SB0650sam001 98TH GENERAL ASSEMBLY

Sen. Antonio Muñoz

Filed: 4/28/2014

09800SB0650sam001 LRB098 04423 RPS 58761 a

AMENDMENT TO SENATE BILL 650

AMENDMENT NO. ______. Amend Senate Bill 650 by replacing everything after the enacting clause with the following:

"Section 5. The State Finance Act is amended by adding Section 5.855 as follows:

(30 ILCS 105/5.855 new)

Sec. 5.855. The Medical Assisted Transport Licensure Fund.

Section 10. The Emergency Medical Services (EMS) Systems Act is amended by changing Sections 3.10 and 3.220 and by adding Section 3.88 as follows:

(210 ILCS 50/3.10)

Sec. 3.10. Scope of Services.

(a) "Advanced Life Support (ALS) Services" means an advanced level of pre-hospital and inter-hospital emergency care and non-emergency medical services that includes basic life support care, cardiac monitoring, cardiac defibrillation, electrocardiography, intravenous therapy, administration of medications, drugs and solutions, use of adjunctive medical devices, trauma care, and other authorized techniques and procedures, as outlined in the Advanced Life Support national curriculum of the United States Department of Transportation and any modifications to that curriculum specified in rules adopted by the Department pursuant to this Act.

That care shall be initiated as authorized by the EMS Medical Director in a Department approved advanced life support EMS System, under the written or verbal direction of a physician licensed to practice medicine in all of its branches or under the verbal direction of an Emergency Communications Registered Nurse.

(b) "Intermediate Life Support (ILS) Services" means an intermediate level of pre-hospital and inter-hospital emergency care and non-emergency medical services that includes basic life support care plus intravenous cannulation and fluid therapy, invasive airway management, trauma care, and other authorized techniques and procedures, as outlined in the Intermediate Life Support national curriculum of the United States Department of Transportation and any modifications to that curriculum specified in rules adopted by the Department pursuant to this Act.

That care shall be initiated as authorized by the EMS Medical Director in a Department approved intermediate or advanced life support EMS System, under the written or verbal direction of a physician licensed to practice medicine in all of its branches or under the verbal direction of an Emergency Communications Registered Nurse.

(c) "Basic Life Support (BLS) Services" means a basic level of pre-hospital and inter-hospital emergency care and non-emergency medical services that includes airway management, clinical observation, cardiopulmonary resuscitation (CPR), control of shock and bleeding and splinting of fractures, as outlined in the Basic Life Support national curriculum of the United States Department of Transportation and any modifications to that curriculum specified in rules adopted by the Department pursuant to this Act.

That care shall be initiated, where authorized by the EMS Medical Director in a Department approved EMS System, under the written or verbal direction of a physician licensed to practice medicine in all of its branches or under the verbal direction of an Emergency Communications Registered Nurse.

(d) "First Response Services" means a preliminary level of pre-hospital emergency care that includes cardiopulmonary resuscitation (CPR), monitoring vital signs and control of bleeding, as outlined in the First Responder curriculum of the United States Department of Transportation and any modifications to that curriculum specified in rules adopted by the Department pursuant to this Act.

(e) "Pre-hospital care" means those emergency medical services rendered to emergency patients for analytic, resuscitative, stabilizing, or preventive purposes, precedent to and during transportation of such patients to hospitals.

(f) "Inter-hospital care" means those emergency medical services rendered to emergency patients for analytic, resuscitative, stabilizing, or preventive purposes, during transportation of such patients from one hospital to another hospital.

(f-5) "Critical care transport" means the pre-hospital or inter-hospital transportation of a critically injured or ill patient by a vehicle service provider, including the provision of medically necessary supplies and services, at a level of service beyond the scope of the EMT-paramedic. When medically indicated for a patient, as determined by a physician licensed to practice medicine in all of its branches, an advanced practice nurse, or a physician's assistant, in compliance with subsections (b) and (c) of Section 3.155 of this Act, critical care transport may be provided by:

(1) Department-approved critical care transport providers, not owned or operated by a hospital, utilizing EMT-paramedics with additional training, nurses, or other qualified health professionals; or

(2) Hospitals, when utilizing any vehicle service provider or any hospital-owned or operated vehicle service provider. Nothing in this amendatory Act of the 96th General Assembly requires a hospital to use, or to be, a Department-approved critical care transport provider when transporting patients, including those critically injured or ill. Nothing in this Act shall restrict or prohibit a hospital from providing, or arranging for, the medically appropriate transport of any patient, as determined by a physician licensed to practice in all of its branches, an advanced practice nurse, or a physician's assistant.

(g) "Non-emergency medical services" means medical care or monitoring rendered to patients whose conditions do not meet this Act's definition of emergency, before or during transportation of such patients to or from health care facilities visited for the purpose of obtaining medical or health care services which are not emergency in nature, using a vehicle regulated by this Act.

(g-1) "Clinical observation" means the ongoing observation of a patient's condition by a licensed physician, nurse, or emergency medical technician using a medical skill set while the licensed physician, nurse, or emergency medical technician continues assessment and care of the patient.

(g-5) The Department shall have the authority to promulgate minimum standards for critical care transport providers through rules adopted pursuant to this Act. All critical care transport providers must function within a Department-approved EMS System. Nothing in Department rules shall restrict a hospital's ability to furnish personnel, equipment, and medical supplies to any vehicle service provider, including a critical care transport provider. Minimum critical care transport provider standards shall include, but are not limited to:

(1) Personnel staffing and licensure.

(2) Education, certification, and experience.

(3) Medical equipment and supplies.

(4) Vehicular standards.

(5) Treatment and transport protocols.

(6) Quality assurance and data collection.

(h) The provisions of this Act shall not apply to the use of an ambulance or SEMSV, unless and until emergency or non-emergency medical services are needed during the use of the ambulance or SEMSV.

(Source: P.A. 96-1469, eff. 1-1-11.)

(210 ILCS 50/3.88 new)

Sec. 3.88. Medical assisted transport providers.

(a) In this Section, "medical assisted transport provider" means an entity licensed by the Department to provide non-emergency bedside-to-bedside transportation of passengers in compliance with this Act or the rules adopted by the Department pursuant to this Act, using a medical assisted transport vehicle.

In this Section, "medical assisted transport vehicle" means any publicly or privately owned on-road vehicle that is equipped for, intended to be used for, and operated for non-emergency bedside-to-bedside transportation.

(b) The Department has the authority and the responsibility to do the following:

(1) Require that all medical assisted transport providers, both publicly and privately owned, be licensed by the Department.

(2) Establish licensing, safety, and training standards and requirements for medical assisted transport providers through rules adopted pursuant to this Act, including, but not limited to, the following:

(A) Vehicle design, specification, operation, and maintenance standards.

(B) Safety equipment requirements and standards.

(C) Medical supply and equipment requirements and standards, including, but not limited to, the requirement to have the following medical supply and equipment items on each medical assisted transport vehicle:

(i) a first aid kit; and

(ii) an automated external defibrillator (AED), as described in Section 10 of the Automated External Defibrillator Act.

(D) Training requirements, including, but not limited to, the requirement that all staff members providing medical assisted transport services under this Section receive the following training:

(i) safety training as specified in subsection (e) of Section 5-4.2 of the Illinois Public Aid Code;

(ii) defensive driving training equivalent to the National Safety Council's Coaching the Van Driver 3 course;

(iii) basic first aid training equivalent to the American Red Cross's First Aid course; and

(iv) cardiopulmonary resuscitation (CPR) training, including training in the proper use of an automated external defibrillator (AED), equivalent to the American Red Cross's CPR/AED for Professional Rescuers and Health Care Providers course.

(E) Annual license renewal.

(3) License all medical assisted transport providers that have met the Department's requirements for licensure.

(4) Annually inspect all licensed medical assisted transport providers and relicense providers that have met the Department's requirements for license renewal.

(5) Suspend, revoke, refuse to issue, or refuse to renew the license of any medical assisted transport provider, or that portion of a license pertaining to a specific vehicle operated by a provider, after an opportunity for a hearing when findings show that the provider or one or more of its vehicles has failed to comply with the rules adopted by the Department pursuant to this Act.

(6) Issue an emergency suspension order for any medical assisted transport provider or vehicle licensed under this Act when the Director or his or her designee has determined that an immediate or serious danger to the public health, safety, and welfare exists. Suspension or revocation proceedings that offer an opportunity for a hearing shall be promptly initiated after the emergency suspension order has been issued.

(7) Prohibit any medical assisted transport provider from advertising, identifying its vehicles, or disseminating information in a false or misleading manner concerning the provider's type and level of vehicles, location, response times, level of personnel, licensure status, or EMS System participation.

(8) Charge each medical assisted transport provider a fee that shall not exceed $25 per vehicle nor $500 per provider. The fee shall be submitted with each application for licensure and license renewal.

(c) A medical assisted transport provider may provide transport of a passenger who is ambulatory or is in a wheelchair, provided that all of the following requirements are met:

(1) The passenger needs no medical monitoring or clinical observation.

(2) The passenger is transported as follows: (A) if the passenger resides in a facility licensed under the Nursing Home Care Act, he or she is transported from the inside of his or her room to a room at a physician's office or to a ward, unit, or room of a hospital licensed under the Hospital Licensing Act or operated under the University of Illinois Hospital Act or (B) from a room at a physician's office or ward, unit, or room of a hospital licensed under the Hospital Licensing Act or operated under the University of Illinois Hospital Act to the inside of his or her residence or, if the passenger resides in a facility licensed under the Nursing Home Care Act, to the inside of his or her room.

(d) A medical assisted transport provider may not transport a passenger who meets any of the following conditions:

(1) He or she is acutely ill, wounded, or medically unstable as determined by a licensed physician.

(2) He or she is experiencing an emergency medical condition, an acute medical condition, or a sudden illness or injury.

(3) He or she was administered a medication that might prevent the passenger from caring for himself or herself.

(4) He or she requires active medical monitoring, clinical observation, isolation precautions, supplemental oxygen that is not self-administered, continuous airway management, suctioning during transport, or the administration of intravenous fluids during transport.

(e) The Medical Assisted Transport Licensure Fund is created as a special fund in the State treasury. All fees received by the Department in connection with the licensure of medical assisted transport providers under this Section shall be deposited into the Fund. Moneys in the Fund shall be used by the Department, subject to appropriation, to implement this Section.

(210 ILCS 50/3.220)

Sec. 3.220. EMS Assistance Fund.

(a) There is hereby created an "EMS Assistance Fund" within the State treasury, for the purpose of receiving fines and fees collected by the Illinois Department of Health pursuant to this Act.

(b) (Blank).

(b-5) All licensing, testing, and certification fees authorized by this Act, excluding ambulance licensure fees, within this fund shall be used by the Department for administration, oversight, and enforcement of activities authorized under this Act.

(c) All other moneys within this fund shall be distributed by the Department to the EMS Regions for disbursement in accordance with protocols established in the EMS Region Plans, for the purposes of organization, development and improvement of Emergency Medical Services Systems, including but not limited to training of personnel and acquisition, modification and maintenance of necessary supplies, equipment and vehicles.

(d) All fees and fines collected pursuant to this Act shall be deposited into the EMS Assistance Fund, except that all fees collected under Section 3.86 in connection with the licensure of stretcher van providers shall be deposited into the Stretcher Van Licensure Fund and all fees collected under Section 3.88 in connection with the licensure of medical assisted transport providers shall be deposited into the Medical Assisted Transport Licensure Fund.

(Source: P.A. 96-702, eff. 8-25-09; 96-1469, eff. 1-1-11.)

Section 99. Effective date. This Act takes effect upon becoming law.".