BILL NUMBER:  S1315

 TITLE OF BILL :

An act to amend the public health law, in relation to applications for
determination of public need

 PURPOSE :

To clarify the right of a municipality or a fire district to establish
an advanced life-support first response service or municipal ambulance
service within the municipality or fire district when it meets Health
Department training, staffing, and equipment standards

 SUMMARY OF PROVISIONS :

Subdivision 7 (b) of Section 3008 of the Public Health Law is amended
by removing the requirement that a municipality or fire district apply
to the regional emergency medical services council for permanent
operating authority at the conclusion of its initial two-year period.
Requires the Commissioner of Health to approve the application for
permanent operating authority if the service meets applicable
training, staffing and equipment standards, unless the municipality or
fire district has caused a detrimental impact on services in the
surrounding region.

              

 EXISTING LAW :

Currently, Public Health Law § 3008 grants municipalities or fire
districts acting on behalf of municipalities a two-year presumption of
need for advanced life support first response services or municipal
ambulance services. After two years, an application must be filed with
a regional council for determination of need prior to continued
operation of the service.

 JUSTIFICATION :

Like police and fire service, emergency medical service is a basic
public service that a municipality should be entitled to provide.

Despite amendments to § 3008, municipalities are still at a distinct
disadvantage when applying for a certificate of need to continue the
provision of ambulance services, as evidenced by the 2012 City of
Utica and Glens Falls legislation. Municipalities or fire districts
seeking to continue established operations must apply to their
Regional Emergence Medical Services Council (REMSCO), which by statute
includes at least one-third representatives of private ambulance
services that may have a business interest in preventing competition.
Pursuant to the REMSCO process and the definition of public need
contained in the Bureau of EMS Policy 06-06, any entity, private or
otherwise, can challenge the application for continued operation of
the municipality or fire district based on public need through a
simple statement that such challenging entity is ready, willing, and
able to take over the municipality or fire district's current
territory.

Given that many municipalities have spent great time and expense in
training municipal employees in advanced life support and have the
appropriate equipment and staffing necessary to provide services in
compliance with DOH safety requirements, they should not be subject to
additional scrutiny by private providers through the REMSCO process.

The operation of ambulance services has proven to provide an
invaluable benefit to municipalities. Municipal ambulance services
have shown to provide faster response times by virtue of their

knowledge of the communities and the fact that they are already
responding to emergency calls.

Additionally, when the municipality is providing both treatment and
transportation, the responders provide a continuity of care as opposed
to waiting for another provider to arrive on scene before transporting
the patient to a treatment facility. This continuity results in more
efficient patient care and limits the need to hand off patients to
another provider. For instance, the City of Saratoga Springs has
operated its municipal ambulance service since 2012 and reported an
18-month average response time half that of other ambulance providers
in the same area.

The bill explicitly provides that the Commissioner shall not grant the
municipal or district service authority to operate permanently if it
"has caused a detrimental impact on services in the surrounding
region". Therefore, there should be no concern for existing providers
that the removal of the RESMCO from the application process will
undermine existing services. This same argument was made by the
opponents to the 1992, 1997, and 2012 amendments of § 3008 and was not
borne out by experience.

 LEGISLATIVE HISTORY :

2015-16: S.3354 Referred to Health; Advance to Third Reading
2014:  A9852 - passed Assembly Health, died in Assembly Rules

 FISCAL IMPLICATIONS :

None.

 LOCAL FISCAL IMPLICATIONS :

Potential generation of revenue to offset first responder services.

 EFFECTIVE DATE :
This act shall take effect immediately and shall apply to any
municipality or fire district that has a temporary determination of
public need, any application made by a municipality or fire district
for a permanent operating certificate that is currently in the
administrative appellate process or judicial review.