S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   10568
 
                           I N  A S S E M B L Y
 
                               June 4, 2024
                                ___________
 
 Introduced  by  COMMITTEE  ON  RULES -- (at request of M. of A. Otis) --
   read once and referred to the Committee on Local Governments
 
 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:

   Section 1. The opening paragraph of subdivision 1 of section 122-b  of
 the  general  municipal  law,  as  amended by chapter 471 of the laws of
 2011, is amended and a new paragraph (g) is added to read as follows:
   [Any] GENERAL AMBULANCE SERVICES ARE  AN  ESSENTIAL  SERVICE.    EVERY
 county,  city,  town [or] AND village, acting individually or jointly OR
 IN CONJUNCTION WITH A SPECIAL DISTRICT, [may provide] SHALL ENSURE  THAT
 an  emergency medical service, a general ambulance service or a combina-
 tion of such services ARE PROVIDED for the purpose of providing  prehos-
 pital  emergency  medical  treatment  or  transporting  sick  or injured
 persons found within the boundaries of the municipality or  the  munici-
 palities acting jointly to a hospital, clinic, sanatorium or other place
 for  treatment  of  such illness or injury, [and for] PROVIDED, HOWEVER,
 THAT THE PROVISIONS OF THIS SUBDIVISION SHALL NOT APPLY TO A CITY WITH A
 POPULATION OF ONE MILLION OR MORE.  IN FURTHERANCE OF  that  purpose,  A
 COUNTY, CITY, TOWN OR VILLAGE may:
   (G)  ESTABLISH  A  SPECIAL DISTRICT FOR THE FINANCING AND OPERATION OF
 GENERAL AMBULANCE SERVICES, INCLUDING  SUPPORT  FOR  AGENCIES  CURRENTLY
 PROVIDING  EMS SERVICES, AS SET FORTH BY THIS SECTION, WHEREBY ANY COUN-
 TY, CITY, TOWN OR VILLAGE, ACTING  INDIVIDUALLY,  OR  JOINTLY  WITH  ANY
 OTHER  COUNTY,  CITY, TOWN AND/OR VILLAGE, THROUGH ITS GOVERNING BODY OR
 BODIES, FOLLOWING APPLICABLE PROCEDURES AS ARE REQUIRED FOR  THE  ESTAB-
 LISHMENT  OF FIRE DISTRICTS IN ARTICLE ELEVEN OF THE TOWN LAW OR FOLLOW-
 ING APPLICABLE PROCEDURES AS ARE REQUIRED FOR THE ESTABLISHMENT OF JOINT
 FIRE DISTRICTS IN ARTICLE ELEVEN-A OF THE TOWN LAW,  WITH  SUCH  SPECIAL
 DISTRICT  BEING  AUTHORIZED  BY THIS SECTION TO BE ESTABLISHED IN ALL OR
 ANY PART OF ANY SUCH PARTICIPATING COUNTY OR COUNTIES,  TOWN  OR  TOWNS,
 CITY  OR  CITIES  AND/OR  VILLAGE  OR  VILLAGES.    NOTWITHSTANDING  ANY
 PROVISION OF THIS ARTICLE, RULE  OR  REGULATION  TO  THE  CONTRARY,  ANY
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD15850-01-4
 A. 10568                            2
 
 SPECIAL  DISTRICT  CREATED  UNDER  THIS SECTION SHALL NOT OVERLAP WITH A
 PRE-EXISTING CITY, TOWN OR VILLAGE AMBULANCE DISTRICT UNLESS SUCH EXIST-
 ING DISTRICT IS MERGED INTO THE NEWLY CREATED DISTRICT.   NO CITY,  TOWN
 OR VILLAGE SHALL ELIMINATE OR DISSOLVE A PRE-EXISTING AMBULANCE DISTRICT
 WITHOUT  EXPRESS  APPROVAL AND CONSENT BY THE COUNTY TO ASSUME RESPONSI-
 BILITY FOR THE EMERGENCY MEDICAL SERVICES PREVIOUSLY  PROVIDED  BY  SUCH
 DISTRICT.  WHEN A SPECIAL DISTRICT IS ESTABLISHED PURSUANT TO THIS ARTI-
 CLE, THE CITIES, TOWNS, OR VILLAGES CONTAINED WITHIN  THE  COUNTY  SHALL
 NOT REDUCE CURRENT AMBULANCE FUNDING WITHOUT SUCH CHANGES BEING INCORPO-
 RATED INTO THE COMPREHENSIVE COUNTY EMERGENCY MEDICAL SYSTEM PLAN.
   §  2. Section 3000 of the public health law, as amended by chapter 804
 of the laws of 1992, is amended to read as follows:
   § 3000. Declaration of policy and statement of purpose. The furnishing
 of medical assistance in an emergency  is  a  matter  of  vital  concern
 affecting  the  public  health,  safety and welfare.   EMERGENCY MEDICAL
 SERVICES AND AMBULANCE SERVICES ARE  ESSENTIAL  SERVICES  AND  SHALL  BE
 AVAILABLE TO EVERY PERSON IN THE STATE OF NEW YORK IN A RELIABLE MANNER.
 Prehospital  emergency  medical  care, OTHER EMERGENCY MEDICAL SERVICES,
 the provision of prompt and effective communication among ambulances and
 hospitals and safe and effective care and transportation of the sick and
 injured are essential public health services AND SHALL BE  AVAILABLE  TO
 EVERY PERSON IN THE STATE OF NEW YORK IN A RELIABLE MANNER.
   It is the purpose of this article to promote the public health, safety
 and  welfare by providing for certification of all advanced life support
 first response services and ambulance services; the creation of regional
 emergency medical services councils; and  a  New  York  state  emergency
 medical  services  council  to  develop  minimum  training standards for
 certified first responders, emergency medical technicians  and  advanced
 emergency  medical  technicians  and minimum equipment and communication
 standards for advanced life support first response  services  and  ambu-
 lance services.
   §  3.  Subdivision  1  of  section  3001  of the public health law, as
 amended by chapter 804 of the laws  of  1992,  is  amended  to  read  as
 follows:
   1.  "Emergency  medical  service"  means  [initial  emergency  medical
 assistance including, but not  limited  to,  the  treatment  of  trauma,
 burns,  respiratory,  circulatory and obstetrical emergencies] A COORDI-
 NATED SYSTEM OF HEALTHCARE DELIVERY THAT RESPONDS TO THE NEEDS  OF  SICK
 AND  INJURED  ADULTS  AND  CHILDREN, BY PROVIDING: ESSENTIAL CARE AT THE
 SCENE OF AN EMERGENCY; COMMUNITY  EDUCATION  PROGRAMS;  GROUND  AND  AIR
 AMBULANCE  SERVICES;  CENTRALIZED ACCESS AND EMERGENCY MEDICAL DISPATCH;
 TRAINING FOR EMERGENCY MEDICAL  SERVICES  PRACTITIONERS;  MEDICAL  FIRST
 RESPONSE; MOBILE TRAUMA CARE SYSTEMS; MASS CASUALTY MANAGEMENT; OR QUAL-
 ITY CONTROL AND SYSTEM EVALUATION PROCEDURES.
   §  4. The public health law is amended by adding a new section 3019 to
 read as follows:
   § 3019. STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SYSTEM PLAN. 1.  THE
 STATE  EMERGENCY  MEDICAL  SERVICES  COUNCIL,  IN COLLABORATION AND WITH
 FINAL APPROVAL OF THE DEPARTMENT, SHALL DEVELOP AND MAINTAIN A STATEWIDE
 COMPREHENSIVE EMERGENCY MEDICAL SYSTEM PLAN THAT  SHALL  PROVIDE  FOR  A
 COORDINATED  EMERGENCY  MEDICAL  SYSTEM  WITHIN  THE  STATE, WHICH SHALL
 INCLUDE BUT NOT BE LIMITED TO:
   (A) ESTABLISHING A COMPREHENSIVE STATEWIDE EMERGENCY  MEDICAL  SYSTEM,
 CONSISTING OF FACILITIES, TRANSPORTATION, WORKFORCE, COMMUNICATIONS, AND
 OTHER  COMPONENTS  TO  IMPROVE THE DELIVERY OF EMERGENCY MEDICAL SERVICE
 A. 10568                            3
 
 AND THEREBY DECREASE MORBIDITY, HOSPITALIZATION, DISABILITY, AND MORTAL-
 ITY;
   (B)  IMPROVING  THE  ACCESSIBILITY  OF  HIGH-QUALITY EMERGENCY MEDICAL
 SERVICE; AND
   (C) CONDUCTING, PROMOTING, AND ENCOURAGING PROGRAMS OF  EDUCATION  AND
 TRAINING  DESIGNED  TO  IMPROVE  THE  KNOWLEDGE  AND SKILLS OF EMERGENCY
 MEDICAL SERVICE PRACTITIONERS THROUGHOUT  THE  STATE  WITH  EMPHASIS  ON
 REGIONS  UNDERSERVED  BY  OR  WITH  LIMITED  ACCESS TO EMERGENCY MEDICAL
 SERVICES.
   2. THE STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SYSTEM PLAN SHALL  BE
 REVIEWED,  UPDATED  IF  NECESSARY, AND PUBLISHED EVERY FIVE YEARS ON THE
 DEPARTMENT'S WEBSITE, OR AT SUCH EARLIER TIMES AS MAY  BE  NECESSARY  TO
 IMPROVE  THE  EFFECTIVENESS  AND  EFFICIENCY  OF  THE  STATE'S EMERGENCY
 MEDICAL SERVICE SYSTEM.
   3. EACH REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL SHALL DEVELOP  AND
 MAINTAIN A COMPREHENSIVE REGIONAL EMERGENCY MEDICAL SYSTEM PLAN OR ADOPT
 THE  STATEWIDE  COMPREHENSIVE  EMERGENCY MEDICAL SERVICE SYSTEM PLAN, TO
 PROVIDE FOR A COORDINATED EMERGENCY MEDICAL SYSTEM  WITHIN  THE  REGION.
 SUCH  PLANS  SHALL INCORPORATE ALL AMBULANCE SERVICES WITH A CURRENT EMS
 OPERATING CERTIFICATE FOR RESPONSE TO CALLS IN THEIR DESIGNATED  OPERAT-
 ING  TERRITORY  AND  SHALL  BE  SUBJECT TO REVIEW BY THE STATE EMERGENCY
 MEDICAL SERVICES COUNCIL AND FINAL APPROVAL  BY  THE  DEPARTMENT.    ANY
 PROPOSED  PERMANENT  CHANGES  TO  THE  REGIONAL EMERGENCY MEDICAL SYSTEM
 PLAN, INCLUDING THE DISSOLUTION OF AN  AMBULANCE  SERVICES  DISTRICT  OR
 OTHER  SIGNIFICANT  MODIFICATION OF EXISTING COVERAGE SHALL BE SUBMITTED
 IN WRITING TO THE DEPARTMENT NO  LATER  THAN  ONE  HUNDRED  EIGHTY  DAYS
 BEFORE  THE  CHANGE  SHALL  TAKE  EFFECT. SUCH CHANGES SHALL NOT BE MADE
 UNTIL RECEIPT OF THE APPROPRIATE DEPARTMENTAL APPROVALS.
   4. EACH COUNTY SHALL DEVELOP AND MAINTAIN A COMPREHENSIVE COUNTY EMER-
 GENCY MEDICAL SYSTEM PLAN THAT SHALL PROVIDE FOR A COORDINATED EMERGENCY
 MEDICAL SYSTEM WITHIN THE COUNTY, TO PROVIDE ESSENTIAL EMERGENCY MEDICAL
 SERVICES FOR ALL RESIDENTS WITHIN THE COUNTY. THE COUNTY OFFICE OF EMER-
 GENCY MEDICAL SERVICES SHALL BE RESPONSIBLE FOR THE DEVELOPMENT,  IMPLE-
 MENTATION, AND MAINTENANCE OF THE COMPREHENSIVE COUNTY EMERGENCY MEDICAL
 SYSTEM  PLAN.  SUCH PLANS MAY REQUIRE REVIEW AND APPROVAL, AS DETERMINED
 BY THE STATE EMERGENCY MEDICAL SERVICES COUNCIL, BY  SUCH  COUNCIL,  THE
 REGIONAL  EMERGENCY MEDICAL SERVICES COUNCIL AND APPROVAL BY THE DEPART-
 MENT.  SUCH PLAN SHALL INCORPORATE ALL AMBULANCE SERVICES WITH A CURRENT
 EMS OPERATING CERTIFICATE FOR RESPONSE  TO  CALLS  IN  THEIR  DESIGNATED
 OPERATING  TERRITORY AND SHALL OUTLINE THE PRIMARY RESPONDING AGENCY FOR
 REQUESTS FOR SERVICE FOR EACH PART OF THE COUNTY.   ANY PROPOSED  PERMA-
 NENT  CHANGES TO THE COUNTY EMERGENCY MEDICAL SYSTEM PLAN, INCLUDING THE
 DISSOLUTION OF AN  AMBULANCE  SERVICES  DISTRICT  OR  OTHER  SIGNIFICANT
 MODIFICATION  OF  EXISTING COVERAGE SHALL BE SUBMITTED IN WRITING TO THE
 DEPARTMENT NO LATER THAN ONE HUNDRED EIGHTY DAYS BEFORE THE CHANGE SHALL
 TAKE EFFECT. SUCH CHANGES SHALL NOT BE MADE UNTIL RECEIPT OF THE  APPRO-
 PRIATE  APPROVALS.  NO COUNTY SHALL REMOVE OR REASSIGN AN AREA SERVED BY
 AN EXISTING MEDICAL EMERGENCY  RESPONSE  AGENCY  WHERE  SUCH  AGENCY  IS
 COMPLIANT WITH ALL STATUTORY AND REGULATORY REQUIREMENTS, AND HAS AGREED
 TO THE PROVISION OF THE APPROVED PLAN.
   5.  THE  PROVISIONS  OF  THIS SECTION SHALL NOT APPLY TO A CITY WITH A
 POPULATION OF ONE MILLION OR MORE.
   § 5. The public health law is amended by adding a new  section  3019-a
 to read as follows:
   §  3019-A.  EMERGENCY  MEDICAL SYSTEMS TRAINING PROGRAM. 1.  THE STATE
 EMERGENCY MEDICAL SERVICES COUNCIL SHALL  MAKE  RECOMMENDATIONS  TO  THE
 A. 10568                            4
 
 DEPARTMENT  FOR  THE  DEPARTMENT  TO  IMPLEMENT STANDARDS RELATED TO THE
 ESTABLISHMENT OF TRAINING PROGRAMS FOR EMERGENCY  MEDICAL  SYSTEMS  THAT
 INCLUDE BUT ARE NOT LIMITED TO STUDENTS, EMERGENCY MEDICAL SERVICE PRAC-
 TITIONERS,  EMERGENCY  MEDICAL  SERVICES  AGENCIES, APPROVED EDUCATIONAL
 INSTITUTIONS, GEOGRAPHIC  AREAS,  FACILITIES,  AND  PERSONNEL,  AND  THE
 COMMISSIONER  SHALL FUND SUCH TRAINING PROGRAMS IN FULL OR IN PART BASED
 ON STATE APPROPRIATIONS.  UNTIL SUCH TIME AS  THE  DEPARTMENT  ANNOUNCES
 THE  TRAINING PROGRAM ESTABLISHED PURSUANT TO THIS SECTION IS IN EFFECT,
 ALL CURRENT STANDARDS, CURRICULA, AND REQUIREMENTS FOR  STUDENTS,  EMER-
 GENCY MEDICAL SERVICE PRACTITIONERS, AGENCIES, FACILITIES, AND PERSONNEL
 SHALL REMAIN IN EFFECT.
   2.  THE  STATE EMERGENCY MEDICAL SERVICES COUNCIL, WITH FINAL APPROVAL
 OF THE DEPARTMENT, SHALL ESTABLISH MINIMUM EDUCATION STANDARDS,  CURRIC-
 ULA,  AND  REQUIREMENTS  FOR  ALL  EMERGENCY  MEDICAL SYSTEM EDUCATIONAL
 INSTITUTIONS. NO PERSON OR  EDUCATIONAL  INSTITUTION  SHALL  PROFESS  TO
 PROVIDE  EMERGENCY  MEDICAL SYSTEM TRAINING WITHOUT MEETING THE REQUIRE-
 MENTS SET FORTH IN REGULATION AND ONLY AFTER APPROVAL OF THE DEPARTMENT.
   3. THE DEPARTMENT IS AUTHORIZED TO PROVIDE, EITHER DIRECTLY OR THROUGH
 CONTRACT, FOR LOCAL OR STATEWIDE INITIATIVES, EMERGENCY  MEDICAL  SYSTEM
 TRAINING  FOR  EMERGENCY  MEDICAL  SERVICE  PRACTITIONERS  AND EMERGENCY
 MEDICAL SYSTEM AGENCY PERSONNEL, USING FUNDING INCLUDING BUT NOT LIMITED
 TO ALLOCATIONS TO AID  TO  LOCALITIES  FOR  EMERGENCY  MEDICAL  SERVICES
 TRAINING.
   4.  NOTWITHSTANDING ANY OTHER PROVISIONS OF THIS SECTION, THE REGIONAL
 EMERGENCY  MEDICAL  SERVICES  COUNCIL WITH JURISDICTION OVER THE CITY OF
 NEW YORK SHALL HAVE AUTHORITY TO ESTABLISH, SUBJECT TO THE  APPROVAL  OF
 THE  COMMISSIONER,  TRAINING  AND  EDUCATIONAL  REQUIREMENTS WHICH SHALL
 APPLY TO ALL EMERGENCY MEDICAL SERVICE PRACTITIONERS WORKING IN THE  911
 SYSTEM OF THE CITY OF NEW YORK AND TO DETERMINE PROTOCOLS FOR THE DELIV-
 ERY  OF  EMERGENCY MEDICAL CARE, INCLUDING THOSE RELATED TO STAFFING, IN
 THE 911 SYSTEM OF THE CITY OF NEW YORK. SUCH  TRAINING  AND  EDUCATIONAL
 REQUIREMENTS  AND  PROTOCOLS  FOR THE DELIVERY OF CARE SHALL BE AT LEAST
 EQUAL OR COMPARABLE TO THOSE APPLICABLE  TO  EMERGENCY  MEDICAL  SERVICE
 PRACTITIONERS IN OTHER AREAS OF THE STATE.
   5.  THE DEPARTMENT MAY REQUEST THE STATE OR REGIONAL EMERGENCY MEDICAL
 SERVICES COUNCIL'S ASSISTANCE TO ENSURE THE COMPLIANCE, MAINTENANCE, AND
 COORDINATION OF TRAINING PROGRAMS.  EMERGENCY  MEDICAL  SERVICES  INSTI-
 TUTIONS  THAT  FAIL  TO MEET APPLICABLE STANDARDS AND REGULATIONS MAY BE
 SUBJECT TO ENFORCEMENT ACTION, INCLUDING BUT NOT LIMITED TO  REVOCATION,
 SUSPENSION,  PERFORMANCE IMPROVEMENT PLANS, OR RESTRICTION FROM SPECIFIC
 TYPES OF EDUCATION.
   § 6. Section 3020 of the public health law is amended by  adding  four
 new subdivisions 3, 4, 5 and 6 to read as follows:
   3.  THE  DEPARTMENT,  WITH THE APPROVAL OF THE STATE EMERGENCY MEDICAL
 SERVICES COUNCIL, MAY CREATE OR ADOPT ADDITIONAL STANDARDS, TRAINING AND
 CRITERIA TO BECOME AN EMERGENCY MEDICAL  SERVICE  PRACTITIONER  CREDENT-
 IALLED  TO PROVIDE SPECIALIZED, ADVANCED, OR OTHER SERVICES THAT FURTHER
 SUPPORT OR ADVANCE THE EMERGENCY MEDICAL SYSTEM.   THE DEPARTMENT,  WITH
 APPROVAL  OF  THE  STATE EMERGENCY MEDICAL SERVICES COUNCIL MAY ALSO SET
 STANDARDS AND REQUIREMENTS TO REQUIRE SPECIALIZED CREDENTIALS TO PERFORM
 CERTAIN FUNCTIONS IN THE EMERGENCY MEDICAL SERVICES SYSTEM.
   4. THE DEPARTMENT,  WITH  APPROVAL  OF  THE  STATE  EMERGENCY  MEDICAL
 SERVICES  COUNCIL  MAY  ALSO  SET STANDARDS FOR EMERGENCY MEDICAL SYSTEM
 AGENCIES TO BECOME ACCREDITED IN A  SPECIFIC  AREA  TO  INCREASE  SYSTEM
 PERFORMANCE AND AGENCY RECOGNITION.
 A. 10568                            5
 
   5.  NOTWITHSTANDING ANY OTHER PROVISIONS OF THIS SECTION, THE REGIONAL
 EMERGENCY MEDICAL SERVICES COUNCIL WITH JURISDICTION OVER  THE  CITY  OF
 NEW  YORK  SHALL HAVE AUTHORITY TO ESTABLISH, SUBJECT TO THE APPROVAL OF
 THE COMMISSIONER, TRAINING  AND  EDUCATIONAL  REQUIREMENTS  WHICH  SHALL
 APPLY  TO ALL EMERGENCY MEDICAL SERVICE PRACTITIONERS WORKING IN THE 911
 SYSTEM OF THE CITY OF NEW YORK AND TO DETERMINE PROTOCOLS FOR THE DELIV-
 ERY OF EMERGENCY MEDICAL CARE, INCLUDING THOSE RELATED TO  STAFFING,  IN
 THE  911  SYSTEM  OF THE CITY OF NEW YORK. SUCH TRAINING AND EDUCATIONAL
 REQUIREMENTS AND PROTOCOLS FOR THE DELIVERY OF CARE SHALL  BE  AT  LEAST
 EQUAL  OR  COMPARABLE  TO  THOSE APPLICABLE TO EMERGENCY MEDICAL SERVICE
 PRACTITIONERS IN OTHER AREAS OF THE STATE.
   6. NOTHING IN THIS SECTION SHALL BE CONSTRUED TO  ALLOW  A  PERSON  TO
 PROVIDE  ANY  SERVICE  FOR WHICH THE PERSON IS NOT LICENSED, REGISTERED,
 CERTIFIED OR OTHERWISE AUTHORIZED UNDER LAW.
   § 7. This act shall take effect six months after it shall have  become
 a law.