: certificate
discipline
SOURCE : California Professional Firefighters
DIGEST : This bill, if certain conditions are met,
requires the Emergency Medical Services 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, and requires EMS
providers to verify that a background check is completed on
all EMT-I and EMT-II holders and to submit certification
data.
NOTE: This bill is substantially similar to SB 583
(Ridley-Thomas) of this session, which passed the Senate
Health Committee on April 11, 2007 with a vote of 7-1.
ANALYSIS :
Existing Law
CONTINUED
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Under existing law, the medical director of a Local
Emergency Medical Services Agency (LEMSA) is permitted to
deny, suspend, or revoke any EMT-I or EMT II certificate
issued, or to place any EMT-I or EMT-II certificate holder
on probation, upon a finding by the medical director of
specific actions, including (1) fraud in the procurement of
the certificate or license; gross negligence or repeated
negligent acts, (2) incompetence, (3) commission of any
fraudulent, dishonest or corrupt act or conviction of any
crime which is substantially related to the qualifications,
functions and duties of prehospital personnel, (4)
violating directly or indirectly any provision of law or
regulations pertaining to prehospital personnel, (5)
violation of laws and regulations dealing with narcotics,
dangerous drugs or controlled substances, or excess use of
alcohol or drugs, as specified, and (6) unprofessional
conduct.
Existing law requires the Emergency Medical Services
Authority (Authority) to ensure that the LEMSAs
disciplinary policies and procedures are, at a minimum, as
effective in protecting the due process rights of any EMT-I
or EMT-II certificate holder, as those contained in the
Administrative Procedure Act. Those procedures require an
administrative process which includes a formal accusation,
statement of issues, an opportunity for the respondent to
request a hearing within 15 days or waive his or her right
to a hearing and other procedural requirements.
This bill:
1.Requires the Authority to establish a central registry of
all EMT-I and EMT-II certificate holders and all EMT-P
license holders to contain:
A. Name.
B. Certification/license.
C. Certificate issuing agency/license number.
D. Date of issuance.
E. Status of license/certificate (active, inactive,
suspended, revoked).
F. Federal Bureau of Investigation/Department of
Justice background check verification.
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2.Requires LEMSAs to provide certification status updates
within three working days following a certification
status change.
3.Requires emergency medical service providers to provide
any certification data required for the registry.
4.Requires the Authority to establish statewide standards
for all of the following:
A. Disciplinary Orders and Conditions of Probation -
to be used by emergency medical service providers and
LEMSAs when imposing certification disciplinary
action.
B. The issuance of EMT-I and EMT-II certificates and
renewal of those certificates - to include the
requirement that certificates be issued within the
county of employment.
C. Disciplinary Hearings for EMT-I and EMT-II
personnel.
5.Requires emergency medical service providers to do all of
the following:
A. Conduct investigations, as necessary, and take
disciplinary action for actions that may result in
denial, suspension or revocation of an EMT-I or
EMT-II certificate.
B. Develop and implement disciplinary plans
established in accordance with the state orders
developed by the Authority.
C. Notify the LEMSA of the disciplinary plan - which
may also contain a recommendation that the LESMA
consider taking action against the EMT's
certification.
6.Requires a LESMA to conduct investigations for all
unemployed EMT-I and EMT-II personnel.
7.Revises the LESMA's authority to deny, suspend or revoke
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an EMT-I or EMT-II certificate by adding the following
requirements:
A. Requires the LEMSA to follow the disciplinary
hearing procedures established by the Authority.
B. Requires that action be taken if one of the
following are true:
(1) The emergency medical service provider
recommended certification action in the
disciplinary plan.
(2) The emergency medical service provider
failed to impose discipline, or the medical
director makes a finding that the discipline
imposed was not sufficient and the act or omission
constitutes grounds for certification action.
(3) The LEMSA determines that certification
action is necessary for a person not employed as
an EMT.
8.Revises the list of actions that are evidence of a threat
to the public health and safety to add:
A. Denial of licensure or certification in another
state or any other California licensing entity.
B. Impersonating an applicant or acting as a proxy in
an exam or continuing education.
C. Making a false statement in connection with the
application for a certification or license.
D. Impersonating another practitioner, or permitting
another to impersonate a practitioner of emergency
medical service.
E. Obtaining or possessing a controlled substance.
F. Use of any controlled substance.
G. Use of alcohol to an extent or manner dangerous or
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injurious to the EMT or another person, or the
public, or the extent it impairs the EMT's ability to
perform his/her duties.
H. Conviction of a criminal offense involving the
prescription, consumption or self-administration of
controlled substances or alcohol, or the possession
or falsification of a prescription record.
I. Being committed or confined by a court for
intemperate use of or addiction to controlled
substances or alcohol.
J. Falsifying or making grossly incorrect entries in
any hospital, patient, or other record pertaining to
controlled substances.
Background
Emergency Medical Technicians . EMT-I's are skilled medical
workers who respond by ambulance to medical emergencies for
the injured and ill. They are sent to emergencies by
dispatchers who maintain radio contact or patch them
through to medical professionals for ongoing instructions.
Following instructions, they examine victims to determine
the nature and extent of an injury or illness and
administer first aid and emergency basic life support, such
as giving oxygen and doing cardiopulmonary resuscitation.
They continue the basic life support treatment during
transport to hospitals. They help the emergency room staff
with pre-admittance treatment and obtain medical histories.
EMT-I's are certified locally and their certificates are
valid statewide. EMT-II's, whose certificates are valid
only where certified, are utilized primarily in rural
areas.
A variety of institutions provide approved EMT-I training
programs for EMT certification. These institutions include
community colleges, county health departments, EMS
agencies, adult schools, ambulance companies, state
universities and school districts. These programs are open
to the general public. Fire departments provide the
training for firefighters exclusively. This certification
may be a condition of employment in the fire department.
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To be certified as an EMT, the applicant must successfully
complete the training program and pass a written and skills
certifying examination. Certification is done by LEMSAs,
the State Fire Marshal, and some of the fire departments
that offer the training program. Recent mandates also
require EMTs to pass a test administered by the National
Registry of EMTs.
In addition to ambulance attendants, many firefighters and
police officers have EMT certificates which can be a
condition of employment. According to the Authority, there
are approximately 70,000 EMT-Is certified statewide, with
an estimated 10,000 new EMT-Is certified annually.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
Fiscal Impact (in thousands)
Major Provisions 2007-08 2008-09
2009-10 Fund
Program support $ 91 $ 168
$ 168 GF
SUPPORT : (Verified 3/28/07)
California Professional Firefighters (source)
CDF Firefighters
Marin Professional Firefighters, Local 1775
United Firefighters of Los Angeles County, Local 112
OPPOSITION : (Verified 3/28/07)
County Health Executives Association of California
Emergency Medical Services Administrators Association of
California
Emergency Nurses Association, California State Council
First Responder Emergency Medical Services, Inc.
Morongo Basin Ambulance Association, Inc.
North Coast Emergency Medical Services
Riggs Ambulance Service
Sequoia Safety Council
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ARGUMENTS IN SUPPORT : Supporters argue that, since fire
departments require their firefighters to obtain EMT-I
certification as a matter of public safety, it is only
appropriate that the public safety agency have significant
involvement in the disciplinary process of EMTs.
CDF Firefighters state that the legislation is balanced and
allows everyone a clear understanding of employee
responsibilities and ways in which a disciplinary process
would work.
ARGUMENTS IN OPPOSITION : The County Health Executives of
California and the Emergency Medical Services
Administrators' Association of California state this is a
proposal that guarantees inconsistency in imposing
discipline and fractures the medical control within an
emergency medical service agency by restricting medically
sound and neutral disciplinary decisions by the local LEMSA
medical director regarding EMT-Is and EMT-IIs. They argue
that an employer, whether public or private, cannot, and
should not, be expected to evaluate an EMT-I's medical
performance within an emergency medical service system.
They are also concerned that this bill will create major
financial burdens upon counties by requiring the LEMSA
disciplinary actions be conducted in accordance with the
Administrative Procedure Act.
ASSEMBLY FLOOR :
AYES: Aghazarian, Arambula, Bass, Beall, Benoit, Berg,
Blakeslee, Brownley, Caballero, Charles Calderon, Carter,
Cook, Coto, Davis, De La Torre, De Leon, DeSaulnier,
Emmerson, Eng, Evans, Feuer, Galgiani, Garcia, Hancock,
Hayashi, Hernandez, Horton, Houston, Jones, Karnette,
Keene, Krekorian, Laird, Leno, Levine, Lieber, Ma,
Mendoza, Mullin, Nakanishi, Nava, Niello, Parra, Plescia,
Portantino, Price, Richardson, Salas, Saldana, Silva,
Smyth, Solorio, Spitzer, Strickland, Swanson, Torrico,
Tran, Villines, Wolk
NOES: Adams, Berryhill, DeVore, Fuller, Gaines, Jeffries,
La Malfa, Maze
NO VOTE RECORDED: Anderson, Duvall, Dymally, Garrick,
Huff, Huffman, Lieu, Sharon Runner, Ruskin, Soto,
Walters, Nunez, Vacancy
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DLW:cm 9/6/07 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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