BILL NUMBER: S4020C
SPONSOR: MAYER
 
TITLE OF BILL:
An act to amend the general municipal law and the public health law, in
relation to emergency medical services
 
PURPOSE:
To deem emergency medical services as an essential service; to provide
municipalities with the flexibility to ensure provision of emergency
medical services; to establish statewide, regional, and county coordi-
nation of emergency medical services; and to provide for enhanced train-
ing and credentialing of emergency medical service practitioners, agen-
cies, and educational institutions.
 
SUMMARY OF PROVISIONS:
Section 1 amends the opening paragraph of subdivision 1 of section 122-b
of the general municipal law to declare that general ambulance services
are an essential service; requires that every county, city, town, and
village, acting individually or jointly, or in conjunction with a
special district, ensure that emergency medical service, general ambu-
lance service or a combination of such services are provided for;
exempts cities with a population of one million or more from the
requirements. This section also adds a new paragraph (g) to subdivision
1 of section 122-b to allow a county, city, town, or village, acting
individually, or jointly with any other county, city, town and/or
village, to establish a special district for the financing and operation
of general ambulance services by following the procedures in town law as
are required for establishment of fire districts.
Section 2 amends section 3000 of the public health law to clarify that
emergency medical services and ambulance services are essential services
that must be available to every person in the state in a reliable
manner.
Section 3 amends section 3001 of the public health law to expand the
definition of emergency medical services.
Section 4 creates a new section 3019 of the public health law providing
that the state emergency medical services council, in collaboration with
the department of health, shall develop and maintain a statewide compre-
hensive emergency medical system plan to improve coordination, accessi-
bility, and delivery of services, coordinate development of alternative
delivery models, and conduct and promote education and training of emer-
gency medical service practitioners; that regional emergency medical
services councils develop and maintain regional comprehensive emergency
medical system plans; and that counties develop and maintain comprehen-
sive county emergency medical system plans.
Section 5 creates a new section 3019-a of the public health law estab-
lishing the emergency medical systems training program, and provides
that the state emergency medical services council shall make recommenda-
tions to the department of health for the implementation of standards
related to the establishment of emergency medical systems training
programs, curricula, and requirements for emergency medical system
educational institutions. This section further provides that the depart-
ment of health shall ensure compliance with such standards.
Section 6 amends section 3020 of the public health law to provide for
the creation or adoption of additional standards, training, and criteria
to become an emergency medical service practitioner credentialled to
provide specialized, advanced, or other services, and for emergency
medical service agencies to become accredited in specific areas to
increase system performance.
Section 7 sets forth the effective date.
 
JUSTIFICATION:
New Yorkers expect emergency medical services (EMS) to be available at
all times and in all locations should they need assistance. These
services are essential, providing a wide range of prehospital medical
care to sick or injured people in emergency situations, and are often a
matter of life and death. EMS is a vital resource, necessary to the
health and well-being of communities across New York.
Despite the vast importance of EMS, there is an ongoing crisis in this
state, particularly in how EMS is funded, staffed, and operated. Much of
this stems from a fundamental misconception about EMS vis-a-vis other
critical services like police and fire. This is reflected in New York
State law, which currently fails to recognize the essential nature of
EMS. As a result, the work of EMS providers is undervalued within our
emergency and health care systems compared to other critical public
services, creating a disparity between the immense value that EMS work-
ers and volunteers provide to our communities and the resources made
available to provide these services. Accordingly, many EMS providers
across the state struggle to find and retain staff.
EMS providers are multi-faceted, highly-trained public servants who not
only provide ambulance services for New Yorkers in times of medical
emergency, but also pre-hospital care and general emergency response for
those who are injured, sick, or in need of immediate help. It is time
that New York law reflects the enormous sacrifices and critical work of
the EMS community.
Under the existing framework for the provision of EMS in New York,
private, public, and not-for-profit providers serve needs across the
state in a scattered, patchwork approach. This leaves many New York
residents uncertain whether an EMS provider will be available in their
locality in a time of need. Creating greater flexibility for munici-
palities to facilitate EMS to meet unique local challenges represents a
critical next step in the provision of these much needed services.
With that in mind, this bill amends the general municipal law to declare
general ambulance service to be an "essential service" and requires that
every county, city, town and village, acting individually or jointly, or
in conjunction with a special district, ensure that an emergency medical
service, a general ambulance service, or a combination of such services
is provided for. The bill allows any county, city, town, or village,
acting individually or jointly with any other county, city, town, or
village, to establish a special district for the financing and operation
of general ambulance services. The bill exempts any city with a popu-
lation of one million or more from this requirement.
Additionally, the bill provides for coordination of emergency medical
services on a statewide, regional, and countywide basis, and enhances
education and training programs for emergency medical service providers
and training institutions.
This bill takes necessary steps to recognize EMS as an essential service
that must be provided in every area of the state.
 
LEGISLATIVE HISTORY:
A-print reconciled inclusions in the 2023 budget, removed §§ 2-11, and
exempted cities with a population of one million or more.
B-print reconciled inclusions in the 2023 budget; restores provisions
declaring emergency medical services and ambulance services as essential
service that shall be available to every person in the state of New York
in a reliable manner; restores training and coordination provisions; and
exempts cities with a population of one million or more.
C-print adds provisions to ensure that communication, coordination, and
planning take place among counties and other municipalities when new
special districts are created or existing districts dissolved and when
service changes are contemplated; to ensure inclusion of current EMS
providers in county and regional planning; and to require notice to the
department of health when permanent changes are proposed to county or
regional emergency medical system plans.
S4020A / A3392A (2023): Referred to Local Government S8432A / A9509A
(2021-22): Referred to Local Government
 
FISCAL IMPLICATIONS:
Minimal fiscal impact to the state.
 
EFFECTIVE DATE:
This act shall take effect six months after it shall have become a law.

Statutes affected:
S4020: 163 civil service law, 163(2) civil service law, 3000 public health law, 3001 public health law, 3001(1) public health law, 3002 public health law, 3003 public health law, 3008 public health law
S4020B: 3000 public health law, 3001 public health law, 3001(1) public health law, 3020 public health law
S4020C: 3000 public health law, 3001 public health law, 3001(1) public health law, 3020 public health law