BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 535|
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VETO
Bill No: SB 535
Author: Nielsen (R)
Amended: 4/17/13
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 4/10/13
AYES: Hernandez, Anderson, Beall, De Le�n, DeSaulnier, Monning,
Nielsen, Pavley, Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
SENATE FLOOR : 37-2, 5/29/13
AYES: Anderson, Beall, Berryhill, Calderon, Cannella, Corbett,
Correa, De Le�n, DeSaulnier, Emmerson, Evans, Fuller, Gaines,
Galgiani, Hancock, Hernandez, Hill, Hueso, Huff, Jackson,
Knight, Lara, Leno, Lieu, Liu, Monning, Nielsen, Padilla,
Pavley, Price, Roth, Steinberg, Walters, Wolk, Wright, Wyland,
Yee
NOES: Block, Torres
NO VOTE RECORDED: Vacancy
ASSEMBLY FLOOR : 77-0, 9/3/13 - See last page for vote
SUBJECT : Commission on Emergency Medical Services
SOURCE : California Association of Air Medical Services
DIGEST : This bill increases the membership of the Emergency
Medical Services (EMS) Commission from 18 to 20 members.
Requires the additional members to be an air ambulance
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representative appointed by the Senate Committee on Rules from a
list of three names submitted by the California Association of
Air Medical services, and a representative appointed by the
Speaker of the Assembly from a public agency that provides air
rescue and transport.
ANALYSIS :
Existing law:
1.Establishes the Emergency Medical Services Authority (EMSA)
within the California Health and Human Services Agency, and
requires the director of EMSA to be a physician appointed by
the Governor.
2.Requires EMSA, among other things, to develop planning and
implementation guidelines for emergency medical services
systems which address specified components, including manpower
and training, communications, transportation, system
organization and management, data collection and evaluation,
and disaster response.
3.Establishes the EMS Commission within the California Health
and Human Services Agency, composed of 18 members appointed by
the Governor, the Speaker of the Assembly, and the Senate
Committee on Rules to represent specified entities,
professions and associations.
4.Requires the EMS Commission to review and approve regulations,
standards and guidelines to be developed by EMSA for
implementation of the EMS System and the Prehospital Emergency
Medical Care Personnel Act.
5.Establishes the Emergency Medical Air Transportation Act,
which imposes an additional $4 on every Vehicle Code violation
to augment Medi-Cal reimbursement rates for medical air
transportation services. The penalties provision sunsets on
July 1, 2016, and the Emergency Medical Air Transportation Act
sunsets on January 1, 2018.
This bill increases the membership of the EMS Commission from 18
to 20 members. It requires the additional members to be an air
ambulance representative appointed by the Senate Committee on
Rules from a list of three names submitted by the California
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3
Association of Air Medical services, and a representative
appointed by the Speaker of the Assembly from a public agency
that provides air rescue and transport.
Prior Legislation
AB 2394 (Nielsen, 2012), was substantially similar to this bill
and was referred to Assembly Health Committee, but did not have
a hearing.
AB 2173 (Beall, Chapter 547, Statutes of 2010), established the
Emergency Medical Air Transportation Act, which imposes an
additional $4 on every Vehicle Code violation to augment
Medi-Cal reimbursement rates for medical air transportation
services. This penalties provision sunsets on July 1, 2016, and
the entire bill sunsets on January 1, 2018.
SB 997 (Ridley-Thomas, Chapter 275, Statutes of 2008), added two
members to the EMS Commission: one employee of CAL-FIRE, and
one employee of a city, county or special district that provides
fire protection. Both of these added members are appointed by
the Governor from a list of names provided by the California
Professional Firefighters.
AB 2917 (Torrico, Chapter 274, Statutes of 2008), require EMSA
to establish and maintain a statewide registry of the status of
emergency medical technician (EMT) licenses and certificates, to
be used by certifying entities, and requires EMSA to develop
standards, guidelines and regulations for certification of
specified EMTs.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 4/30/13)
California Association of Air Medical Services (source)
OPPOSITION : (Verified 4/30/13)
California State Sheriffs' Association
Los Angeles County Sheriff's Department
San Bernardino County Sheriff's Office
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ARGUMENTS IN SUPPORT : According to the author, air medical
service providers are based all over California. Often a base
will cover a 100 mile radius which could include a few counties.
Each helicopter usually includes a pilot, a paramedic or EMT
and a nurse. Based on this scenario, these providers are
regulated by several entities. First, as an air carrier, they
are regulated by the Federal Aviation Authority (FAA). As an
EMS provider, they are regulated by the state and the local EMS
authority. In addition, the pilot is regulated by the FAA and
the paramedic or EMT is regulated by the state and local EMS
authority. The nurse is regulated by the Board of Registered
Nursing. Lastly, the landing zones are regulated by the FAA and
the California Department of Transportation.
The author states the primary role of the EMS Commission is to
review and approve regulations, standards, and guidelines
developed by the California EMS Authority (Authority). The EMS
Commission also advises the Authority with regard to
communications, medical equipment, training personnel,
facilities and other components of an emergency medical services
system. However, the author states, air ambulance providers do
not currently have a voice on this Commission. The author
claims because air ambulance providers are regulated by multiple
federal, state and local agencies it is important that these
providers are able to clarify how a proposed regulation will
affect the provision of air services in the state.
This bill is sponsored by the California Association of Air
Medical Services (CAAMS), which states the additional members
will provide the appropriate representation of this segment of
the EMS community at the EMS Commission. According to CAAMS, air
medical providers are not represented on the EMS Commission, but
are a key provider of emergency medical services. By adding an
air medical representatives, these providers will have an
opportunity to provide their perspective.
ARGUMENTS IN OPPOSITION : The California State Sheriffs'
Association (CSSA) opposes this bill, stating that the revision
of the EMS Commission's membership could create policies and
procedures that would be detrimental to local government and the
law enforcement community. For example, limiting fire and
sheriff medical transport capabilities and the scope of the type
of aircraft local fire and sheriffs fly for rescue. In some
counties, CSSA states that these additional member companies are
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not part of the local emergency service plan as fire and
sheriffs handle rescue and transport, and adding them to the EMS
Commission could create policies that work against local rescue
efforts.
The Los Angeles County Sheriff's Department (LACSD) also opposes
this bill, stating that in Los Angeles County, the Los Angeles
County Fire Department, the City of Los Angeles Fire Department
and the LACSD handles all of the rescues and related air
transports. LACSD states that while it is true that private air
ambulance members are not represented on the EMS Commission
specifically, there is no member of a public agency that
specifically provides air rescue and transport either. LACSD
states that it does not believe that the private air ambulance
providers should be placed on the EMS Commission.
GOVERNOR'S VETO MESSAGE:
"I am returning Senate Bill 535 without my signature.
The bill seeks to increase the membership of the California
Commission on Emergency Medical Services from 18 members to
20 members, adding representatives from air ambulance and
air rescue and transport.
My administration proposed to eliminate this commission in
2011, as part of an overall effort to consolidate
departments and streamline boards and commissions. For as
long as the Commission continues to perform its work, there
should be no shortage of expertise or willingness of an
18-member body to address all aspects of the system,
including air ambulance and air rescue. Any lack of
appropriate attention should be remedied by the commission
and the public process that is used to address matters of
import to the public and other system stakeholders."
ASSEMBLY FLOOR : 77-0, 9/3/13
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,
Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox, Frazier,
Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,
Gray, Grove, Hagman, Harkey, Roger Hern�ndez, Holden, Jones,
Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,
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Mansoor, Medina, Melendez, Mitchell, Morrell, Mullin,
Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, Perea,
V. Manuel P�rez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,
Stone, Ting, Wagner, Waldron, Weber, Wieckowski, Wilk,
Williams, Yamada, John A. P�rez
NO VOTE RECORDED: Hall, Vacancy, Vacancy
JL:nld 1/6/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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