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: 9/7/07 in Senate
Vote: 21
PRIOR VOTES NOT RELEVANT
SUBJECT : Emergency medical technicians: certificate
discipline
SOURCE : California Professional Firefighters
California Ambulance Association
DIGEST : This bill, if certain conditions are met,
requires the Emergency Medical Services (EMS) Authority to
maintain a centralized system for monitoring and tracing
Emergency Medical Technician-I (EMT) 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.
Senate Floor Amendments of 8/7/07 (1) require the registry
system to include when a background check was conducted
instead of whether a background check was conducted, and
further clarify that the Federal Bureau of Investigation
(FBI) and the Department of Justice (DOJ) background check
is a requirement of certification, licensure or employment,
(2) include the notification of an EMS service provider to
CONTINUED
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the Local Emergency Medical Services Agency (LEMSA) when a
disciplinary investigation has been opened, in the
recommended guidelines for disciplinary hearings, to allow
the medical director of the LEMSA to step in if
disciplinary action is not taken, and (3) include temporary
suspensions in the recommended guidelines for disciplinary
orders.
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
Under existing law, the medical director of a 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.
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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.
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
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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
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:
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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 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.
9.Requires the registry system to include when a
background check was conducted instead of whether a
background check was conducted, and further clarify that
a FBI and DOJ background check is a requirement of
certification, licensure or employment.
10.Includes the notification of an EMS service provider to
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the LEMSA when a disciplinary investigation has been
opened, in the recommended guidelines for disciplinary
hearings, to allow the medical director of the LEMSA to
step in if disciplinary action is not taken.
11.Includes temporary suspensions in the recommended
guidelines for disciplinary orders.
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.
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
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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 9/8/07)
California Ambulance Association (co-source)
California Professional Firefighters (co-source)
CDF Firefighters
Marin Professional Firefighters, Local 1775
United Firefighters of Los Angeles County, Local 112
OPPOSITION : (Verified 9/8/07)
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
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
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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
DLW:cm 9/8/07 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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