BILL ANALYSIS
AB 941
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 941 (Torrico)
As Amended September 7, 2007
2/3 vote. Urgency
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|ASSEMBLY: | |(May 10, 2007) |SENATE: | |(September 11, |
| | | | | |2007) |
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(vote not relevant) (vote not available)
Original Committee Reference: B. & F.
SUMMARY : Revises the disciplinary authority of local emergency
medical services agencies (LEMSAs) with regard to emergency
medical technicians (EMTs).
The Senate amendments delete the contents of the Assembly
approved version of this bill and instead:
1)Require 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-P licensure
status, to be used by local emergency medical agencies
(LEMSAs) and employers of EMTs. Require 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. Make the
registry contingent on a specific Budget appropriation if
additional funds are needed for this purpose.
2)Require LEMSAs to provide certification status updates within
three working days following a certification status change.
3)Require 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)Require EMSA to establish recommended guidelines for all of
the following:
a) Disciplinary orders, temporary suspensions, and
conditions of probation to be used by EMS providers and
LEMSAs when imposing disciplinary action;
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b) The issuance and renewal of EMT-I and EMT-II
certificates by emergency medical services (EMS) providers
and LEMSAs as specified; and,
c) Disciplinary hearings for EMT-I and EMT-II personnel.
5)Require EMS providers to do all of the following:
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)Require a LESMA to conduct investigations and disciplinary
actions of unemployed EMT-I and EMT-II personnel.
7)Revise 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,
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iii) The LEMSA determines that disciplinary action
against the certificate is necessary for a person not
employed as an EMT.
8)Permit a LEMSA to refer to EMSA the task of performing the
LEMSA's duties under #7) above.
9)Add 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.
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10) State 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.
11) Contain 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.
AS PASSED BY THE ASSEMBLY , this bill required a real estate
broker or lender to provide the borrower with the option to
receive all documents connected with a loan in an electronic
format.
FISCAL EFFECT : This bill has been gutted and amended since it
was analyzed in the Senate Appropriations Committee. 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 : 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 department,
which has supervisory and disciplinary control over its EMT
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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.
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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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.
Analysis Prepared by : John Gilman / HEALTH / (916) 319-2097
FN: 0003511