Bill Text: NY S04020 | 2023-2024 | General Assembly | Amended


Bill Title: Relates to emergency medical services; establishes a special district for the financing and operation of general ambulance services; provides for a statewide comprehensive emergency medical system plan.

Spectrum: Slight Partisan Bill (Republican 16-10)

Status: (Engrossed) 2024-05-29 - referred to local governments [S04020 Detail]

Download: New_York-2023-S04020-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         4020--C

                               2023-2024 Regular Sessions

                    IN SENATE

                                    February 2, 2023
                                       ___________

        Introduced  by  Sens.  MAYER,  HINCHEY,  BORRELLO, CHU, GRIFFO, HELMING,
          KAVANAGH, MARTINEZ, MAY, PERSAUD,  SKOUFIS,  STEC,  TEDISCO,  WALCZYK,
          WEBB,  WEBER -- read twice and ordered printed, and when printed to be
          committed  to  the  Committee  on  Local   Government   --   committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to  said committee -- recommitted to the Committee on Local Government
          in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill
          amended, ordered reprinted as amended and recommitted to said  commit-
          tee  --  committee  discharged,  bill  amended,  ordered  reprinted as
          amended and recommitted to said committee

        AN ACT to amend the general municipal law and the public health law,  in
          relation to emergency medical services

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The opening paragraph of subdivision 1 of section 122-b  of
     2  the  general  municipal  law,  as  amended by chapter 471 of the laws of
     3  2011, is amended and a new paragraph (g) is added to read as follows:
     4    [Any] General ambulance services are  an  essential  service.    Every
     5  county,  city,  town [or] and village, acting individually or jointly or
     6  in conjunction with a special district, [may provide] shall ensure  that
     7  an  emergency medical service, a general ambulance service or a combina-
     8  tion of such services are provided for the purpose of providing  prehos-
     9  pital  emergency  medical  treatment  or  transporting  sick  or injured
    10  persons found within the boundaries of the municipality or  the  munici-
    11  palities acting jointly to a hospital, clinic, sanatorium or other place
    12  for  treatment  of  such illness or injury, [and for] provided, however,
    13  that the provisions of this subdivision shall not apply to a city with a
    14  population of one million or more.  In furtherance of  that  purpose,  a
    15  county, city, town or village may:
    16    (g)  Establish  a  special district for the financing and operation of
    17  general ambulance services, including  support  for  agencies  currently

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05007-12-4

        S. 4020--C                          2

     1  providing  EMS services, as set forth by this section, whereby any coun-
     2  ty, city, town or village, acting  individually,  or  jointly  with  any
     3  other  county,  city, town and/or village, through its governing body or
     4  bodies,  following  applicable procedures as are required for the estab-
     5  lishment of fire districts in article eleven of the town law or  follow-
     6  ing applicable procedures as are required for the establishment of joint
     7  fire  districts  in  article eleven-A of the town law, with such special
     8  district being authorized by this section to be established  in  all  or
     9  any  part  of  any such participating county or counties, town or towns,
    10  city  or  cities  and/or  village  or  villages.    Notwithstanding  any
    11  provision  of  this  article,  rule  or  regulation to the contrary, any
    12  special district created under this section shall  not  overlap  with  a
    13  pre-existing city, town or village ambulance district unless such exist-
    14  ing  district  is merged into the newly created district.  No city, town
    15  or village shall eliminate or dissolve a pre-existing ambulance district
    16  without express approval and consent by the county to  assume  responsi-
    17  bility  for  the  emergency medical services previously provided by such
    18  district. When a special district is established pursuant to this  arti-
    19  cle,  the  cities,  towns, or villages contained within the county shall
    20  not reduce current ambulance funding without such changes being incorpo-
    21  rated into the comprehensive county emergency medical system plan.
    22    § 2. Section 3000 of the public health law, as amended by chapter  804
    23  of the laws of 1992, is amended to read as follows:
    24    § 3000. Declaration of policy and statement of purpose. The furnishing
    25  of  medical  assistance  in  an  emergency  is a matter of vital concern
    26  affecting the public health, safety  and  welfare.    Emergency  medical
    27  services  and  ambulance  services  are  essential services and shall be
    28  available to every person in the state of New York in a reliable manner.
    29  Prehospital emergency medical care, other  emergency  medical  services,
    30  the provision of prompt and effective communication among ambulances and
    31  hospitals and safe and effective care and transportation of the sick and
    32  injured  are  essential public health services and shall be available to
    33  every person in the state of New York in a reliable manner.
    34    It is the purpose of this article to promote the public health, safety
    35  and welfare by providing for certification of all advanced life  support
    36  first response services and ambulance services; the creation of regional
    37  emergency  medical  services  councils;  and  a New York state emergency
    38  medical services council  to  develop  minimum  training  standards  for
    39  certified  first  responders, emergency medical technicians and advanced
    40  emergency medical technicians and minimum  equipment  and  communication
    41  standards  for  advanced  life support first response services and ambu-
    42  lance services.
    43    § 3. Subdivision 1 of section  3001  of  the  public  health  law,  as
    44  amended  by  chapter  804  of  the  laws  of 1992, is amended to read as
    45  follows:
    46    1.  "Emergency  medical  service"  means  [initial  emergency  medical
    47  assistance  including,  but  not  limited  to,  the treatment of trauma,
    48  burns, respiratory, circulatory and obstetrical emergencies]  a  coordi-
    49  nated  system  of healthcare delivery that responds to the needs of sick
    50  and injured adults and children, by providing:  essential  care  at  the
    51  scene  of  an  emergency, non-emergency, specialty need or public event;
    52  community education and prevention programs; ground  and  air  ambulance
    53  services;  centralized  access  and emergency medical dispatch; training
    54  for emergency medical services practitioners;  medical  first  response;
    55  mobile trauma care systems; mass casualty management; medical direction;
    56  or quality control and system evaluation procedures.

        S. 4020--C                          3

     1    §  4. The public health law is amended by adding a new section 3019 to
     2  read as follows:
     3    §  3019. Statewide comprehensive emergency medical system plan. 1. The
     4  state emergency medical services  council,  in  collaboration  and  with
     5  final approval of the department, shall develop and maintain a statewide
     6  comprehensive  emergency  medical  system  plan that shall provide for a
     7  coordinated emergency medical  system  within  the  state,  which  shall
     8  include but not be limited to:
     9    (a)  establishing  a comprehensive statewide emergency medical system,
    10  consisting of facilities, transportation, workforce, communications, and
    11  other components to improve the delivery of  emergency  medical  service
    12  and thereby decrease morbidity, hospitalization, disability, and mortal-
    13  ity;
    14    (b)  improving  the  accessibility  of  high-quality emergency medical
    15  service;
    16    (c) coordinating professional medical  organizations,  hospitals,  and
    17  other  public  and  private  agencies in developing alternative delivery
    18  models for persons who are presently  using  emergency  departments  for
    19  routine,  nonurgent  and primary medical care to be served appropriately
    20  and economically, provided, however, that the provisions of this  subdi-
    21  vision  shall  not  apply  to a city with a population of one million or
    22  more; and
    23    (d) conducting, promoting, and encouraging programs of  education  and
    24  training  designed  to  upgrade  the  knowledge  and skills of emergency
    25  medical service practitioners throughout  the  state  with  emphasis  on
    26  regions  underserved  by  or  with  limited  access to emergency medical
    27  services.
    28    2. The statewide comprehensive emergency medical system plan shall  be
    29  reviewed,  updated  if  necessary, and published every five years on the
    30  department's website, or at such earlier times as may  be  necessary  to
    31  improve  the  effectiveness  and  efficiency  of  the  state's emergency
    32  medical service system.
    33    3. Each regional emergency medical services council shall develop  and
    34  maintain a comprehensive regional emergency medical system plan or adopt
    35  the  statewide  comprehensive  emergency medical service system plan, to
    36  provide for a coordinated emergency medical system  within  the  region.
    37  Such  plans  shall incorporate all ambulance services with a current EMS
    38  operating certificate for response to calls in their designated  operat-
    39  ing  territory  and  shall  be  subject to review by the state emergency
    40  medical services council and final approval  by  the  department.    Any
    41  proposed  permanent  changes  to  the  regional emergency medical system
    42  plan, including the dissolution of an  ambulance  services  district  or
    43  other  significant  modification of existing coverage shall be submitted
    44  in writing to the department no  later  than  one  hundred  eighty  days
    45  before  the  change  shall  take  effect. Such changes shall not be made
    46  until receipt of the appropriate departmental approvals.
    47    4. Each county shall develop and maintain a comprehensive county emer-
    48  gency medical system plan that shall provide for a coordinated emergency
    49  medical system within the county, to provide essential emergency medical
    50  services for all residents within the county. The county office of emer-
    51  gency medical services shall be responsible for the development,  imple-
    52  mentation, and maintenance of the comprehensive county emergency medical
    53  system  plan.  Such plans may require review and approval, as determined
    54  by the state emergency medical services council, by  such  council,  the
    55  regional  emergency medical services council and approval by the depart-
    56  ment.  Such plan shall incorporate all ambulance services with a current

        S. 4020--C                          4

     1  EMS operating certificate for response  to  calls  in  their  designated
     2  operating  territory and shall outline the primary responding agency for
     3  requests for service for each part of the county.   Any proposed  perma-
     4  nent  changes to the county emergency medical system plan, including the
     5  dissolution of an  ambulance  services  district  or  other  significant
     6  modification  of  existing coverage shall be submitted in writing to the
     7  department no later than one hundred eighty days before the change shall
     8  take effect. Such changes shall not be made until receipt of the  appro-
     9  priate  approvals.  No county shall remove or reassign an area served by
    10  an existing medical emergency  response  agency  where  such  agency  is
    11  compliant with all statutory and regulatory requirements, and has agreed
    12  to the provision of the approved plan.
    13    §  5.  The public health law is amended by adding a new section 3019-a
    14  to read as follows:
    15    § 3019-a. Emergency medical systems training program. 1.    The  state
    16  emergency  medical  services  council  shall make recommendations to the
    17  department for the department to  implement  standards  related  to  the
    18  establishment  of  training  programs for emergency medical systems that
    19  include but are not limited to students, emergency medical service prac-
    20  titioners, emergency medical  services  agencies,  approved  educational
    21  institutions,  geographic  areas,  facilities,  and  personnel,  and the
    22  commissioner shall fund such training programs in full or in part  based
    23  on  state  appropriations.   Until such time as the department announces
    24  the training program established pursuant to this section is in  effect,
    25  all  current  standards, curricula, and requirements for students, emer-
    26  gency medical service practitioners, agencies, facilities, and personnel
    27  shall remain in effect.
    28    2. The state emergency medical services council, with  final  approval
    29  of  the department, shall establish minimum education standards, curric-
    30  ula, and requirements  for  all  emergency  medical  system  educational
    31  institutions.  No  person  or  educational  institution shall profess to
    32  provide emergency medical system training without meeting  the  require-
    33  ments set forth in regulation and only after approval of the department.
    34    3. The department is authorized to provide, either directly or through
    35  contract,  for  local or statewide initiatives, emergency medical system
    36  training for  emergency  medical  service  practitioners  and  emergency
    37  medical system agency personnel, using funding including but not limited
    38  to  allocations  to  aid  to  localities  for emergency medical services
    39  training.
    40    4.  Notwithstanding any other provisions of this section, the regional
    41  emergency medical services council with jurisdiction over  the  city  of
    42  New  York  shall have authority to establish, subject to the approval of
    43  the commissioner, training  and  educational  requirements  which  shall
    44  apply  to  all emergency medical practitioners working in the 911 system
    45  of the city of New York and to determine protocols for the  delivery  of
    46  emergency  medical care, including those related to staffing, in the 911
    47  system of the city of New York. Such training and  educational  require-
    48  ments  and protocols for the delivery of care shall be at least equal or
    49  comparable to those applicable to emergency medical service  practition-
    50  ers in other areas of the state.
    51    5.  The  department may visit and inspect any emergency medical system
    52  training program or training center  operating  under  this  article  to
    53  ensure  compliance.    The  department may request the state or regional
    54  emergency medical services council's assistance to  ensure  the  compli-
    55  ance,  maintenance,  and  coordination  of  training programs. Emergency
    56  medical services institutions that fail to meet applicable standards and

        S. 4020--C                          5

     1  regulations may be subject to  enforcement  action,  including  but  not
     2  limited  to  revocation,  suspension,  performance improvement plans, or
     3  restriction from specific types of education.
     4    §  6. Section 3020 of the public health law is amended by adding three
     5  new subdivisions 3, 4 and 5 to read as follows:
     6    3. The department, with the approval of the  state  emergency  medical
     7  services council, may create or adopt additional standards, training and
     8  criteria  to  become  an emergency medical service practitioner credent-
     9  ialled to provide specialized, advanced, or other services that  further
    10  support  or  advance the emergency medical system.  The department, with
    11  approval of the state emergency medical services council  may  also  set
    12  standards and requirements to require specialized credentials to perform
    13  certain functions in the emergency medical services system.
    14    4.  The  department,  with  approval  of  the  state emergency medical
    15  services council may also set standards  for  emergency  medical  system
    16  agencies  to  become  accredited  in  a specific area to increase system
    17  performance and agency recognition.
    18    5. Notwithstanding any other provisions of this section, the  regional
    19  emergency  medical  services  council with jurisdiction over the city of
    20  New York shall have authority to establish, subject to the  approval  of
    21  the  commissioner,  training  and  educational  requirements which shall
    22  apply to all emergency medical practitioners working in the  911  system
    23  of  the  city of New York and to determine protocols for the delivery of
    24  emergency medical care, including those related to staffing, in the  911
    25  system  of  the city of New York. Such training and educational require-
    26  ments and protocols for the delivery of care shall be at least equal  or
    27  comparable  to those applicable to emergency medical service practition-
    28  ers in other areas of the state.
    29    § 7. This act shall take effect six months after it shall have  become
    30  a law.
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