Bill Text: NY A09509 | 2021-2022 | General Assembly | Amended


Bill Title: Relates to emergency medical services; includes the establishment of an emergency medical services quality and sustainability assurance program, a statewide comprehensive emergency medical system plan and an emergency medical systems training program.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced - Dead) 2022-05-18 - print number 9509a [A09509 Detail]

Download: New_York-2021-A09509-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         9509--A

                   IN ASSEMBLY

                                     March 16, 2022
                                       ___________

        Introduced  by  M.  of A. OTIS, BUTTENSCHON, CLARK, LUPARDO -- read once
          and referred to  the  Committee  on  Local  Governments  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee

        AN  ACT  to  amend the general municipal law, the civil service law, the
          retirement and social security 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]. In furtherance of
    13   that purpose, a county, city, town or village may:
    14    (g)  Establish  a  special district for the financing and operation of
    15  general ambulance services as set forth by  this  section,  whereby  any
    16  county,  city, town or village, acting individually, or jointly with any
    17  other county, city, town and/or village, through its governing  body  or
    18  bodies,  following  applicable procedures as are required for the estab-
    19  lishment of fire districts in article eleven of the town law or  follow-
    20  ing applicable procedures as are required for the establishment of joint
    21  fire  districts  in  article eleven-A of the town law, with such special
    22  district being authorized by this section to be established  in  all  or
    23  any  part  of  any such participating county or counties, town or towns,
    24  city or cities and/or village or villages.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14641-04-2

        A. 9509--A                          2

     1    § 2. Subdivision 2 of section 163 of the civil service law, as amended
     2  by section 4 of part T of chapter 56 of the laws of 2010, is amended  to
     3  read as follows:
     4    2.  The  contract  or  contracts shall provide for health benefits for
     5  retired employees of the state and of the state colleges of agriculture,
     6  home economics, industrial labor relations and veterinary medicine,  the
     7  state  agricultural experiment station at Geneva, and any other institu-
     8  tion or agency under the management and control of Cornell university as
     9  the representative of the board of trustees of the state  university  of
    10  New  York,  and  the  state college of ceramics under the management and
    11  control of Alfred university as the representative of the board of trus-
    12  tees of the state university of New York, and their spouses and  depend-
    13  ent  children  as  defined  by the regulations of the president, on such
    14  terms as the president may  deem  appropriate,  and  the  president  may
    15  authorize the inclusion in the plan of the employees and retired employ-
    16  ees   of   public   authorities,  public  benefit  corporations,  school
    17  districts, special districts, district  corporations,  municipal  corpo-
    18  rations  excluding  active  employees  and  retired  employees of cities
    19  having a population of one million or  more  inhabitants  whose  compen-
    20  sation  is  or  was  before retirement paid out of the city treasury, or
    21  other appropriate agencies, subdivisions or  quasi-public  organizations
    22  of  the  state, including active members of volunteer fire and volunteer
    23  ambulance companies serving one or more municipal corporations  pursuant
    24  to  subdivision  seven  of section ninety-two-a of the general municipal
    25  law, and their spouses and dependent children as defined  by  the  regu-
    26  lations  of the president.  Notwithstanding any law or regulation to the
    27  contrary, active members of volunteer ambulance companies serving one or
    28  more municipal corporations pursuant to  subdivision  seven  of  section
    29  ninety-two-a  of  the general municipal law shall be eligible for health
    30  benefits regardless of the amount of funds derived from public  sources.
    31  Any  such  corporation,  district,  agency  or  organization electing to
    32  participate in the plan shall be required to pay its proportionate share
    33  of the expenses of administration of the plan in  such  amounts  and  at
    34  such times as determined and fixed by the president. All amounts payable
    35  for such expenses of administration shall be paid to the commissioner of
    36  taxation  and finance and shall be applied to the reimbursement of funds
    37  previously advanced for such purposes. Neither the state nor  any  other
    38  participant  in the plan shall be charged with the particular experience
    39  attributable to the employees of the participant, and all  dividends  or
    40  retroactive  rate  credits  shall be distributed pro-rata based upon the
    41  number of employees of such participant covered by the plan.
    42    § 3. Paragraph 9 of subdivision c of section 40 of the retirement  and
    43  social  security  law, as amended by chapter 525 of the laws of 1963, is
    44  amended to read as follows:
    45    9. Active members of volunteer ambulance companies serving one or more
    46  municipal corporations pursuant to subdivision seven of section  ninety-
    47  two-a of the general municipal law.
    48    10.  Notwithstanding  any  inconsistent  provision of subdivision e of
    49  this section, or of this chapter or of any  other  law,  an  officer  or
    50  employee in the service of the state or of a participating employer who,
    51  at  the time of entering such service, was or is entitled to benefits by
    52  any other pension or retirement system maintained  by  the  state  or  a
    53  political  subdivision thereof, provided such benefits, exclusive of any
    54  annuity based solely on his own contributions and interest thereon,  are
    55  suspended  during  his  active  membership  in the retirement system. He
    56  shall contribute to the retirement system as a new member.

        A. 9509--A                          3

     1    § 4. Section 3000 of the public health law, as amended by chapter  804
     2  of the laws of 1992, is amended to read as follows:
     3    § 3000. Declaration of policy and statement of purpose. The furnishing
     4  of  medical  assistance  in  an  emergency  is a matter of vital concern
     5  affecting the public health, safety  and  welfare.    Emergency  medical
     6  services  and  ambulance  services  are  essential services that must be
     7  available to everyone in New York  in  a  reliable  manner.  Prehospital
     8  emergency  medical care, other emergency medical services, the provision
     9  of prompt and effective communication among ambulances and hospitals and
    10  safe and effective care and transportation of the sick and  injured  are
    11  essential  public  health services that must be available to everyone in
    12  New York in a reliable manner.
    13    It is the purpose of this article to promote the public health, safety
    14  and welfare by providing for certification of all advanced life  support
    15  first response services and ambulance services; the creation of regional
    16  emergency  medical  services  councils;  and  a New York state emergency
    17  medical services council  to  develop  minimum  training  standards  for
    18  certified  first  responders, emergency medical technicians and advanced
    19  emergency medical technicians and minimum  equipment  and  communication
    20  standards  for  advanced  life support first response services and ambu-
    21  lance services.
    22    § 5. Subdivision 1 of section  3001  of  the  public  health  law,  as
    23  amended  by  chapter  804  of  the  laws  of 1992, is amended to read as
    24  follows:
    25    1.  "Emergency  medical  service"  means  [initial  emergency  medical
    26  assistance  including,  but  not  limited  to,  the treatment of trauma,
    27  burns, respiratory, circulatory and obstetrical emergencies] care  of  a
    28  person  to, from, at, in, or between the person's home, scene of injury,
    29  hospitals, health care facilities, public events or other locations,  by
    30  emergency  medical services practitioners as a patient care team member,
    31  for emergency, non-emergency, specialty, low  acuity,  preventative,  or
    32  interfacility  care; emergency and non-emergency medical dispatch; coor-
    33  dination of emergency medical system equipment  and  personnel;  assess-
    34  ment;  treatment,  transportation, routing, referrals and communications
    35  with treatment facilities and medical personnel; public education, inju-
    36  ry prevention and wellness initiatives; administration of  immunizations
    37  as  approved  by  the  state  emergency  medical  services  council; and
    38  follow-up and restorative care.
    39    § 6. Section 3002 of the public health law is amended by adding a  new
    40  subdivision 9 to read as follows:
    41    9.  The  state council shall advise the commissioner on such issues as
    42  the commissioner may require  related  to  the  provision  of  emergency
    43  medical  service, specialty care, designated facility care, and disaster
    44  medical care, and assist in the coordination of such service  and  care.
    45  This  shall include, but is not limited to, the recommendation, periodic
    46  revision, and application  of  rules  and  regulations,  appropriateness
    47  review  standards,  treatment  protocols, and quality improvement stand-
    48  ards. Such rules, regulations, standards and protocols shall be  region-
    49  alized,  as  necessary.  The  state  council shall meet as frequently as
    50  determined necessary by the commissioner.
    51    § 7. Section 3003 of the public health law is amended  by  adding  two
    52  new subdivisions 11 and 12 to read as follows:
    53    11.  Each  regional  council  shall advise the state emergency medical
    54  services council, the commissioner and the department on such issues  as
    55  the  state  emergency medical services council, the commissioner and the
    56  department may require related to the  provision  of  emergency  medical

        A. 9509--A                          4

     1  service,  specialty care, designated facility care, and disaster medical
     2  care, and assist in the regional coordination of such service and care.
     3    12.  Each  regional  council  shall advise the state emergency medical
     4  services council, the commissioner and the department on the appropriate
     5  regional standards required  for  the  provision  of  emergency  medical
     6  services.
     7    §  8. The public health law is amended by adding a new section 3004 to
     8  read as follows:
     9    § 3004. Emergency medical services quality and  sustainability  assur-
    10  ance  program.  The commissioner, with the advice of the state emergency
    11  medical advisory committee, may create  an  emergency  medical  services
    12  quality and sustainability assurance program. Standards and requirements
    13  of  the quality and sustainability assurance program may include but not
    14  be limited to, clinical standards, quality  metrics,  safety  standards,
    15  emergency  vehicle  operator standards, clinical competencies, sustaina-
    16  bility metrics  and  minimum  requirements  for  quality  assurance  and
    17  sustainability  assurance  programs  to be followed by emergency medical
    18  services agencies, to promote positive  patient  outcomes,  safety,  and
    19  emergency  medical  services system sustainability throughout the state.
    20  Standards and requirements of the quality and  sustainability  assurance
    21  program  may  be  regionalized. The commissioner is hereby authorized to
    22  promulgate regulations related to the standards and requirements of  the
    23  quality and sustainability assurance program. Quality and sustainability
    24  assurance  programs shall require each emergency medical services agency
    25  to perform regular and periodic review  of  quality  and  sustainability
    26  assurance  program  metrics,  identification  of agency deficiencies and
    27  strengths, development of programs to improve agency metrics, strengthen
    28  system sustainability, and continuous monitoring of care  provided.  The
    29  department  may  contract  for  services  with subject matter experts to
    30  assist in the oversight of these metrics statewide. The  department  may
    31  delegate  authority to oversee these metrics and regulations to counties
    32  or other  contractors  as  determined  by  the  commissioner.  Emergency
    33  medical  services  agencies  that do not meet the standards and require-
    34  ments set forth in the quality assurance program set by the commissioner
    35  may be subject to enforcement actions,  including  but  not  limited  to
    36  revocation,  suspension,  performance  improvement plans, or restriction
    37  from specific types of responses including, but not limited to,  suspen-
    38  sion of the ability to respond to requests for emergency medical assist-
    39  ance or to perform emergency medical services.
    40    §  9. The public health law is amended by adding a new section 3018 to
    41  read as follows:
    42    § 3018. Statewide comprehensive emergency medical system plan. 1.  The
    43  department,  in  consultation  with the state emergency medical advisory
    44  committee, shall develop and maintain a statewide comprehensive emergen-
    45  cy medical system plan that shall provide for  a  coordinated  emergency
    46  medical  system within the state, which shall include but not be limited
    47  to:
    48    (a) establishing a comprehensive statewide emergency  medical  system,
    49  incorporating facilities, transportation, workforce, communications, and
    50  other  ways  to  improve  the  delivery of emergency medical service and
    51  thereby decrease morbidity, hospitalization, disability, and mortality;
    52    (b) improving the  accessibility  of  high-quality  emergency  medical
    53  service;
    54    (c)  coordinating  with professional medical organizations, hospitals,
    55  and other public and private agencies to develop approaches for  persons

        A. 9509--A                          5

     1  who are presently using emergency departments for routine, nonurgent and
     2  primary medical care to be served appropriately and economically; and
     3    (d)  conducting,  promoting, and encouraging programs of education and
     4  training designed to upgrade  the  knowledge  and  skills  of  emergency
     5  medical  service  practitioners  throughout  the  state with emphasis on
     6  regions underserved by emergency medical services.
     7    2. The statewide comprehensive emergency medical system plan shall  be
     8  reviewed,  updated  if  necessary, and published every five years on the
     9  department's website, or at such earlier times as may  be  necessary  to
    10  improve  the  effectiveness  and  efficiency  of  the  state's emergency
    11  medical service system.
    12    3. Each regional emergency medical advisory  committee  shall  develop
    13  and maintain a comprehensive regional emergency medical system plan that
    14  shall  provide  for  a  coordinated  emergency medical system within the
    15  region. Such plans shall be subject to review  by  the  state  emergency
    16  medical advisory committee and approval by the department.
    17    4. Each county shall develop and maintain a comprehensive county emer-
    18  gency medical system plan that shall provide for a coordinated emergency
    19  medical system within the county. The county office of emergency medical
    20  services shall be responsible for the development and maintenance of the
    21  comprehensive  county emergency medical system plan. Such plans shall be
    22  subject to review by the regional emergency medical advisory  committee,
    23  the  state  advisory council and approval by the department. The depart-
    24  ment shall be responsible for oversight of each county's compliance with
    25  its plan.
    26    5. The commissioner may promulgate regulations  to  ensure  compliance
    27  with this section.
    28    § 10. Section 3008 of the public health law is amended by adding a new
    29  subdivision 8 to read as follows:
    30    8.  (a)  Notwithstanding any provision of law other than paragraph (b)
    31  of this subdivision to the contrary, all determinations of need shall be
    32  consistent with the state emergency medical system plan  established  in
    33  section  three  thousand  eighteen of this article. The commissioner may
    34  promulgate regulations to provide for standards on the determination  of
    35  need.  The  department shall issue a new emergency medical system agency
    36  certificate only upon  a  determination  that  a  public  need  for  the
    37  proposed  service  has  been  established pursuant to regulation. If the
    38  department determines that a public need exists for only a portion of  a
    39  proposed service, a certificate may be issued for that portion. Prior to
    40  reaching  a  final determination of need, the department shall forward a
    41  summary of the proposed service including any documentation received  or
    42  subsequent  reports  created  thereto,  to  the  state emergency medical
    43  services advisory council for review and recommendation to  the  depart-
    44  ment on the approval of the application. An applicant or other concerned
    45  party  may  appeal  any determination made by the department pursuant to
    46  this section within fourteen days. Appeals shall be  heard  pursuant  to
    47  the provisions of section twelve-a of this chapter, and a final determi-
    48  nation  as  to need shall be made by the commissioner upon review of the
    49  report and recommendation by the presiding administrative law judge.
    50    (b) Notwithstanding the provisions of paragraph (a) of  this  subdivi-
    51  sion,  the  commissioner  may  promulgate regulations to provide for the
    52  issuance of an emergency medical system  agency  certificate  without  a
    53  determination of public need.
    54    § 11. The public health law is amended by adding a new section 3019 to
    55  read as follows:

        A. 9509--A                          6

     1    § 3019. Emergency medical systems training program. 1. There is hereby
     2  established  a  training  program  for  emergency  medical  systems that
     3  includes students, emergency medical  service  practitioners,  agencies,
     4  facilities,  and  personnel,  and  the  commissioner may provide funding
     5  within  the amount appropriated to conduct such training programs. Until
     6  such time as the department announces the training  program  established
     7  pursuant to this section is in effect, all current standards, curricula,
     8  and  requirements for students, emergency medical service practitioners,
     9  agencies, facilities, and personnel shall remain in effect.
    10    2. The department, in consultation with the  state  emergency  medical
    11  advisory  council,  shall establish minimum education standards, curric-
    12  ula,  and  requirements  for  all  emergency  medical  system   training
    13  programs.  No  person  shall profess to provide emergency medical system
    14  training without the approval of the department.
    15    3. The department is authorized to provide, either directly or through
    16  contract,  emergency  medical  system  training  for  emergency  medical
    17  service  practitioners  and  emergency  medical system agency personnel,
    18  develop and distribute training materials for use by instructors, and to
    19  recruit additional instructors to provide training.
    20    4. The department may visit and inspect any emergency  medical  system
    21  training program or training center operating under this article and the
    22  regulations adopted therefore to ensure compliance.
    23    5.  The  commissioner  shall, within amounts appropriated, establish a
    24  public service campaign to recruit additional personnel into  the  emer-
    25  gency medical system fields.
    26    6.  The  commissioner shall, within amounts appropriated, establish an
    27  emergency  medical  system  mental  health  and  wellness  program  that
    28  provides  resources to emergency medical service practitioners to reduce
    29  burnout; prevent depression, suicide and other  negative  mental  health
    30  outcomes; and increase safety.
    31    7. The department may create or adopt with the approval of the commis-
    32  sioner  additional standards, training and criteria to become a credent-
    33  ialled emergency medical service practitioner  to  provide  specialized,
    34  advanced, or other services that further support or advance the emergen-
    35  cy medical system.
    36    § 12. This act shall take effect immediately.
feedback