S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3392
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 2, 2023
                                ___________
 
 Introduced  by  M.  of A. OTIS, BUTTENSCHON, CLARK, LUPARDO -- read once
   and referred to the Committee on Local Governments
 
 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:
 
   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]. 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  AS  SET FORTH BY THIS SECTION, WHEREBY ANY
 COUNTY, 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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05007-01-3
              

 A. 3392                             2
 
   § 2. Subdivision 2 of section 163 of the civil service law, as amended
 by  section 4 of part T of chapter 56 of the laws of 2010, is amended to
 read as follows:
   2.  The  contract  or  contracts shall provide for health benefits for
 retired employees of the state and of the state colleges of agriculture,
 home economics, industrial labor relations and veterinary medicine,  the
 state  agricultural experiment station at Geneva, and any other institu-
 tion or agency under the management and control of Cornell university as
 the representative of the board of trustees of the state  university  of
 New  York,  and  the  state college of ceramics under the management and
 control of Alfred university as the representative of the board of trus-
 tees of the state university of New York, and their spouses and  depend-
 ent  children  as  defined  by the regulations of the president, on such
 terms as the president may  deem  appropriate,  and  the  president  may
 authorize the inclusion in the plan of the employees and retired employ-
 ees   of   public   authorities,  public  benefit  corporations,  school
 districts, special districts, district  corporations,  municipal  corpo-
 rations  excluding  active  employees  and  retired  employees of cities
 having a population of one million or  more  inhabitants  whose  compen-
 sation  is  or  was  before retirement paid out of the city treasury, or
 other appropriate agencies, subdivisions or  quasi-public  organizations
 of  the  state, including active members of volunteer fire and volunteer
 ambulance companies serving one or more municipal corporations  pursuant
 to  subdivision  seven  of section ninety-two-a of the general municipal
 law, and their spouses and dependent children as defined  by  the  regu-
 lations  of the president.  NOTWITHSTANDING ANY LAW OR REGULATION TO THE
 CONTRARY, ACTIVE MEMBERS OF VOLUNTEER AMBULANCE COMPANIES SERVING ONE OR
 MORE MUNICIPAL CORPORATIONS PURSUANT TO  SUBDIVISION  SEVEN  OF  SECTION
 NINETY-TWO-A  OF  THE GENERAL MUNICIPAL LAW SHALL BE ELIGIBLE FOR HEALTH
 BENEFITS REGARDLESS OF THE AMOUNT OF FUNDS DERIVED FROM PUBLIC  SOURCES.
 Any  such  corporation,  district,  agency  or  organization electing to
 participate in the plan shall be required to pay its proportionate share
 of the expenses of administration of the plan in  such  amounts  and  at
 such times as determined and fixed by the president. All amounts payable
 for such expenses of administration shall be paid to the commissioner of
 taxation  and finance and shall be applied to the reimbursement of funds
 previously advanced for such purposes. Neither the state nor  any  other
 participant  in the plan shall be charged with the particular experience
 attributable to the employees of the participant, and all  dividends  or
 retroactive  rate  credits  shall be distributed pro-rata based upon the
 number of employees of such participant covered by the plan.
   § 3. Paragraph 9 of subdivision c of section 40 of the retirement  and
 social  security  law, as amended by chapter 525 of the laws of 1963, is
 amended to read as follows:
   9. ACTIVE MEMBERS OF VOLUNTEER AMBULANCE COMPANIES SERVING ONE OR MORE
 MUNICIPAL CORPORATIONS PURSUANT TO SUBDIVISION SEVEN OF SECTION  NINETY-
 TWO-A OF THE GENERAL MUNICIPAL LAW.
   10.  Notwithstanding  any  inconsistent  provision of subdivision e of
 this section, or of this chapter or of any  other  law,  an  officer  or
 employee in the service of the state or of a participating employer who,
 at  the time of entering such service, was or is entitled to benefits by
 any other pension or retirement system maintained  by  the  state  or  a
 political  subdivision thereof, provided such benefits, exclusive of any
 annuity based solely on his own contributions and interest thereon,  are
 suspended  during  his  active  membership  in the retirement system. He
 shall contribute to the retirement system as a new member.
 A. 3392                             3
 
   § 4. 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 THAT MUST BE
 AVAILABLE TO EVERYONE IN 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 THAT MUST BE AVAILABLE TO EVERYONE IN
 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.
   § 5. 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] CARE  OF  A
 PERSON  TO, FROM, AT, IN, OR BETWEEN THE PERSON'S HOME, SCENE OF INJURY,
 HOSPITALS, HEALTH CARE FACILITIES, PUBLIC EVENTS OR OTHER LOCATIONS,  BY
 EMERGENCY  MEDICAL SERVICES PRACTITIONERS AS A PATIENT CARE TEAM MEMBER,
 FOR EMERGENCY, NON-EMERGENCY, SPECIALTY, LOW  ACUITY,  PREVENTATIVE,  OR
 INTERFACILITY  CARE; EMERGENCY AND NON-EMERGENCY MEDICAL DISPATCH; COOR-
 DINATION OF EMERGENCY MEDICAL SYSTEM EQUIPMENT  AND  PERSONNEL;  ASSESS-
 MENT;  TREATMENT,  TRANSPORTATION, ROUTING, REFERRALS AND COMMUNICATIONS
 WITH TREATMENT FACILITIES AND MEDICAL PERSONNEL; PUBLIC EDUCATION, INJU-
 RY PREVENTION AND WELLNESS INITIATIVES; ADMINISTRATION OF  IMMUNIZATIONS
 AS  APPROVED  BY  THE  STATE  EMERGENCY  MEDICAL  SERVICES  COUNCIL; AND
 FOLLOW-UP AND RESTORATIVE CARE.
   § 6. Section 3002 of the public health law is amended by adding a  new
 subdivision 9 to read as follows:
   9.  THE  STATE COUNCIL SHALL ADVISE THE COMMISSIONER ON SUCH ISSUES AS
 THE COMMISSIONER MAY REQUIRE  RELATED  TO  THE  PROVISION  OF  EMERGENCY
 MEDICAL  SERVICE, SPECIALTY CARE, DESIGNATED FACILITY CARE, AND DISASTER
 MEDICAL CARE, AND ASSIST IN THE COORDINATION OF SUCH SERVICE  AND  CARE.
 THIS  SHALL INCLUDE, BUT IS NOT LIMITED TO, THE RECOMMENDATION, PERIODIC
 REVISION, AND APPLICATION  OF  RULES  AND  REGULATIONS,  APPROPRIATENESS
 REVIEW  STANDARDS,  TREATMENT  PROTOCOLS, AND QUALITY IMPROVEMENT STAND-
 ARDS. SUCH RULES, REGULATIONS, STANDARDS AND PROTOCOLS SHALL BE  REGION-
 ALIZED,  AS  NECESSARY.  THE  STATE  COUNCIL SHALL MEET AS FREQUENTLY AS
 DETERMINED NECESSARY BY THE COMMISSIONER.
   § 7. Section 3003 of the public health law is amended  by  adding  two
 new subdivisions 11 and 12 to read as follows:
   11.  EACH  REGIONAL  COUNCIL  SHALL ADVISE THE STATE EMERGENCY MEDICAL
 SERVICES COUNCIL, THE COMMISSIONER AND THE DEPARTMENT ON SUCH ISSUES  AS
 THE  STATE  EMERGENCY MEDICAL SERVICES COUNCIL, THE COMMISSIONER AND THE
 DEPARTMENT MAY REQUIRE RELATED TO THE  PROVISION  OF  EMERGENCY  MEDICAL
 A. 3392                             4
 
 SERVICE,  SPECIALTY CARE, DESIGNATED FACILITY CARE, AND DISASTER MEDICAL
 CARE, AND ASSIST IN THE REGIONAL COORDINATION OF SUCH SERVICE AND CARE.
   12.  EACH  REGIONAL  COUNCIL  SHALL ADVISE THE STATE EMERGENCY MEDICAL
 SERVICES COUNCIL, THE COMMISSIONER AND THE DEPARTMENT ON THE APPROPRIATE
 REGIONAL STANDARDS REQUIRED  FOR  THE  PROVISION  OF  EMERGENCY  MEDICAL
 SERVICES.
   §  8. The public health law is amended by adding a new section 3004 to
 read as follows:
   § 3004. EMERGENCY MEDICAL SERVICES QUALITY AND  SUSTAINABILITY  ASSUR-
 ANCE  PROGRAM.  THE COMMISSIONER, WITH THE ADVICE OF THE STATE EMERGENCY
 MEDICAL ADVISORY COMMITTEE, MAY CREATE  AN  EMERGENCY  MEDICAL  SERVICES
 QUALITY AND SUSTAINABILITY ASSURANCE PROGRAM. STANDARDS AND REQUIREMENTS
 OF  THE QUALITY AND SUSTAINABILITY ASSURANCE PROGRAM MAY INCLUDE BUT NOT
 BE LIMITED TO, CLINICAL STANDARDS, QUALITY  METRICS,  SAFETY  STANDARDS,
 EMERGENCY  VEHICLE  OPERATOR STANDARDS, CLINICAL COMPETENCIES, SUSTAINA-
 BILITY METRICS  AND  MINIMUM  REQUIREMENTS  FOR  QUALITY  ASSURANCE  AND
 SUSTAINABILITY  ASSURANCE  PROGRAMS  TO BE FOLLOWED BY EMERGENCY MEDICAL
 SERVICES AGENCIES, TO PROMOTE POSITIVE  PATIENT  OUTCOMES,  SAFETY,  AND
 EMERGENCY  MEDICAL  SERVICES SYSTEM SUSTAINABILITY THROUGHOUT THE STATE.
 STANDARDS AND REQUIREMENTS OF THE QUALITY AND  SUSTAINABILITY  ASSURANCE
 PROGRAM  MAY  BE  REGIONALIZED. THE COMMISSIONER IS HEREBY AUTHORIZED TO
 PROMULGATE REGULATIONS RELATED TO THE STANDARDS AND REQUIREMENTS OF  THE
 QUALITY AND SUSTAINABILITY ASSURANCE PROGRAM. QUALITY AND SUSTAINABILITY
 ASSURANCE  PROGRAMS SHALL REQUIRE EACH EMERGENCY MEDICAL SERVICES AGENCY
 TO PERFORM REGULAR AND PERIODIC REVIEW  OF  QUALITY  AND  SUSTAINABILITY
 ASSURANCE  PROGRAM  METRICS,  IDENTIFICATION  OF AGENCY DEFICIENCIES AND
 STRENGTHS, DEVELOPMENT OF PROGRAMS TO IMPROVE AGENCY METRICS, STRENGTHEN
 SYSTEM SUSTAINABILITY, AND CONTINUOUS MONITORING OF CARE  PROVIDED.  THE
 DEPARTMENT  MAY  CONTRACT  FOR  SERVICES  WITH SUBJECT MATTER EXPERTS TO
 ASSIST IN THE OVERSIGHT OF THESE METRICS STATEWIDE. THE  DEPARTMENT  MAY
 DELEGATE  AUTHORITY TO OVERSEE THESE METRICS AND REGULATIONS TO COUNTIES
 OR OTHER  CONTRACTORS  AS  DETERMINED  BY  THE  COMMISSIONER.  EMERGENCY
 MEDICAL  SERVICES  AGENCIES  THAT DO NOT MEET THE STANDARDS AND REQUIRE-
 MENTS SET FORTH IN THE QUALITY ASSURANCE PROGRAM SET BY THE COMMISSIONER
 MAY BE SUBJECT TO ENFORCEMENT ACTIONS,  INCLUDING  BUT  NOT  LIMITED  TO
 REVOCATION,  SUSPENSION,  PERFORMANCE  IMPROVEMENT PLANS, OR RESTRICTION
 FROM SPECIFIC TYPES OF RESPONSES INCLUDING, BUT NOT LIMITED TO,  SUSPEN-
 SION OF THE ABILITY TO RESPOND TO REQUESTS FOR EMERGENCY MEDICAL ASSIST-
 ANCE OR TO PERFORM EMERGENCY MEDICAL SERVICES.
   §  9. The public health law is amended by adding a new section 3018 to
 read as follows:
   § 3018. STATEWIDE COMPREHENSIVE EMERGENCY MEDICAL SYSTEM PLAN. 1.  THE
 DEPARTMENT,  IN  CONSULTATION  WITH THE STATE EMERGENCY MEDICAL ADVISORY
 COMMITTEE, SHALL DEVELOP AND MAINTAIN A STATEWIDE COMPREHENSIVE EMERGEN-
 CY 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,
 INCORPORATING FACILITIES, TRANSPORTATION, WORKFORCE, COMMUNICATIONS, AND
 OTHER  WAYS  TO  IMPROVE  THE  DELIVERY OF EMERGENCY MEDICAL SERVICE AND
 THEREBY DECREASE MORBIDITY, HOSPITALIZATION, DISABILITY, AND MORTALITY;
   (B) IMPROVING THE  ACCESSIBILITY  OF  HIGH-QUALITY  EMERGENCY  MEDICAL
 SERVICE;
   (C)  COORDINATING  WITH PROFESSIONAL MEDICAL ORGANIZATIONS, HOSPITALS,
 AND OTHER PUBLIC AND PRIVATE AGENCIES TO DEVELOP APPROACHES FOR  PERSONS
 A. 3392                             5
 
 WHO ARE PRESENTLY USING EMERGENCY DEPARTMENTS FOR ROUTINE, NONURGENT AND
 PRIMARY MEDICAL CARE TO BE SERVED APPROPRIATELY AND ECONOMICALLY; AND
   (D)  CONDUCTING,  PROMOTING, AND ENCOURAGING PROGRAMS OF EDUCATION AND
 TRAINING DESIGNED TO UPGRADE  THE  KNOWLEDGE  AND  SKILLS  OF  EMERGENCY
 MEDICAL  SERVICE  PRACTITIONERS  THROUGHOUT  THE  STATE WITH EMPHASIS ON
 REGIONS UNDERSERVED BY 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 ADVISORY  COMMITTEE  SHALL  DEVELOP
 AND MAINTAIN A COMPREHENSIVE REGIONAL EMERGENCY MEDICAL SYSTEM PLAN THAT
 SHALL  PROVIDE  FOR  A  COORDINATED  EMERGENCY MEDICAL SYSTEM WITHIN THE
 REGION. SUCH PLANS SHALL BE SUBJECT TO REVIEW  BY  THE  STATE  EMERGENCY
 MEDICAL ADVISORY COMMITTEE AND APPROVAL BY THE DEPARTMENT.
   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. THE COUNTY OFFICE OF EMERGENCY MEDICAL
 SERVICES SHALL BE RESPONSIBLE FOR THE DEVELOPMENT AND MAINTENANCE OF THE
 COMPREHENSIVE  COUNTY EMERGENCY MEDICAL SYSTEM PLAN. SUCH PLANS SHALL BE
 SUBJECT TO REVIEW BY THE REGIONAL EMERGENCY MEDICAL ADVISORY  COMMITTEE,
 THE  STATE  ADVISORY COUNCIL AND APPROVAL BY THE DEPARTMENT. THE DEPART-
 MENT SHALL BE RESPONSIBLE FOR OVERSIGHT OF EACH COUNTY'S COMPLIANCE WITH
 ITS PLAN.
   5. THE COMMISSIONER MAY PROMULGATE REGULATIONS  TO  ENSURE  COMPLIANCE
 WITH THIS SECTION.
   § 10. Section 3008 of the public health law is amended by adding a new
 subdivision 8 to read as follows:
   8.  (A)  NOTWITHSTANDING ANY PROVISION OF LAW OTHER THAN PARAGRAPH (B)
 OF THIS SUBDIVISION TO THE CONTRARY, ALL DETERMINATIONS OF NEED SHALL BE
 CONSISTENT WITH THE STATE EMERGENCY MEDICAL SYSTEM PLAN  ESTABLISHED  IN
 SECTION  THREE  THOUSAND  EIGHTEEN OF THIS ARTICLE. THE COMMISSIONER MAY
 PROMULGATE REGULATIONS TO PROVIDE FOR STANDARDS ON THE DETERMINATION  OF
 NEED.  THE  DEPARTMENT SHALL ISSUE A NEW EMERGENCY MEDICAL SYSTEM AGENCY
 CERTIFICATE ONLY UPON  A  DETERMINATION  THAT  A  PUBLIC  NEED  FOR  THE
 PROPOSED  SERVICE  HAS  BEEN  ESTABLISHED PURSUANT TO REGULATION. IF THE
 DEPARTMENT DETERMINES THAT A PUBLIC NEED EXISTS FOR ONLY A PORTION OF  A
 PROPOSED SERVICE, A CERTIFICATE MAY BE ISSUED FOR THAT PORTION. PRIOR TO
 REACHING  A  FINAL DETERMINATION OF NEED, THE DEPARTMENT SHALL FORWARD A
 SUMMARY OF THE PROPOSED SERVICE INCLUDING ANY DOCUMENTATION RECEIVED  OR
 SUBSEQUENT  REPORTS  CREATED  THERETO,  TO  THE  STATE EMERGENCY MEDICAL
 SERVICES ADVISORY COUNCIL FOR REVIEW AND RECOMMENDATION TO  THE  DEPART-
 MENT ON THE APPROVAL OF THE APPLICATION. AN APPLICANT OR OTHER CONCERNED
 PARTY  MAY  APPEAL  ANY DETERMINATION MADE BY THE DEPARTMENT PURSUANT TO
 THIS SECTION WITHIN FOURTEEN DAYS. APPEALS SHALL BE  HEARD  PURSUANT  TO
 THE PROVISIONS OF SECTION TWELVE-A OF THIS CHAPTER, AND A FINAL DETERMI-
 NATION  AS  TO NEED SHALL BE MADE BY THE COMMISSIONER UPON REVIEW OF THE
 REPORT AND RECOMMENDATION BY THE PRESIDING ADMINISTRATIVE LAW JUDGE.
   (B) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (A) OF  THIS  SUBDIVI-
 SION,  THE  COMMISSIONER  MAY  PROMULGATE REGULATIONS TO PROVIDE FOR THE
 ISSUANCE OF AN EMERGENCY MEDICAL SYSTEM  AGENCY  CERTIFICATE  WITHOUT  A
 DETERMINATION OF PUBLIC NEED.
   § 11. The public health law is amended by adding a new section 3019 to
 read as follows:
 A. 3392                             6

   § 3019. EMERGENCY MEDICAL SYSTEMS TRAINING PROGRAM. 1. THERE IS HEREBY
 ESTABLISHED  A  TRAINING  PROGRAM  FOR  EMERGENCY  MEDICAL  SYSTEMS THAT
 INCLUDES STUDENTS, EMERGENCY MEDICAL  SERVICE  PRACTITIONERS,  AGENCIES,
 FACILITIES,  AND  PERSONNEL,  AND  THE  COMMISSIONER MAY PROVIDE FUNDING
 WITHIN  THE AMOUNT APPROPRIATED TO CONDUCT SUCH TRAINING PROGRAMS. 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, EMERGENCY MEDICAL SERVICE PRACTITIONERS,
 AGENCIES, FACILITIES, AND PERSONNEL SHALL REMAIN IN EFFECT.
   2. THE DEPARTMENT, IN CONSULTATION WITH THE  STATE  EMERGENCY  MEDICAL
 ADVISORY  COUNCIL,  SHALL ESTABLISH MINIMUM EDUCATION STANDARDS, CURRIC-
 ULA,  AND  REQUIREMENTS  FOR  ALL  EMERGENCY  MEDICAL  SYSTEM   TRAINING
 PROGRAMS.  NO  PERSON  SHALL PROFESS TO PROVIDE EMERGENCY MEDICAL SYSTEM
 TRAINING WITHOUT THE APPROVAL OF THE DEPARTMENT.
   3. THE DEPARTMENT IS AUTHORIZED TO PROVIDE, EITHER DIRECTLY OR THROUGH
 CONTRACT,  EMERGENCY  MEDICAL  SYSTEM  TRAINING  FOR  EMERGENCY  MEDICAL
 SERVICE  PRACTITIONERS  AND  EMERGENCY  MEDICAL SYSTEM AGENCY PERSONNEL,
 DEVELOP AND DISTRIBUTE TRAINING MATERIALS FOR USE BY INSTRUCTORS, AND TO
 RECRUIT ADDITIONAL INSTRUCTORS TO PROVIDE TRAINING.
   4. THE DEPARTMENT MAY VISIT AND INSPECT ANY EMERGENCY  MEDICAL  SYSTEM
 TRAINING PROGRAM OR TRAINING CENTER OPERATING UNDER THIS ARTICLE AND THE
 REGULATIONS ADOPTED THEREFORE TO ENSURE COMPLIANCE.
   5.  THE  COMMISSIONER  SHALL, WITHIN AMOUNTS APPROPRIATED, ESTABLISH A
 PUBLIC SERVICE CAMPAIGN TO RECRUIT ADDITIONAL PERSONNEL INTO  THE  EMER-
 GENCY MEDICAL SYSTEM FIELDS.
   6.  THE  COMMISSIONER SHALL, WITHIN AMOUNTS APPROPRIATED, ESTABLISH AN
 EMERGENCY  MEDICAL  SYSTEM  MENTAL  HEALTH  AND  WELLNESS  PROGRAM  THAT
 PROVIDES  RESOURCES TO EMERGENCY MEDICAL SERVICE PRACTITIONERS TO REDUCE
 BURNOUT; PREVENT DEPRESSION, SUICIDE AND OTHER  NEGATIVE  MENTAL  HEALTH
 OUTCOMES; AND INCREASE SAFETY.
   7. THE DEPARTMENT MAY CREATE OR ADOPT WITH THE APPROVAL OF THE COMMIS-
 SIONER  ADDITIONAL STANDARDS, TRAINING AND CRITERIA TO BECOME A CREDENT-
 IALLED EMERGENCY MEDICAL SERVICE PRACTITIONER  TO  PROVIDE  SPECIALIZED,
 ADVANCED, OR OTHER SERVICES THAT FURTHER SUPPORT OR ADVANCE THE EMERGEN-
 CY MEDICAL SYSTEM.
   § 12. This act shall take effect immediately.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  3392--B
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 2, 2023
                                ___________
 
 Introduced  by M. of A. OTIS, BUTTENSCHON, CLARK, LUPARDO, SANTABARBARA,
   EACHUS, LEVENBERG, SILLITTI, KELLES, BENDETT -- read once and referred
   to the Committee on Local Governments --  committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee -- recommitted to the Committee on Local Governments in accordance
   with Assembly Rule 3, sec. 2 -- again  reported  from  said  committee
   with  amendments, 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:
 
   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 AS SET FORTH BY  THIS  SECTION,  WHEREBY  ANY
 COUNTY,  CITY, TOWN OR VILLAGE, ACTING INDIVIDUALLY, OR JOINTLY WITH ANY
 OTHER COUNTY, CITY, TOWN AND/OR VILLAGE, THROUGH ITS GOVERNING  BODY  OR
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05007-09-4
              

 A. 3392--B                          2
 
 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.
   § 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, NON-EMERGENCY, SPECIALTY NEED OR PUBLIC EVENT;
 COMMUNITY EDUCATION AND PREVENTION 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; MEDICAL DIRECTION;
 OR QUALITY 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
 AND THEREBY DECREASE MORBIDITY, HOSPITALIZATION, DISABILITY, AND MORTAL-
 ITY;
 A. 3392--B                          3
 
   (B) IMPROVING THE  ACCESSIBILITY  OF  HIGH-QUALITY  EMERGENCY  MEDICAL
 SERVICE;
   (C)  COORDINATING  PROFESSIONAL  MEDICAL ORGANIZATIONS, HOSPITALS, AND
 OTHER PUBLIC AND PRIVATE AGENCIES  IN  DEVELOPING  ALTERNATIVE  DELIVERY
 MODELS  FOR  PERSONS  WHO  ARE PRESENTLY USING EMERGENCY DEPARTMENTS FOR
 ROUTINE, NONURGENT AND PRIMARY MEDICAL CARE TO BE  SERVED  APPROPRIATELY
 AND ECONOMICALLY; AND
   (D)  CONDUCTING,  PROMOTING, AND ENCOURAGING PROGRAMS OF EDUCATION AND
 TRAINING DESIGNED TO UPGRADE  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 BE SUBJECT TO REVIEW BY  THE  STATE  EMERGENCY  MEDICAL
 SERVICES COUNCIL AND FINAL APPROVAL BY THE DEPARTMENT.
   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  OUTLINE  THE  PRIMARY  RESPONDING AGENCY FOR
 REQUESTS FOR SERVICE FOR EACH PART OF THE COUNTY.
   § 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
 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.
 A. 3392--B                          4
 
   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. THE DEPARTMENT MAY VISIT AND INSPECT ANY EMERGENCY  MEDICAL  SYSTEM
 TRAINING  PROGRAM  OR  TRAINING  CENTER  OPERATING UNDER THIS ARTICLE TO
 ENSURE COMPLIANCE.  THE DEPARTMENT MAY REQUEST  THE  STATE  OR  REGIONAL
 EMERGENCY  MEDICAL  SERVICES  COUNCIL'S ASSISTANCE TO ENSURE THE COMPLI-
 ANCE, MAINTENANCE, AND  COORDINATION  OF  TRAINING  PROGRAMS.  EMERGENCY
 MEDICAL SERVICES INSTITUTIONS 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 two
 new subdivisions 3 and 4 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.
   § 7. This act shall take effect six months after it shall have  become
 a law.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  3392--C
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 2, 2023
                                ___________
 
 Introduced  by M. of A. OTIS, BUTTENSCHON, CLARK, LUPARDO, SANTABARBARA,
   EACHUS,  LEVENBERG,  SILLITTI,  KELLES,  BENDETT,  LUNSFORD,  MCGOWAN,
   BURDICK,  MAHER,  SIMPSON,  ANGELINO,  NORRIS, SHIMSKY, GUNTHER, FAHY,
   BARRETT, McDONALD, J. M. GIGLIO, BLUMENCRANZ, FLOOD, DeSTEFANO -- read
   once and referred to the Committee on Local Governments  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee -- recommitted to the Committee on Local Governments
   in accordance with Assembly Rule 3, sec. 2 -- again reported from said
   committee  with amendments, ordered reprinted as amended and recommit-
   ted to said committee --  again  reported  from  said  committee  with
   amendments,  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:
 
   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:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05007-13-4
              

 A. 3392--C                          2
 
   (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
 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, NON-EMERGENCY, SPECIALTY NEED  OR  PUBLIC  EVENT;
 COMMUNITY  EDUCATION  AND  PREVENTION PROGRAMS; GROUND AND AIR AMBULANCE
 SERVICES; CENTRALIZED ACCESS AND EMERGENCY  MEDICAL  DISPATCH;  TRAINING
 FOR  EMERGENCY  MEDICAL  SERVICES PRACTITIONERS; MEDICAL FIRST RESPONSE;
 A. 3392--C                          3
 
 MOBILE TRAUMA CARE SYSTEMS; MASS CASUALTY MANAGEMENT; MEDICAL DIRECTION;
 OR QUALITY 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
 AND THEREBY DECREASE MORBIDITY, HOSPITALIZATION, DISABILITY, AND MORTAL-
 ITY;
   (B) IMPROVING THE  ACCESSIBILITY  OF  HIGH-QUALITY  EMERGENCY  MEDICAL
 SERVICE;
   (C)  COORDINATING  PROFESSIONAL  MEDICAL ORGANIZATIONS, HOSPITALS, AND
 OTHER PUBLIC AND PRIVATE AGENCIES  IN  DEVELOPING  ALTERNATIVE  DELIVERY
 MODELS  FOR  PERSONS  WHO  ARE PRESENTLY USING EMERGENCY DEPARTMENTS FOR
 ROUTINE, NONURGENT AND PRIMARY MEDICAL CARE TO BE  SERVED  APPROPRIATELY
 AND  ECONOMICALLY, PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS SUBDI-
 VISION SHALL NOT APPLY TO A CITY WITH A POPULATION  OF  ONE  MILLION  OR
 MORE; AND
   (D)  CONDUCTING,  PROMOTING, AND ENCOURAGING PROGRAMS OF EDUCATION AND
 TRAINING DESIGNED TO UPGRADE  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
 A. 3392--C                          4
 
 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 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
 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 PRACTITIONERS WORKING IN THE 911 SYSTEM
 OF THE CITY OF NEW YORK AND TO DETERMINE PROTOCOLS FOR THE  DELIVERY  OF
 EMERGENCY  MEDICAL CARE, INCLUDING THOSE RELATED TO STAFFING, IN THE 911
 SYSTEM OF THE CITY OF NEW YORK. SUCH TRAINING AND  EDUCATIONAL  REQUIRE-
 MENTS  AND PROTOCOLS FOR THE DELIVERY OF CARE SHALL BE AT LEAST EQUAL OR
 COMPARABLE TO THOSE APPLICABLE TO EMERGENCY MEDICAL SERVICE  PRACTITION-
 ERS IN OTHER AREAS OF THE STATE.
   5.  THE  DEPARTMENT MAY VISIT AND INSPECT ANY EMERGENCY MEDICAL SYSTEM
 TRAINING PROGRAM OR TRAINING CENTER  OPERATING  UNDER  THIS  ARTICLE  TO
 ENSURE  COMPLIANCE.    THE  DEPARTMENT MAY REQUEST THE STATE OR REGIONAL
 EMERGENCY MEDICAL SERVICES COUNCIL'S ASSISTANCE TO  ENSURE  THE  COMPLI-
 A. 3392--C                          5
 
 ANCE,  MAINTENANCE,  AND  COORDINATION  OF  TRAINING PROGRAMS. EMERGENCY
 MEDICAL SERVICES INSTITUTIONS 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  three
 new subdivisions 3, 4 and 5 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.
   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 PRACTITIONERS WORKING IN THE 911 SYSTEM
 OF THE CITY OF NEW YORK AND TO DETERMINE PROTOCOLS FOR THE  DELIVERY  OF
 EMERGENCY  MEDICAL CARE, INCLUDING THOSE RELATED TO STAFFING, IN THE 911
 SYSTEM OF THE CITY OF NEW YORK. SUCH TRAINING AND  EDUCATIONAL  REQUIRE-
 MENTS  AND PROTOCOLS FOR THE DELIVERY OF CARE SHALL BE AT LEAST EQUAL OR
 COMPARABLE TO THOSE APPLICABLE TO EMERGENCY MEDICAL SERVICE  PRACTITION-
 ERS IN OTHER AREAS OF THE STATE.
   §  7. This act shall take effect six months after it shall have become
 a law.