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LEGISLATION COMMITTEE
Meeting Date: 05/14/2018  
Subject:    AB 2293 (Reyes): Emergency Medical Services: Licensure
Submitted For: LEGISLATION COMMITTEE
Department: County Administrator  
Referral No.: 2018-14  
Referral Name: AB 2293 (Reyes): Emergency Medical Services: Licensure
Presenter: Patricia Frost Contact: Patricia Frost, 925-313-9554

Information
Referral History:
Patricia Frost, Director of Emergency Medical Services for Contra Costa County, is recommending a position of "Oppose" on AB 2293. Attachment A is a letter from EMSAAC and EMDAAC that provides the California EMS Agency Administrators' and Medical Directors' concerns associated with this bill.

Author: Eloise Gomez Reyes (D-047)
Title: Emergency Medical Services: Licensure
Fiscal Committee: yes
Urgency Clause: no
Introduced: 02/13/2018
Last Amend: 04/26/2018
Disposition: Pending
Committee: Assembly Appropriations Committee
Hearing: 05/09/2018 9:00 am, State Capitol, Room 4202
Summary: Amends existing law relating to investigations and disciplinary actions against EMTs for specified conduct. Modifies the criteria related to conduct that the authority may consider in denying an EMT application. Permits the authority to consider whether an applicant demonstrates substantial rehabilitation. Extends the time for an applicant to file a notice of defense from 15 to 30 days in response to a denied EMT application.
Referral Update:
The text of AB 2293 is available here: http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2293

2017 CA A 2293: Bill Analysis - 05/07/2018 - Assembly Appropriations Committee, Hearing Date 05/09/2018



Date of Hearing: May 9, 2018
ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez Fletcher, Chair

AB 2293

(Reyes) - As Amended April 26, 2018
Policy             Health             Vote:              12 - 3            
Committee:
Urgency: No        State Mandated     Reimbursable: No                     
                   Local Program:                                          
                   No                                                      
SUMMARY:

For purposes of an application for emergency medical technician-paramedic (EMT-P) license, this bill would limit and narrow the types of crimes and violations that can result in the denial of the application. Specifically, this bill:

1) Allows the Emergency Medical Services Authority (EMSA) to deny an EMT-paramedic application for specified reasons, which are narrower than those under existing law, unless the applicant can demonstrate substantial rehabilitation, as defined.

2) Narrows many of the potentially disqualifying acts to only those acts committed in the course of employment or those directly related to an EMT-P's qualifications, functions, and duties.

3) Allows EMSA to suspend its application review pending resolution of a criminal proceeding related to a sexual offense, as specified.

4) Prohibits EMSA from denying an application based on convictions that have been dismissed, pardoned, or expunged or for which a certificate of rehabilitation has been issued.

5) Prohibits EMSA from denying an application based on arrests, infractions, or citations, as specified, or a matter adjudicated in juvenile court.

FISCAL EFFECT:

Costs to EMSA in the range of $500,000 annually for at least three years to revise regulations and guidelines, process additional new applications, and information technology changes to the central EMS registry (GF, or Emergency Medical Services Personnel Fund with an estimated fee increase of $12 per license). Ongoing costs are expected to be minor once the required changes are made.

COMMENTS:

1) Purpose. According to the author, recent wildfires demonstrate the need for additional firefighters and EMTs. The author contends under current law EMSA denies qualified individuals based purely on a past criminal history. This bill reduces barriers for individuals who have already served their time to have an opportunity for employment that requires an EMT-P license.

2) Background. An EMT is a trained-and-certified or licensed professional who renders immediate medical care in the pre-hospital setting to seriously ill or injured individuals. California has three levels of EMTs: EMT-I (basic), EMT-II (also known as advanced EMT), and EMT-P (paramedic). Paramedics must meet higher training requirements compared to EMT-Is and IIs, and have a broader scope of practice. There are nearly 22,000 licensed EMT-Ps in California.

This Legislature, think-tanks, and advocacy groups have recently demonstrated interest in reducing barriers for formerly incarcerated persons. Occupational licensure for formerly incarcerated persons, which generally include background checks that can disqualify a person from licensure, pose a significant barrier to entry in many professions.

3) Current Process. According to the National Registry of EMTs, EMS professionals under the authority of state licensure have unsupervised, intimate, physical and emotional contact with patients at a time of maximum physical and emotional vulnerability, as well as unsupervised access to a patient's personal property. They note EMS professionals, therefore, are placed in a position of the highest public trust. Accordingly, the National Registry has adopted criminal conviction policies for issuing certifications to safeguard the public and preserve public trust. In order to work as an EMT or paramedic in California, an individual must first pass the National Registry certification test.

At the state level, model disciplinary orders were developed by EMSA in consultation with emergency medical services constituent groups from across the state to provide consistent and equitable treatment for violations and denial of applications.

4) Prior Legislation. AB 1931 (Rodriguez), of the current session, would have added EMT-Ps to the provisions of law governing the procedures for investigations and disciplinary actions that are current law for EMT-Is and IIs. AB 1931 was held on the Senate Appropriations Suspense File.

AB 1008 (McCarty), Chapter 789, Statutes of 2017, prohibits an employer, with certain exceptions, from inquiring about or considering a job applicant's conviction history prior to a conditional offer of employment, and sets requirements regarding the consideration of conviction histories in employment decisions

5) Staff Comment. In ongoing discussions about this bill since it passed the policy committee, concerns have been raised about conflict between this bill and conviction policy for the federal EMT certification that could render this bill's attempt to relax certification standards moot. In other words, unless federal policy changes or the state takes the dramatic step of no longer requiring federal certification, a person could be federally disqualified for many of the acts this bill would allow on a licensed EMT-P's record.

Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors a position of "Oppose" on AB 2293 (Reyes), a bill that would limit and narrow the types of crimes and violations that can result in the denial of an application for emergency medical technician-paramedic (EMT-P) license and direct staff to submit to a Board agenda for consent.
Attachments
Attachment A: Oppose Letter

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