BILL ANALYSIS
AB 941
Page 1
Date of Hearing: September 11, 2006
ASSEMBLY COMMITTEE ON HEALTH
Mervyn Dymally, Chair
AB 941 (Torrico) - As Amended: September 7, 2007
SUBJECT : Emergency medical technicians: certificates:
discipline.
SUMMARY : Revises the disciplinary authority of local emergency
medical services agencies (LEMSAs) with regard to emergency
medical technicians (EMTs). Specifically, this bill :
1)Requires the Emergency Medical Services Authority (EMSA) to
maintain a central registry for monitoring and tracking of
EMT-I and EMT-II certification status and EMT-Paramedic
(EMT-P) licensure status, to be used by LEMSAs and employers
of EMTs. Requires the registry to include the name of each
EMT certificated or licensed person, the issuing agency, date
of issue, status of license or certificate, and background
check information. Makes the registry contingent on a
specific Budget appropriation if additional funds are needed
for this purpose.
2)Requires LEMSAs to provide certification status updates within
three working days following a certification status change.
3)Requires emergency medical service providers to verify that a
background check is completed on each EMT certificate holder
and submit the certification data required by this bill.
4)Requires EMSA to establish recommended guidelines for all of
the following:
a) Disciplinary orders, temporary suspensions, and
conditions of probation to be used by emergency medical
services (EMS) providers and LEMSAs when imposing
disciplinary action;
b) The issuance and renewal of EMT-I and EMT-II
certificates by EMS providers and LEMSAs as specified; and,
c) Disciplinary hearings for EMT-I and EMT-II personnel.
5)Requires EMS providers to do all of the following:
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a) Conduct investigations, as necessary, and take
disciplinary action against EMTs employed by the EMS
provider for conduct that is considered a threat to public
safety, as defined (see #9) below);
b) Develop and implement disciplinary plans established in
accordance with the state guidelines developed by EMSA;
and,
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)States that any information reported or disclosed by an
employer pursuant to the employer's investigation or
disciplinary action is deemed to be an investigatory
communication exempt from disclosure under the Public Records
Act.
7)Requires a LESMA to conduct investigations and disciplinary
actions of unemployed EMT-I and EMT-II personnel.
8)Revises the LEMSAs authority to deny, suspend, or revoke an
EMT-I or EMT-II certificate by adding the following
provisions:
a) Require the LEMSA to follow the disciplinary hearing
procedures established by EMSA;
b) Permit the LEMSA to take disciplinary action, if one of
the following is true, for conduct that is considered a
threat to public safety, as defined (see #9) below):
i) The EMS provider recommended certification action in
the disciplinary plan;
ii) The EMS 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;
or,
iii) The LEMSA determines that disciplinary action
against the certificate is necessary for a person not
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employed as an EMT.
9)Permits a LEMSA to refer to EMSA the task of performing the
LEMSA's duties under #7) above.
10) Adds the following to the current list of actions that are
evidence of a threat to the public health and safety:
a) Denial of licensure or certification in another state or
by 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
services;
e) Obtaining or possessing a controlled substance;
f) Use of controlled substances, prescription drugs or
alcohol that is dangerous to the EMT or another person, or
the public, or that impairs the EMT's ability to perform
his or her duties;
g) 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;
h) Being committed or confined by a court for intemperate
use of or addiction to controlled substances or alcohol;
and,
i) Falsifying or making grossly incorrect entries in any
hospital, patient, or other record pertaining to controlled
substances.
11) States that this bill shall not be construed to limit or
impair the medical control of the medical director of a LEMSA
granted pursuant to existing law.
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12) Includes an urgency clause, allowing this bill to take
effect immediately upon enactment.
EXISTING LAW :
1)Permits the medical director of the LEMSA, in accordance with
regulations, 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 the finding by the
medical director of the occurrence of actions, as specified.
2)Requires EMSA to ensure that the LEMSA's disciplinary policies
and procedures are, at a minimum, effective in protecting the
due process rights of any EMT-I or EMT-II certificate holder,
in accordance with the Administrative Procedures Act, as
specified.
3)Requires an EMT-P employer to report in writing to the LEMSA
and the EMSA, and provide all supporting documentation within
30 days, if an EMT-P is terminated or suspended for
disciplinary reasons, resigns following notice of an impending
investigation, or is removed from duty for disciplinary
reasons. States that the information reported or disclosed
pursuant to this provision is deemed to be an investigatory
communication exempt from disclosure under the Public Records
Act.
FISCAL EFFECT : The fiscal effect for a similar bill, SB 583
(Ridley-Thomas) as analyzed by the Senate Appropriations
Committee estimated costs to the General Fund for program
support of $91,000 for fiscal year (FY) 2007-08; $168,000 for FY
2008-09; and, $168,000 for FY 2009-10.
COMMENTS :
1)PURPOSE . According to the author, several different agencies
are authorized to issue EMT certificates under current law but
some of these agencies have little or no supervisory role over
an EMT's daily duties authorized under the certification. The
author states that current law vests explicit authority for
disciplining EMTs with only one entity, a LEMSA. When
exercising its explicit disciplinary authority, a LEMSA is not
required to take into consideration any other appropriately
administered discipline that may otherwise be concurrently
imposed by an EMT's employing agency, such as a fire
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department, which has supervisory and disciplinary control
over its EMT certificate holders. As a result, some EMT
disciplinary actions imposed by a LEMSA may be duplicative,
inconsistent, and excessive, which creates a punitive
environment of double jeopardy in disciplinary matters.
2)BACKGROUND . EMT-Is, by far the most common of the EMTs, 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. EMT-Is help the emergency room staff with
pre-admittance treatment and obtain medical histories.
EMT-II's, who are utilized primarily in rural areas, perform
all of the tasks required of EMT-Is, plus more complex
procedures such as inserting intravenous catheters,
administering intravenous glucose solutions, administering a
limited number of drugs, and obtaining blood samples for
laboratory analysis. EMT-Ps are paramedics who are the most
highly trained in all phases of emergency and pre-hospital
care, including emergency advanced life support treatment.
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. EMT 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. In addition to ambulance attendants, many
firefighters and police officers have EMT certificates which
can be a condition of employment. According to the EMSA,
there are approximately 70,000 EMT-Is certified statewide,
with an estimated 10,000 new EMT-Is certified annually; less
than 100 EMTs-II are certified in California.
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3)SUPPORT . Supporters argue that this bill represents a
consensus product of many of the participants of the EMS
Commission's Task Force which was convened in December 2005 to
address issues surrounding EMT certification and discipline.
Supporters believe this bill protects the public by
establishing a statewide standard for EMT certification, a
statewide database of background checks for all EMTs, and
standardized disciplinary procedures.
4)OPPOSE . The California Newspaper Publishers Association
opposes this bill because of the provision which states that
information reported or disclosed by an employer to the LEMSA
is deemed to be an investigatory communication and exempt from
disclosure under the Public Records Act.
5)URGENCY CLAUSE . This bill contains an urgency clause,
allowing this bill to take effect immediately upon enactment.
6)SENATE AMENDMENTS . This bill was substantially amended in the
Senate and the Assembly-approved provisions of this bill were
deleted. This bill, as amended in the Senate, is inconsistent
with Assembly actions. The subject matter of the current
version of this bill has not been heard in an Assembly policy
committee.
REGISTERED SUPPORT / OPPOSITION :
Support
California Ambulance Association (sponsor)
California Professional Firefighters (sponsor)
American Medical Response
Emergency Medical Services Administrators Association of
California
Opposition
California Newspaper Publishers Association
Analysis Prepared by : John Gilman / HEALTH / (916) 319-2097