BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1245
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 1245 (Williams)
          As Amended July 11, 2011
          Majority vote
           
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          |ASSEMBLY:  |75-0 |(May 26, 2011)  |SENATE: |38-1 |(September 6,  |
          |           |     |                |        |     |2011)          |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Authorizes the Emergency Medical Services Agency 
          (EMSA) to adopt regulations for the state approval of standards 
          for an emergency medical responder (EMR) training course that 
          meets or exceeds the United States Department of 
          Transportation's Emergency Medical Responder:  Instructional 
          Guidelines.  Specifies that this does not authorize an EMR 
          independent scope of practice, license, or certification, nor 
          does it authorize a new category of emergency medical services 
          personnel  

           The Senate amendments  are technical and clarifying.

           EXISTING LAW  :  

          1)Establishes the state EMSA which is responsible for the 
            coordination and integration of all state activities 
            concerning emergency medical services (EMS) including 
            establishing the minimum standards for the policies and 
            procedures necessary for medical control of the EMS system.

          2)Requires EMSA to maintain a central registry of Emergency 
            Medical Technicians (EMT), and to create EMT certification, 
            recertification, and disciplinary standards.

          3)Requires all EMTs to submit finger prints for a state and 
            federal level criminal offender record information (CORI) 
            search including subsequent arrest information.  

          4)Requires a person to be licensed by EMSA in order to practice 
            as a paramedic. 

           AS PASSED BY THE ASSEMBLY  this bill was substantially similar to 
          the version passed by the Senate.








                                                                  AB 1245
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           FISCAL EFFECT  :  According to the Senate appropriations, the 
          costs are minor and absorbable. 

           COMMENTS  :  According to the author, this bill allows EMSA to 
          continue to develop the EMR regulations, while prohibiting new 
          guidelines from conferring a new EMR scope of practice.  The 
          author contends that once the new regulations are adopted, EMSA 
          will be required to seek Legislative authority to classify EMR 
          as a new recognized first-responder category, with their own 
          scope of practice, and at that time, the state can require a 
          background check to be part of the regulations if it has not 
          already been included.  According to the sponsors, the 
          California Professional Firefighters, the purpose of this bill 
          is to ensure that anyone in training to be employed or volunteer 
          in a public safety capacity rendering first aid in an emergency 
          setting be subject to the same background check as is required 
          of certificated EMTs.  According to the sponsors, California 
          Professional Firefighters, clarification is needed to ensure a 
          consistent application of the requirement that background checks 
          be conducted to facilitate greater coordination and oversight 
          among emergency medical stakeholders and ultimately strengthen 
          patient care.  

          The National EMS Scope of Practice Model was established as part 
          of the National Highway Traffic Safety Administration (NHTSA) 
          and the Health Resources and Services Administration 
          implementation of the EMS Agenda for the Future.  According to 
          the NHTSA, it envisioned as an integrated, interdependent 
          system, to maximize efficiency, consistency of instructional 
          quality, and student competence.  According to the NHTSA Web 
          site, states following the National EMS Scope of Practice Model 
          as closely as possible will increase the consistency of the 
          nomenclature and competencies of EMS personnel nationwide, 
          facilitate reciprocity, improve professional mobility, and 
          enhance the name recognition and public understanding of EMS.

          The National EMS Scope of Practice Model defines and describes 
          four levels of EMS licensure: EMR, EMT, Advanced EMT (AEMT), and 
          paramedic.  New EMSA regulations took effect January 14, 2011, 
          transitioning the category of EMT-II to AEMT.  Among other 
          changes, the new regulations expanded the scope of practice and 
          requires a transition by July 1, 2013, to the use of a written 
          and skills examination by the National Registry of Emergency 
          Medical Technicians in place of one administered by a local 








                                                                  AB 1245
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          training program or a  Local Emergency Medical Services Area 
          (LEMSA).  

          At the March 23, 2011, meeting of the EMS Commission, the acting 
          Director of EMSA reported that an EMR Task Force had been 
          convened to revise the Public Safety First Aid Regulations, 
          adopt a scope of practice for the Public Safety First Aid 
          providers, adopt the EMR as a level of EMS responder and adopt 
          the training requirements and scope of practice for EMRs.  It 
          was further reported that the Task Force recommended removing 
          EMR from the Public Safety First Aid Chapter of Regulations and 
          placing it in its own chapter of regulations.  The purpose was 
          to separate the focus on public safety first aid requirements 
          from the EMR requirements.  The director further reported that 
          the new EMR Regulations will be similar to the EMT Regulations 
          with respect to training program approval requirements and will 
          include a scope of practice consistent with the National Scope 
          of Practice Model.  The EMS Authority is not proposing to 
          require certification or criminal background checks for the EMR, 
          due to the lack of statutory authority.  

          According to NHTSA, the primary focus of the EMR is to initiate 
          immediate lifesaving care to critical patients who access the 
          emergency medical system.  This individual possesses the basic 
          knowledge and skills necessary to provide lifesaving 
          interventions while awaiting additional EMS response and to 
          assist higher level personnel at the scene and during transport. 
           Emergency Medical Responders function as part of a 
          comprehensive EMS response, under medical oversight.  EMRs 
          perform basic interventions with minimal equipment.


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


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