Relates to applications for determinations of public need

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

2014: A9852 - passed Assembly Health, died in Assembly Rules

Fiscal implications

None.

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.