BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           2456 (Torrico)
          
          Hearing Date:  8/2/2010         Amended: 7/15/2010
          Consultant: Katie Johnson       Policy Vote: Health 5-3
          _________________________________________________________________ 
          ____
          BILL SUMMARY:  AB 2456 would require the Emergency Medical  
          Services Authority (EMSA) to develop regulations establishing  
          standards for policies and procedures applicable to the  
          functions of emergency medical technicians. The bill would also  
          permit an emergency medical services (EMS) provider or a local  
          EMS agency to appeal a determination made by EMSA, regarding  
          these regulations, to the EMS Commission.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2010-11      2011-12       2012-13     Fund
                                                                  
          EMSA EMT regulations     $400       $700     $700      General*

          EMSA ongoing approval    Approximately $630 annuallyGeneral
          of guidelines            January 1, 2014 and ongoing

          Commission complaint     Approximately $260 annuallyGeneral
          resolution monthly meetings     January 1, 2014 and ongoing

          *EMSA may charge a fee for the promulgation of regulations to  
          cover costs. However, this bill would require the regulations to  
          be completed before the fee is imposed.
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the  
          Suspense File.
          
          This bill would require the Emergency Medical Services Authority  
          (EMSA), no later than December 31, 2011, to develop regulations  
          establishing standards for policies and procedures applicable to  
          the functions of emergency medical technicians (EMTs). It is  
          unlikely that EMSA would be able to meet with stakeholders and  
          to promulgate regulations within this timeline. These  
          regulations and guidelines would establish standards for  










          policies and procedures applicable to the functions,  
          certification, and licensure of EMT personnel that provide  
          objective criteria for local adaptation. They would address  
          local accreditation, competency skills, medical control for the  
          use of optional skills, approval of providers utilizing optional  
          skills, additional training and maintenance of optional skills,  
          field internships, preceptor evaluation criteria for trainees,  
          and approval and evaluation of advanced EMT service providers. 

          It would cost approximately $400,000 in FY 2010-2011 and  
          $700,000 FY 2011-2012 through January 1, 2014, for EMSA to  
          promulgate the EMT regulations. Since it would take about 3  
          years to promulgate regulations, staff recommends that the bill  
          be amended to require EMSA to promulgate regulations related to  
          EMT qualification and training standards no later than January  
          1, 2014, instead of December 31, 2011. In order to pay for the  
          promulgation of regulations, this bill would permit EMSA to  
          develop 
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          AB 2456 (Torrico)

          and, after approval by the EMSA Commission, adopt a schedule of  
          fees to be collected from each EMT certifying entity in amounts  
          sufficient to support EMSA's actual additional costs. Fees would  
          be imposed proportionally among certifying entities through  
          EMT-P licensure fees based on the number of EMT-Is and EMT-IIs  
          certified by a certifying entity and the number of EMT-Ps  
          licensed by the authority. 

          This bill would also permit EMSA to review and approve or  
          disapprove local EMT standards and polices annually.  
          Additionally, an emergency medical services (EMS) provider or a  
          local EMS agency could appeal EMSA's opinion to the EMS  
          commission. The commission's decision would be final. EMSA would  
          need approximately $630,000 annually commencing January 1, 2014,  
          in order to review policies annually. The EMS Commission would  
          also require resources of approximately $260,000 annually  
          commencing January 1, 2014, to provide for monthy meetings and  
          staff support to hear and adjudicate appeals. Since there is no  
          identified funding source for these ongoing expenses, monies  
          would be paid by the General Fund.