BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2456
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          ASSEMBLY THIRD READING
          AB 2456 (Torrico)
          As Amended May 28, 2010
          Majority vote 

           HEALTH              17-2        APPROPRIATIONS      12-5        
           
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          |Ayes:|Monning, Fletcher,        |Ayes:|Fuentes, Ammiano,         |
          |     |Ammiano, Carter, Conway,  |     |Bradford,                 |
          |     |Brownley, De Leon, Eng,   |     |Charles Calderon, Coto,   |
          |     |Hayashi, Hernandez,       |     |Davis, Monning, Ruskin,   |
          |     |Jones,                    |     |Skinner, Solorio,         |
          |     |Bonnie Lowenthal, Nava,   |     |Torlakson, Torrico        |
          |     |V. Manuel Perez, Salas,   |     |                          |
          |     |Smyth, Audra Strickland   |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Adams, Gaines             |Nays:|Conway, Harkey, Miller,   |
          |     |                          |     |Nielsen, Norby            |
          |     |                          |     |                          |
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           SUMMARY  :  Addresses oversight of emergency medical professionals  
          under the jurisdiction of the California Emergency Medical  
          Services Authority (EMSA).  Specifically,  this bill  : 

          1)Requires EMSA to develop regulations establishing standards  
            for policies and procedures applicable to the functions,  
            certification, and licensure of emergency medical technician  
            (EMT) personnel to address local accreditation, competency  
            examinations, demonstration of skills competency, field  
            competency, preceptor evaluation, and approval and evaluation  
            of service providers.

          2)Requires the regulations to address optional skills including  
            medical oversight, service provider approval, and additional  
            training and maintenance of accreditation.

          3)Requires mandatory adherence by counties that have opted to  
            run the local Emergency Medical Services (EMS) program to  
            comply with the regulations established pursuant to this bill.

          4)Specifies if policies and procedures deviate from regulations  
            established pursuant to this bill, those policies and  








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            procedures must be approved by EMSA and the EMS Commission.

          5)Authorizes EMSA to develop and adopt a fee schedule to support  
            the additional costs of promulgating the regulations, to be  
            apportioned among certifying entities and EMT licensure fees. 

          6)States legislative intent and declarations. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, annual fee-supported special fund costs of $800,000  
          for EMSA to establish regulations and statewide oversight of  
          emergency medical professionals.  Recent amendments provide EMSA  
          to the authority to levy fees to support the workload created by  
          this bill.  
           
           COMMENTS  :  According to the author, this bill is intended to  
          clarify existing law established by AB 2917 (Torrico), Chapter  
          274, Statutes of 2008, with respect to EMSA's current ability to  
          establish guidelines that direct local EMS programs and other  
          essential EMS stakeholders in their operations for the  
          coordinated delivery of EMS in this state.  The author explains  
          that EMS personnel, such as in Kern and San Bernardino counties  
          provide multi-county services but are subject to differing  
          requirements.  The author argues that this bill is necessary to  
          streamline this incongruent process and that policies need to be  
          driven by research and consensus rather than the personality of  
          the local administrator and doctor.  The author also asserts  
          that policies should ensure the safety and competency of EMS  
          personnel through standardized training and accreditation, as  
          well as consistency in training programs which ensures safe and  
          effective delivery of EMS to the public.  This means one state  
          standard for all EMS certified and licensed personnel,  
          regardless of where the service is delivered. 

          California operates on a two-tiered EMS system.  EMSA is the  
          state lead agency and centralized resource to oversee emergency  
          and disaster medical services.  EMSA is charged with providing  
          leadership in developing and implementing EMS systems throughout  
          California and setting standards for the training and scope of  
          practice of various levels of EMS personnel.  EMSA also has  
          responsibility for promoting disaster medical preparedness  
          throughout the state, and, when required, managing the state's  
          medical response to major disasters.  According to EMSA it  
          operates through standard setting, consensus building, and  








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          leadership.  Responsibilities for EMS systems planning and  
          development include assessment of EMS systems in order to  
          coordinate EMS activity based on community needs; technical  
          assistance to local agencies; developing, implementing, or  
          evaluating components of an EMS system; development of statewide  
          standards and guidelines for EMS systems as well as guidelines  
          for the assessment of critical care capabilities of hospitals;  
          and, review and approval of local EMS plans to ensure compliance  
          with the minimum standards set by EMSA

          In California, day-to-day EMS system management is the  
          responsibility of the local and regional EMS agencies.   
          California has 32 local EMS systems that are providing EMS for  
          California's 58 counties.  Seven regional EMS systems comprised  
          of 33 counties and 25 single county agencies provide the  
          services.  Regional systems are usually comprised of small, more  
          rural, less-populated counties and single-county systems  
          generally exist in the larger and more urban counties. 
           

          Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916)  
          319-2097 


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