Amended  IN  Assembly  April 20, 2017
Amended  IN  Assembly  April 06, 2017
Amended  IN  Assembly  March 29, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 1650

Introduced by Assembly Member Maienschein
(Coauthors: Assembly Members Chávez and Mathis)
(Coauthor: Senator Wilk)

February 17, 2017

An act to add and repeal Chapter 13 (commencing with Section 1800) to of Division 2.5 of the Health and Safety Code, relating to emergency medical services.


LEGISLATIVE COUNSEL'S DIGEST


AB 1650, as amended, Maienschein. Emergency medical services: community paramedicine.
Existing law, the Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act, governs local emergency medical services (EMS) systems. The act establishes the Emergency Medical Services Authority, which is responsible for the coordination and integration of all state agencies concerning emergency medical services. Among other duties, the authority is required to develop planning and implementation guidelines for emergency medical services systems, provide technical assistance to existing agencies, counties, and cities for the purpose of developing the components of emergency medical services systems, and receive plans for the implementation of emergency medical services and trauma care systems from local EMS agencies.
This bill would would, until January 1, 2022, create the Community Paramedic Program in the authority. The bill would authorize the authority to authorize a local EMS agency that opts to participate in the program to provide specified services, such as case management services and linkage to nonemergency services for frequent EMS system users, through a local community paramedic program. The bill would require the authority, in consultation with the Office of Statewide Health Planning and Development, to develop criteria to qualify services for participation in the program, develop an application and application process for local EMS agencies seeking to participate in the program, and to review and approve applications for participation in the program as a component of the local EMS agency’s EMS plan. The bill would authorize a local EMS agency to opt to participate in the program if it meets the criteria established by the authority and completes the application process developed by the criteria. The bill would specify the necessary components of a community paramedic service plan to be included in the local EMS agency’s application. The bill would require the medical director of the local EMS agency to oversee the local community paramedic program. The bill would require the authority to annually report specified information related to local community paramedic programs to the office, and require the office to publish the report on its Internet Web site.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Chapter 13 (commencing with Section 1800) is added to Division 2.5 of the Health and Safety Code, to read:
CHAPTER  13. Community Paramedic Program
Article  1. General Provisions

1800.
 This chapter shall be known, and may be cited, as the Community Paramedic Program Act.

1802.
 Unless the context requires otherwise, the following definitions shall apply to this chapter:
(a) “Community paramedic” means an individual who is educated and trained in community paramedicine, whose scope of practice is in accordance with standards established by the authority, who holds a current certification as a mobile integrated health community paramedic by the International Board of Specialty Certification or equivalent, who has a valid license issued pursuant to this chapter, and who is accredited by a local EMS agency.
(b) “Program” means the Community Paramedic Program established by this chapter.

1804.
 Within the authority there is the statewide Community Paramedic Program. The program may authorize a local EMS agency that opts to participate in the program to provide, through a local community paramedic program, and notwithstanding Sections 1797.52 and 1797.218, any of the following services:
(a) (1) Postdischarge followup services for targeted and eligible patients recently discharged from a hospital participating in the program.
(2) A postdischarge service authorized pursuant to this subdivision is intended to provide short-term assistance in order to reduce hospital admissions and shall not replace home health care or any other services available to patients.
(b) (1) Directly observed therapy for eligible patients undergoing tuberculosis treatment in partnership with a county public health department.
(2) A directly observed therapy service authorized pursuant to this subdivision is intended as a supplement to provide for after-hours availability or to reach patients who are difficult to serve, and shall not replace home community health workers or public health nurses.
(c) Hospice rapid response service for eligible and enrolled patients to administer comfort care, coordinate services with the hospice nurse, and, as appropriate, avoid patient transport to an acute care hospital emergency department.
(d) Case management services and linkage to nonemergency services for frequent EMS system users, for the purpose of reducing dependence of those users on the EMS system and acute care hospital emergency departments to provide primary medical care.

Article  2. Duties and Powers of the Authority

1810.
 (a) To implement the program, the authority shall do all of the following:
(1) Develop criteria that qualify local community paramedic services to participate in the program.
(2) Develop an application and application process to be used by a local EMS agency that seeks to participate in the program. The application process shall provide for the submission of a local community paramedic service plan described in Section 1820 that shall be a component of the local EMS agency’s local EMS plan.
(3) Review and approve applications for the implementation of local community paramedic services as a component of the local EMS agency’s EMS plan in accordance with Section 1797.105.
(b) Criteria described in paragraph (1) of subdivision (a) shall include, but not be limited to, the following:
(1) Training Minimum training and certification requirements for a community paramedic. paramedic, including, but not limited to, the following:
(A) Four years of job experience as an EMT-P.
(B) At least 48 hours of classroom-based instruction.
(C) At least four hours of clinical, hands-on training.
(D) At least 56 hours of study outside of the classroom.
(2) Regulations for the initiation, operation, and evaluation of a local community paramedic program.

1812.
 (a) The authority shall consult with the Office of Statewide Health Planning and Development in performing its duties required by this chapter.
(b) The authority shall provide the Office of Statewide Health Planning and Development with an annual report regarding all local community paramedic programs that shall include, but not be limited to, information regarding program effectiveness, cost-savings, and patient safety, including details regarding any adverse patient outcomes. The Office of Statewide Health Planning and Development shall publish the report on its Internet Web site.

Article  3. Local EMS Agency Participation

1820.
 (a) A local EMS agency may opt to participate in the program by meeting the criteria and completing the application and application process established by the authority pursuant to Section 1810.
(b) A community paramedic service plan developed by a local EMS agency that seeks to participate in the program shall demonstrate that the local EMS agency will be able to meet the requirements of the program and shall include, but not be limited to, all of the following:
(1) Agreements between local agencies and service providers participating or partnering in the local community paramedic program.
(2) A description of the local community paramedic program.
(3) A description of existing problems that the local community paramedic program is intended to address.
(4) Criteria for the enrollment or inclusion of patients in the local community paramedic program.
(5) Goals and intended results of the local community paramedic program.
(6) Criteria for patient and provider safety.
(7) Estimated costs and savings attributable to the local community paramedic program.
(8) Data to be collected for the purpose of evaluating the effectiveness of the local community paramedic program.
(9) Criteria and processes for evaluating the effectiveness of the local community paramedic program.
(10) Protocols, policies, and procedures for the implementation and operation of local community paramedic program services by a community paramedic.
(11) Protocols for the assessment of patients served by the local community paramedic program.
(12) Any other information or plan component required by the authority pursuant to Section 1810.

1822.
 The local EMS agency medical director shall oversee a local community paramedic program participating in the program.

1823.
 This chapter shall remain in effect only until January 1, 2022, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2022, deletes or extends that date.