S T A T E O F N E W Y O R K
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9851
I N S E N A T E
June 4, 2024
___________
Introduced by Sen. MAYER -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
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.
S LBD15851-02-4
S. 9851 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
S. 9851 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
S. 9851 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.
S. 9851 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 A LICENSE, REGISTRATION, CERTIFICATION OR
OTHER AUTHORIZATION UNDER TITLE EIGHT OF THE EDUCATION LAW IS REQUIRED.
§ 7. This act shall take effect six months after it shall have become
a law.