BILL ANALYSIS                                                                                                                                                                                                    





                                                                  AB 941

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          GOVERNOR'S VETO
          AB 941 (Torrico)
          As Amended September 7, 2007
          2/3 vote


           ---------------------------------------------------------------------- 
          |ASSEMBLY: |     |(May 10, 2007)  |SENATE: |40-0 |(September 11, 2007) |
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               (vote not relevant)


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          |COMMITTEE VOTE:  |13-0 |(September 11,      |RECOMMENDATION: |concur    |
          |                 |     |2007)               |                |          |
           ------------------------------------------------------------------------ 


           ---------------------------------------------------------------------- 
          |ASSEMBLY: |74-0 |(September 12,  |        |     |                     |
          |          |     |2007)           |        |     |                     |
           ---------------------------------------------------------------------- 

          Original Committee Reference:   B. & F.  

           SUMMARY  :  Revises the disciplinary authority of local emergency  
          medical services agencies (LEMSAs) with regard to emergency  
          medical technicians (EMTs).  Specifically,  this bill  :

           The Senate amendments  delete the Assembly 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-Paramedic  
            (EMT-P) licensure status, to be used by 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  










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            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 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)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)State 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  










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            Act.

          7)Require a LESMA to conduct investigations and take  
            disciplinary actions of unemployed EMT-I and EMT-II personnel.  


          8)Revise LEMSA 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  
                 employed as an EMT.

          9)Permit a LEMSA to refer to EMSA the task of performing the  
            LEMSA's duties under #7) above.

          10)   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;











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             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)   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.

          12)   Include 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.










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          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.  

          AS PASSED BY THE ASSEMBLY  , this bill authorized a real estate  
          broker and lender to provide the borrower with the option to  
          receive specific documents connected with a loan in an  
          electronic format, paper format, or both.

           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.

           COMMTENTS  :  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.
           
          GOVERNOR'S VETO MESSAGE  :

               While I appreciate the efforts by the author and  
               stakeholders to improve coordination and oversight of  
               California's emergency medical technicians in a manner  
               that better protects public safety, I cannot sign this  
               bill.  AB 941 would establish a statewide registry for  
               EMTs, establish background check requirements and  










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               provide for uniform disciplinary standards.  However,  
               it falls short of what is needed to protect public  
               safety and ensure appropriate oversight of EMTs.   
               Specifically, I am concerned this bill lacks  
               requirements and penalties to assure timely notice  
               when an investigation is initiated, does not provide  
               sufficient authority for local medical directors to  
               independently initiate investigations, and fails to  
               establish clear standards for background checks.  In  
               addition, I am concerned that the bill would  
               significantly limit public disclosure.  I therefore  
               direct the Health and Human Services Agency to work in  
               a collaborative manner with stakeholders on  
               legislation that builds on AB 941, and improves it to  
               get the job done.



           Analysis Prepared by:     John Gilman / HEALTH / (916) 319-2097 



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