BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1944
                                                                  Page  1

          Date of Hearing:   May 9, 2012

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                    AB 1944 (Gatto) - As Amended:  April 30, 2012 

          Policy Committee:                              HealthVote:19-0

          Urgency:     No                   State Mandated Local Program: 
          Yes    Reimbursable:              Yes

           SUMMARY  

          This bill gives employers increased authority over disciplinary 
          investigations and actions for paramedics in their employment, 
          and changes existing roles of the Emergency Medical Services 
          Authority (EMSA) and the local EMS agencies (LEMSAs) with regard 
          to such investigations and actions. Specifically, this bill:

          1)Requires employer action (either an employer recommendation, 
            or a finding by EMSA that discipline imposed by an employer 
            was not appropriate) before the authority may deny, suspend, 
            or revoke a license.

          2)Requires local EMS agencies to refer any information received 
            regarding the conduct of an employee to the individual's 
            employer, or to EMSA if the individual is not employed.

          3)Authorizes paramedic employers to conduct investigations to 
            determine disciplinary cause, as defined, authorizes employers 
            to adopt disciplinary plans which meet certain standards, and 
            requires employers to submit disciplinary plans to the local 
            EMS agency and to EMSA.

          4)Requires employers to provide certain status reports of their 
            disciplinary investigations to EMSA.

           FISCAL EFFECT  

          1)Costs to EMSA are likely to be minor and absorbable. 

          2)Potential reimbursable state mandate costs in the range of 
            $1-2 million GF related to the requirement that local EMS 
            agencies refer any information received regarding the conduct 








                                                                  AB 1944
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            of an employee to the individual's employer or to EMSA. 

            Local EMS agencies also expect additional workload associated 
            with reviewing and providing assistance with employer-provided 
            disciplinary plans, but these costs are not reimbursable as 
            technical assistance is not specifically mandated by the bill. 
              

           COMMENTS  
           
           1)Rationale  . According to the author, California adopted a 
            system for the coordinated oversight of EMT-Is and EMT-IIs in 
            AB 2917 (Torrico), Chapter 274, Statutes of 2007. That same 
            system of coordinated oversight does not apply to 
            EMT-Paramedics, and as a result, paramedics are often 
            disciplined by multiple agencies and levels of government.  
            This bill gives the employer primacy to discipline paramedics 
            and requires reporting and coordination between EMSA and 
            employers.

           2)Background  . The EMS system is a partnership between the state 
            EMS Authority (EMSA), county-based or regional local EMS 
            agencies, and other entities such as ambulance providers, fire 
            stations, and hospitals.  EMSA currently licenses paramedics, 
            but to work in the state, paramedics must also be accredited 
            by the local EMS agency with jurisdiction in the county of 
            employment.  EMSA licensure requires education, practical 
            skills, an exam, and a background check ; local EMS agency 
            accreditation ensures a paramedic is familiar with local 
            policies, hospitals, and EMS systems. Disciplinary action can 
            occur at the local level, at the EMSA level, or at the 
            employer level.  Current law requires EMSA to give credit for 
            discipline imposed by the employer or by the local EMS agency 
            for the same conduct when deciding on disciplinary action.  
            EMSA indicates some actions requiring disciplinary action 
            occur outside of the scope of employment, such as DUI charges. 
             

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081