Full Text of SB0761 103rd General Assembly
SB0761enr 103RD GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois, | 3 | | represented in the General Assembly:
| 4 | | Section 5. The Emergency Medical Services (EMS) Systems | 5 | | Act is amended by changing Sections 3.20, 3.55, and 3.85 and by | 6 | | adding Section 3.22 as follows:
| 7 | | (210 ILCS 50/3.20)
| 8 | | Sec. 3.20. Emergency Medical Services (EMS) Systems. | 9 | | (a) "Emergency Medical Services (EMS) System" means an
| 10 | | organization of hospitals, vehicle service providers and
| 11 | | personnel approved by the Department in a specific
geographic | 12 | | area, which coordinates and provides pre-hospital
and | 13 | | inter-hospital emergency care and non-emergency medical
| 14 | | transports at a BLS, ILS and/or ALS level pursuant to a
System | 15 | | program plan submitted to and approved by the
Department, and | 16 | | pursuant to the EMS Region Plan adopted for
the EMS Region in | 17 | | which the System is located. | 18 | | (b) One hospital in each System program plan must be
| 19 | | designated as the Resource Hospital. All other hospitals
which | 20 | | are located within the geographic boundaries of a
System and | 21 | | which have standby, basic or comprehensive level
emergency | 22 | | departments must function in that EMS System as
either an | 23 | | Associate Hospital or Participating Hospital and
follow all |
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| 1 | | System policies specified in the System Program
Plan, | 2 | | including but not limited to the replacement of drugs
and | 3 | | equipment used by providers who have delivered patients
to | 4 | | their emergency departments. All hospitals and vehicle
service | 5 | | providers participating in an EMS System must
specify their | 6 | | level of participation in the System Program
Plan. | 7 | | (c) The Department shall have the authority and
| 8 | | responsibility to: | 9 | | (1) Approve BLS, ILS and ALS level EMS Systems which
| 10 | | meet minimum standards and criteria established in rules
| 11 | | adopted by the Department pursuant to this Act, including
| 12 | | the submission of a Program Plan for Department approval.
| 13 | | Beginning September 1, 1997, the Department shall approve
| 14 | | the development of a new EMS System only when a local or
| 15 | | regional need for establishing such System has been
| 16 | | verified by the Department. This shall not be construed as | 17 | | a needs assessment for health
planning or
other purposes | 18 | | outside of this Act.
Following Department approval, EMS | 19 | | Systems must
be fully operational within one year from the | 20 | | date of
approval. | 21 | | (2) Monitor EMS Systems, based on minimum standards | 22 | | for
continuing operation as prescribed in rules adopted by | 23 | | the
Department pursuant to this Act, which shall include
| 24 | | requirements for submitting Program Plan amendments to the
| 25 | | Department for approval. | 26 | | (3) Renew EMS System approvals every 4 years, after
an |
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| 1 | | inspection, based on compliance with the standards for
| 2 | | continuing operation prescribed in rules adopted by the
| 3 | | Department pursuant to this Act. | 4 | | (4) Suspend, revoke, or refuse to renew approval of
| 5 | | any EMS System, after providing an opportunity for a
| 6 | | hearing, when findings show that it does not meet the
| 7 | | minimum standards for continuing operation as prescribed | 8 | | by
the Department, or is found to be in violation of its
| 9 | | previously approved Program Plan. | 10 | | (5) Require each EMS System to adopt written protocols
| 11 | | for the bypassing of or diversion to any hospital, trauma
| 12 | | center or regional trauma center, which provide that a | 13 | | person
shall not be transported to a facility other than | 14 | | the nearest
hospital, regional trauma center or trauma | 15 | | center unless the
medical benefits to the patient | 16 | | reasonably expected from the
provision of appropriate | 17 | | medical treatment at a more distant
facility outweigh the | 18 | | increased risks to the patient from
transport to the more | 19 | | distant facility, or the transport is in
accordance with | 20 | | the System's protocols for patient
choice or refusal. | 21 | | (6) Require that the EMS Medical Director of an ILS or
| 22 | | ALS level EMS System be a physician licensed to practice
| 23 | | medicine in all of its branches in Illinois, and certified | 24 | | by
the American Board of Emergency Medicine or the | 25 | | American Osteopathic Board
of Emergency Medicine, and that | 26 | | the EMS Medical
Director of a BLS level EMS System be a |
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| 1 | | physician licensed to
practice medicine in all of its | 2 | | branches in Illinois, with
regular and frequent | 3 | | involvement in pre-hospital emergency
medical services. In | 4 | | addition, all EMS Medical Directors shall: | 5 | | (A) Have experience on an EMS vehicle at the
| 6 | | highest level available within the System, or make | 7 | | provision
to gain such experience within 12 months | 8 | | prior to the
date responsibility for the System is | 9 | | assumed or within 90
days after assuming the position; | 10 | | (B) Be thoroughly knowledgeable of all skills
| 11 | | included in the scope of practices of all levels of EMS
| 12 | | personnel within the System; | 13 | | (C) Have or make provision to gain experience
| 14 | | instructing students at a level similar to that of the | 15 | | levels
of EMS personnel within the System; and | 16 | | (D) For ILS and ALS EMS Medical Directors,
| 17 | | successfully complete a Department-approved EMS | 18 | | Medical
Director's Course. | 19 | | (7) Prescribe statewide EMS data elements to be
| 20 | | collected and documented by providers in all EMS Systems | 21 | | for
all emergency and non-emergency medical services, with | 22 | | a
one-year phase-in for commencing collection of such data
| 23 | | elements. | 24 | | (8) Define, through rules adopted pursuant to this | 25 | | Act,
the terms "Resource Hospital", "Associate Hospital",
| 26 | | "Participating Hospital", "Basic Emergency Department",
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| 1 | | "Standby Emergency Department", "Comprehensive Emergency | 2 | | Department", "EMS
Medical Director", "EMS Administrative
| 3 | | Director", and "EMS System Coordinator". | 4 | | (A) (Blank). | 5 | | (B) (Blank). | 6 | | (9) Investigate the
circumstances that caused a | 7 | | hospital
in an EMS system
to go on
bypass status to | 8 | | determine whether that hospital's decision to go on bypass
| 9 | | status was reasonable. The Department may impose | 10 | | sanctions, as
set forth in Section 3.140 of the Act, upon a | 11 | | Department determination that the
hospital unreasonably
| 12 | | went on bypass status in violation of the Act. | 13 | | (10) Evaluate the capacity and performance of any | 14 | | freestanding emergency center established under Section | 15 | | 32.5 of this Act in meeting emergency medical service | 16 | | needs of the public, including compliance with applicable | 17 | | emergency medical standards and assurance of the | 18 | | availability of and immediate access to the highest | 19 | | quality of medical care possible.
| 20 | | (11) Permit limited EMS System participation by | 21 | | facilities operated by the United States Department of | 22 | | Veterans Affairs, Veterans Health Administration. Subject | 23 | | to patient preference, Illinois EMS providers may | 24 | | transport patients to Veterans Health Administration | 25 | | facilities that voluntarily participate in an EMS System. | 26 | | Any Veterans Health Administration facility seeking |
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| 1 | | limited participation in an EMS System shall agree to | 2 | | comply with all Department administrative rules | 3 | | implementing this Section. The Department may promulgate | 4 | | rules, including, but not limited to, the types of | 5 | | Veterans Health Administration facilities that may | 6 | | participate in an EMS System and the limitations of | 7 | | participation. | 8 | | (12) Ensure that EMS systems are transporting pregnant | 9 | | women to the appropriate facilities based on the | 10 | | classification of the levels of maternal care described | 11 | | under subsection (a) of Section 2310-223 of the Department | 12 | | of Public Health Powers and Duties Law of the Civil | 13 | | Administrative Code of Illinois. | 14 | | (13) Provide administrative support to the EMT | 15 | | Training, Recruitment, and Retention Task Force. | 16 | | (Source: P.A. 101-447, eff. 8-23-19.) | 17 | | (210 ILCS 50/3.22 new) | 18 | | Sec. 3.22. EMT Training, Recruitment, and Retention Task | 19 | | Force. | 20 | | (a) The EMT Training, Recruitment, and Retention Task | 21 | | Force is created to address the following: | 22 | | (1) the impact that the EMT and Paramedic shortage is | 23 | | having on this State's EMS System and health care system; | 24 | | (2) barriers to the training, recruitment, and | 25 | | retention of Emergency Medical Technicians throughout this |
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| 1 | | State; | 2 | | (3) steps that the State of Illinois can take, | 3 | | including coordination and identification of State and | 4 | | federal funding sources, to assist Illinois high schools, | 5 | | community colleges, and ground ambulance providers to | 6 | | train, recruit, and retain emergency medical technicians; | 7 | | (4) the examination of current testing mechanisms for | 8 | | EMRs, EMTs, and Paramedics and the utilization of the | 9 | | National Registry of Emergency Medical Technicians, | 10 | | including current pass rates by licensure level, national | 11 | | utilization, and test preparation strategies; | 12 | | (5) how apprenticeship programs, local, regional, and | 13 | | statewide, can be utilized to recruit and retain EMRs, | 14 | | EMTs, and Paramedics; | 15 | | (6) how ground ambulance reimbursement affects the | 16 | | recruitment and retention of EMTs and Paramedics; and | 17 | | (7) all other areas that the Task Force deems | 18 | | necessary to examine and assist in the recruitment and | 19 | | retention of EMTs and Paramedics. | 20 | | (b) The Task Force shall be comprised of the following | 21 | | members: | 22 | | (1) one member of the Illinois General Assembly, | 23 | | appointed by the President of the Senate, who shall serve | 24 | | as co-chair; | 25 | | (2) one member of the Illinois General Assembly, | 26 | | appointed by the Speaker of the House of Representatives; |
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| 1 | | (3) one member of the Illinois General Assembly, | 2 | | appointed by the Senate Minority Leader; | 3 | | (4) one member of the Illinois General Assembly, | 4 | | appointed by the House Minority Leader, who shall serve as | 5 | | co-chair; | 6 | | (5) 9 members representing private ground ambulance | 7 | | providers throughout this State representing for-profit | 8 | | and non-profit rural and urban ground ambulance providers, | 9 | | appointed by the President of the Senate; | 10 | | (6) 3 members representing hospitals, appointed by the | 11 | | Speaker of the House of Representatives, with one member | 12 | | representing safety net hospitals and one member | 13 | | representing rural hospitals; | 14 | | (7) 3 members representing a statewide association of | 15 | | nursing homes, appointed by the President of the Senate; | 16 | | (8) one member representing the State Board of | 17 | | Education, appointed by the House Minority Leader; | 18 | | (9) 2 EMS Medical Directors from a Regional EMS | 19 | | Medical Directors Committee, appointed by the Governor; | 20 | | and | 21 | | (10) one member representing the Illinois Community | 22 | | College Systems, appointed by the Minority Leader of the | 23 | | Senate. | 24 | | (c) Members of the Task Force shall serve without | 25 | | compensation. | 26 | | (d) The Task Force shall convene at the call of the |
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| 1 | | co-chairs and shall hold at least 6 meetings. | 2 | | (e) The Task Force shall submit its final report to the | 3 | | General Assembly and the Governor no later than January 1, | 4 | | 2024, and upon the submission of its final report, the Task | 5 | | Force shall be dissolved.
| 6 | | (210 ILCS 50/3.55)
| 7 | | Sec. 3.55. Scope of practice.
| 8 | | (a) Any person currently licensed as an EMR, EMT, EMT-I,
| 9 | | A-EMT, PHRN, PHAPRN, PHPA, or Paramedic may perform emergency | 10 | | and non-emergency medical
services as defined in this Act, in | 11 | | accordance with his or her level of
education, training and | 12 | | licensure, the standards of
performance and conduct prescribed | 13 | | by the Department in
rules adopted pursuant to this Act, and | 14 | | the requirements of
the EMS System in which he or she | 15 | | practices, as contained in the
approved Program Plan for that | 16 | | System. The Director may, by written order, temporarily modify | 17 | | individual scopes of practice in response to public health | 18 | | emergencies for periods not exceeding 180 days.
| 19 | | (a-5) EMS personnel who have successfully completed a | 20 | | Department approved
course in automated defibrillator | 21 | | operation and who are functioning within a
Department approved | 22 | | EMS System may utilize such automated defibrillator
according | 23 | | to the standards of performance and conduct prescribed by the
| 24 | | Department
in rules adopted pursuant to this Act and the | 25 | | requirements of the EMS System in
which they practice, as |
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| 1 | | contained in the approved Program Plan for that
System.
| 2 | | (a-7) An EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or | 3 | | Paramedic
who has successfully completed a Department approved | 4 | | course in the
administration of epinephrine shall be required | 5 | | to carry epinephrine
with him or her as part of the EMS | 6 | | personnel medical supplies whenever
he or she is performing | 7 | | official duties as determined by the EMS System. The | 8 | | epinephrine may be administered from a glass vial, | 9 | | auto-injector, ampule, or pre-filled syringe.
| 10 | | (b) An EMR, EMT,
EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or | 11 | | Paramedic may practice as an EMR, EMT, EMT-I, A-EMT, or | 12 | | Paramedic or utilize his or her EMR, EMT, EMT-I, A-EMT, PHRN, | 13 | | PHAPRN, PHPA, or Paramedic license
in pre-hospital or | 14 | | inter-hospital emergency care settings or
non-emergency | 15 | | medical transport situations, under the
written or verbal | 16 | | direction of the EMS Medical Director.
For purposes of this | 17 | | Section, a "pre-hospital emergency care
setting" may include a | 18 | | location, that is not a health care
facility, which utilizes | 19 | | EMS personnel to render pre-hospital
emergency care prior to | 20 | | the arrival of a transport vehicle.
The location shall include | 21 | | communication equipment and all
of the portable equipment and | 22 | | drugs appropriate for the EMR, EMT, EMT-I, A-EMT, or | 23 | | Paramedic's
level of care, as required by this Act, rules | 24 | | adopted
by the Department pursuant to this Act, and the | 25 | | protocols of
the EMS Systems, and shall operate only with the | 26 | | approval
and under the direction of the EMS Medical Director.
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| 1 | | This Section shall not prohibit an EMR, EMT, EMT-I, A-EMT, | 2 | | PHRN, PHAPRN, PHPA, or Paramedic
from practicing within an | 3 | | emergency department or
other health care setting for the | 4 | | purpose of receiving
continuing education or training approved | 5 | | by the EMS Medical
Director. This Section shall also not | 6 | | prohibit an EMT,
EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or | 7 | | Paramedic from seeking credentials other than his or her EMT, | 8 | | EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic
license and | 9 | | utilizing such credentials to work in emergency
departments or | 10 | | other health care settings under the
jurisdiction of that | 11 | | employer.
| 12 | | (c) An EMT,
EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic | 13 | | may honor Do Not Resuscitate (DNR) orders and powers
of | 14 | | attorney for health care only in accordance with rules
adopted | 15 | | by the Department pursuant to this Act and protocols
of the EMS | 16 | | System in which he or she practices.
| 17 | | (d) A student enrolled in a Department approved EMS | 18 | | personnel
program, while fulfilling the
clinical training and | 19 | | in-field supervised experience
requirements mandated for | 20 | | licensure or approval by the
System and the Department, may | 21 | | perform prescribed procedures
under the direct supervision of | 22 | | a physician licensed to
practice medicine in all of its | 23 | | branches, a qualified
registered professional nurse, or | 24 | | qualified EMS personnel, only when
authorized by the EMS | 25 | | Medical Director.
| 26 | | (e) An EMR, EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or |
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| 1 | | Paramedic may transport a police dog injured in the line of | 2 | | duty to a veterinary clinic or similar facility if there are no | 3 | | persons requiring medical attention or transport at that time. | 4 | | For the purposes of this subsection, "police dog" means a dog | 5 | | owned or used by a law enforcement department or agency in the | 6 | | course of the department or agency's work, including a search | 7 | | and rescue dog, service dog, accelerant detection canine, or | 8 | | other dog that is in use by a county, municipal, or State law | 9 | | enforcement agency. | 10 | | (f) Nothing in this Act shall be construed to prohibit an | 11 | | EMT, EMT-I, A-EMT, Paramedic, or PHRN from completing an | 12 | | initial Occupational Safety and Health Administration | 13 | | Respirator Medical Evaluation Questionnaire on behalf of fire | 14 | | service personnel, as permitted by his or her EMS System | 15 | | Medical Director. | 16 | | (g) An EMT, EMT-I, A-EMT, Paramedic, PHRN, PHAPRN, or PHPA | 17 | | shall be eligible to work for another EMS System for a period | 18 | | not to exceed 2 weeks if the individual is under the direct | 19 | | supervision of another licensed individual operating at the | 20 | | same or higher level as the EMT, EMT-I, A-EMT, Paramedic, | 21 | | PHRN, PHAPRN, or PHPA; obtained approval in writing from the | 22 | | EMS System's Medical Director; and tests into the EMS System | 23 | | based upon appropriate standards as outlined in the EMS System | 24 | | Program Plan. The EMS System within which the EMT, EMT-I, | 25 | | A-EMT, Paramedic, PHRN, PHAPRN, or PHPA is seeking to join | 26 | | must make all required testing available to the EMT, EMT-I, |
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| 1 | | A-EMT, Paramedic, PHRN, PHAPRN, or PHPA within 2 weeks after | 2 | | the written request. Failure to do so by the EMS System shall | 3 | | allow the EMT, EMT-I, A-EMT, Paramedic, PHRN, PHAPRN, or PHPA | 4 | | to continue working for another EMS System until all required | 5 | | testing becomes available. | 6 | | (Source: P.A. 102-79, eff. 1-1-22 .)
| 7 | | (210 ILCS 50/3.85)
| 8 | | Sec. 3.85. Vehicle Service Providers.
| 9 | | (a) "Vehicle Service Provider" means an entity
licensed by | 10 | | the Department to provide emergency or
non-emergency medical | 11 | | services in compliance with this Act,
the rules promulgated by | 12 | | the Department pursuant to this
Act, and an operational plan | 13 | | approved by its EMS System(s),
utilizing at least ambulances | 14 | | or specialized emergency
medical service vehicles (SEMSV).
| 15 | | (1) "Ambulance" means any publicly or
privately owned | 16 | | on-road vehicle that is specifically designed,
constructed | 17 | | or modified and equipped, and is intended to be
used for, | 18 | | and is maintained or operated for the emergency
| 19 | | transportation of persons who are sick, injured, wounded | 20 | | or
otherwise incapacitated or helpless, or the | 21 | | non-emergency
medical transportation of persons who | 22 | | require the presence
of medical personnel to monitor the | 23 | | individual's condition
or medical apparatus being used on | 24 | | such individuals.
| 25 | | (2) "Specialized Emergency Medical Services
Vehicle" |
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| 1 | | or "SEMSV" means a vehicle or conveyance, other
than those | 2 | | owned or operated by the federal government, that
is | 3 | | primarily intended for use in transporting the sick or
| 4 | | injured by means of air, water, or ground transportation,
| 5 | | that is not an ambulance as defined in this Act. The term
| 6 | | includes watercraft, aircraft and special purpose ground
| 7 | | transport vehicles or conveyances not intended for use on
| 8 | | public roads.
| 9 | | (3) An ambulance or SEMSV may also be
designated as a | 10 | | Limited Operation Vehicle or Special-Use Vehicle:
| 11 | | (A) "Limited Operation Vehicle" means a
vehicle | 12 | | which is licensed by the Department to provide
basic, | 13 | | intermediate or advanced life support emergency or
| 14 | | non-emergency medical services that are exclusively | 15 | | limited
to specific events or locales.
| 16 | | (B) "Special-Use Vehicle" means any
publicly or | 17 | | privately owned vehicle that is specifically designed,
| 18 | | constructed or modified and equipped, and is intended | 19 | | to be
used for, and is maintained or operated solely | 20 | | for the
emergency or non-emergency transportation of a | 21 | | specific
medical class or category of persons who are | 22 | | sick, injured,
wounded or otherwise incapacitated or | 23 | | helpless (e.g.
high-risk obstetrical patients, | 24 | | neonatal patients).
| 25 | | (C) "Reserve Ambulance" means a vehicle that meets | 26 | | all criteria set forth in this Section and all |
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| 1 | | Department rules, except for the required inventory of | 2 | | medical supplies and durable medical equipment, which | 3 | | may be rapidly transferred from a fully functional | 4 | | ambulance to a reserve ambulance without the use of | 5 | | tools or special mechanical expertise. | 6 | | (b) The Department shall have the authority and
| 7 | | responsibility to:
| 8 | | (1) Require all Vehicle Service Providers, both
| 9 | | publicly and privately owned, to function within an EMS
| 10 | | System.
| 11 | | (2) Require a Vehicle Service Provider
utilizing | 12 | | ambulances to have a primary affiliation with an EMS | 13 | | System
within the EMS Region in which its Primary Service | 14 | | Area is
located, which is the geographic areas in which | 15 | | the provider
renders the majority of its emergency | 16 | | responses. This
requirement shall not apply to Vehicle | 17 | | Service Providers
which exclusively utilize Limited | 18 | | Operation Vehicles.
| 19 | | (3) Establish licensing standards and
requirements for | 20 | | Vehicle Service Providers, through rules
adopted pursuant | 21 | | to this Act, including but not limited to:
| 22 | | (A) Vehicle design, specification,
operation and | 23 | | maintenance standards, including standards for the use | 24 | | of reserve ambulances;
| 25 | | (B) Equipment requirements;
| 26 | | (C) Staffing requirements; and
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| 1 | | (D) License renewal at intervals determined by the | 2 | | Department, which shall be not less than every 4 | 3 | | years. | 4 | | The Department's standards and requirements with | 5 | | respect to vehicle staffing for private, nonpublic local | 6 | | government employers must allow for alternative staffing | 7 | | models that include an EMR who
drives an ambulance with a | 8 | | licensed EMT, EMT-I, A-EMT,
Paramedic, or PHRN, as | 9 | | appropriate, in the patient
compartment providing care to | 10 | | the patient pursuant to the approval of the EMS System | 11 | | Program Plan developed and approved by the EMS Medical | 12 | | Director for an EMS System. The EMS personnel licensed at | 13 | | the highest level shall provide the initial assessment of | 14 | | the patient to determine the level of care required for | 15 | | transport to the receiving health care facility, and this | 16 | | assessment shall be documented in the patient care report | 17 | | and documented with online medical control. The EMS | 18 | | personnel licensed at or above the level of care required | 19 | | by the specific patient as directed by the EMS Medical | 20 | | Director shall be the primary care provider en route to | 21 | | the destination facility or patient's residence. The | 22 | | Department shall monitor the implementation and | 23 | | performance of alternative staffing models and may issue a | 24 | | notice of termination of an alternative staffing model | 25 | | only upon evidence that an EMS System Program Plan is not | 26 | | being adhered to. Adoption of an alternative staffing |
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| 1 | | model shall not result in a Vehicle Service Provider being | 2 | | prohibited or limited in the utilization of its staff or | 3 | | equipment from providing any of the services authorized by | 4 | | this Act or as otherwise outlined in the approved EMS | 5 | | System Program Plan, including, without limitation, the | 6 | | deployment of resources to provide out-of-state disaster | 7 | | response. EMS System Program Plans must address a process | 8 | | for out-of-state disaster response deployments that must | 9 | | meet the following: | 10 | | (A) All deployments to provide out-of-state | 11 | | disaster response must first be approved by the EMS | 12 | | Medical Director and submitted to the Department. | 13 | | (B) The submission must include the number of | 14 | | units being deployed, vehicle identification numbers, | 15 | | length of deployment, and names of personnel and their | 16 | | licensure level. | 17 | | (C) Ensure that all necessary in-state requests | 18 | | for services will be covered during the duration of | 19 | | the deployment. | 20 | | An EMS System Program Plan for a Basic Life Support , | 21 | | advanced life support, and critical care transport
| 22 | | utilizing an EMR and an EMT shall include the
following: | 23 | | (A) Alternative staffing models for a Basic Life | 24 | | Support transport utilizing an EMR and an EMT shall | 25 | | only be utilized for interfacility Basic Life Support | 26 | | transports as specified by the EMS System Program Plan |
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| 1 | | as determined by the EMS System Medical Director and | 2 | | medical appointments, excluding any transport to or | 3 | | from a dialysis center . | 4 | | (B) Protocols that shall include dispatch | 5 | | procedures to properly screen and assess patients for | 6 | | EMR-staffed transports and EMT-staffed Basic Life | 7 | | Support transport . | 8 | | (C) A requirement that a provider and EMS System | 9 | | shall implement a quality assurance plan that shall | 10 | | include for the initial waiver period the review of at | 11 | | least 5% of total interfacility transports utilizing | 12 | | an EMR with mechanisms outlined to audit dispatch | 13 | | screening , reason for transport, patient diagnosis, | 14 | | level of care, and the outcome of transports | 15 | | performed. Quality assurance reports must be submitted | 16 | | and reviewed by the provider and EMS System monthly | 17 | | and made available to the Department upon request. The | 18 | | percentage of transports reviewed under quality | 19 | | assurance plans for renewal periods shall be | 20 | | determined by the EMS Medical Director, however, it | 21 | | shall not be less than 3%. | 22 | | (D) The EMS System Medical Director shall develop | 23 | | a minimum set of requirements for individuals based on | 24 | | level of licensure that includes education, training, | 25 | | and credentialing for all team members identified to | 26 | | participate in an alternative staffing plan. The EMT , |
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| 1 | | Paramedic, PHRN, PHPA, PHAPRN, and critical care | 2 | | transport staff shall have the minimum at least one | 3 | | year of experience in performance of pre-hospital and | 4 | | inter-hospital emergency care , as determined by the | 5 | | EMS Medical Director in accordance with the EMS System | 6 | | Program Plan, but at a minimum of 6 months of | 7 | | prehospital experience or at least 50 documented | 8 | | patient care interventions during transport as the | 9 | | primary care provider and approved by the Department . | 10 | | (E) The licensed EMR must complete a defensive | 11 | | driving course prior to participation in the | 12 | | Department's alternative staffing model. | 13 | | (F) The length of the EMS System Program Plan for a | 14 | | Basic Life Support transport
utilizing an EMR and an | 15 | | EMT shall be for one year, and must be renewed annually | 16 | | if proof of the criteria being met is submitted, | 17 | | validated, and approved by the EMS Medical Director | 18 | | for the EMS System and the Department. | 19 | | (G) Beginning July 1, 2023, the utilization of | 20 | | EMRs for advanced life support transports and Tier III | 21 | | Critical Care Transports shall be allowed for periods | 22 | | not to exceed 3 years under a pilot program. The pilot | 23 | | program shall not be implemented before Department | 24 | | approval. Agencies requesting to utilize this staffing | 25 | | model for the time period of the pilot program must | 26 | | complete the following: |
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| 1 | | (i) Submit a waiver request to the Department | 2 | | requesting to participate in the pilot program | 3 | | with specific details of how quality assurance and | 4 | | improvement will be gathered, measured, reported | 5 | | to the Department, and reviewed and utilized | 6 | | internally by the participating agency. | 7 | | (ii) Submit a signed approval letter from the | 8 | | EMS System Medical Director approving | 9 | | participation in the pilot program. | 10 | | (iii) Submit updated EMS System plans, | 11 | | additional education, and training of the EMR and | 12 | | protocols related to the pilot program. | 13 | | (iv) Submit agency policies and procedures | 14 | | related to the pilot program. | 15 | | (v) Submit the number of individuals currently | 16 | | participating and committed to participating in | 17 | | education programs to achieve a higher level of | 18 | | licensure at the time of submission. | 19 | | (vi) Submit an explanation of how the provider | 20 | | will support individuals obtaining a higher level | 21 | | of licensure and encourage a higher level of | 22 | | licensure during the year of the alternative | 23 | | staffing plan and specific examples of recruitment | 24 | | and retention activities or initiatives. | 25 | | Upon submission of a renewal application and | 26 | | recruitment and retention plan, the provider shall |
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| 1 | | include additional data regarding current employment | 2 | | numbers, attrition rates over the year, and activities | 3 | | and initiatives over the previous year to address | 4 | | recruitment and retention. | 5 | | The information required under this subparagraph | 6 | | (G) shall be provided to and retained by the EMS System | 7 | | upon initial application and renewal and shall be | 8 | | provided to the Department upon request. | 9 | | The Department must allow for an alternative rural | 10 | | staffing model for those vehicle service providers that | 11 | | serve a rural or semi-rural population of 10,000 or fewer | 12 | | inhabitants and exclusively uses volunteers, paid-on-call, | 13 | | or a combination thereof.
| 14 | | (4) License all Vehicle Service Providers
that have | 15 | | met the Department's requirements for licensure, unless
| 16 | | such Provider is owned or licensed by the federal
| 17 | | government. All Provider licenses issued by the Department
| 18 | | shall specify the level and type of each vehicle covered | 19 | | by
the license (BLS, ILS, ALS, ambulance, critical care | 20 | | transport, SEMSV, limited
operation vehicle, special use | 21 | | vehicle, reserve ambulance).
| 22 | | (5) Annually inspect all licensed vehicles operated by | 23 | | Vehicle
Service Providers.
| 24 | | (6) Suspend, revoke, refuse to issue or refuse to
| 25 | | renew the license of any Vehicle Service Provider, or that
| 26 | | portion of a license pertaining to a specific vehicle
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| 1 | | operated by the Provider, after an opportunity for a
| 2 | | hearing, when findings show that the Provider or one or | 3 | | more
of its vehicles has failed to comply with the | 4 | | standards and
requirements of this Act or rules adopted by | 5 | | the Department
pursuant to this Act.
| 6 | | (7) Issue an Emergency Suspension Order for
any | 7 | | Provider or vehicle licensed under this Act, when the
| 8 | | Director or his designee has determined that an immediate
| 9 | | and serious danger to the public health, safety and | 10 | | welfare
exists. Suspension or revocation proceedings which | 11 | | offer an
opportunity for hearing shall be promptly | 12 | | initiated after
the Emergency Suspension Order has been | 13 | | issued.
| 14 | | (8) Exempt any licensed vehicle from
subsequent | 15 | | vehicle design standards or specifications required by the
| 16 | | Department, as long as said vehicle is continuously in
| 17 | | compliance with the vehicle design standards and
| 18 | | specifications originally applicable to that vehicle, or
| 19 | | until said vehicle's title of ownership is transferred.
| 20 | | (9) Exempt any vehicle (except an SEMSV)
which was | 21 | | being used as an ambulance on or before December 15,
1980, | 22 | | from vehicle design standards and specifications
required | 23 | | by the Department, until said vehicle's title of
ownership | 24 | | is transferred. Such vehicles shall not be exempt
from all | 25 | | other licensing standards and requirements
prescribed by | 26 | | the Department.
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| 1 | | (10) Prohibit any Vehicle Service Provider
from | 2 | | advertising, identifying its vehicles, or disseminating
| 3 | | information in a false or misleading manner concerning the
| 4 | | Provider's type and level of vehicles, location, primary
| 5 | | service area, response times, level of personnel, | 6 | | licensure
status or System participation.
| 7 | | (10.5) Prohibit any Vehicle Service Provider, whether | 8 | | municipal, private, or hospital-owned, from advertising | 9 | | itself as a critical care transport provider unless it | 10 | | participates in a Department-approved EMS System critical | 11 | | care transport plan. | 12 | | (11) Charge each Vehicle Service Provider a
fee per | 13 | | transport vehicle, due annually at time of inspection. The | 14 | | fee per transport vehicle shall be set by administrative | 15 | | rule by the Department and shall not exceed 100 vehicles | 16 | | per provider. | 17 | | (12) Beginning July 1, 2023, as part of a pilot | 18 | | program that shall not exceed a term of 3 years, an | 19 | | ambulance may be upgraded to a higher level of care for | 20 | | interfacility transports by an ambulance assistance | 21 | | vehicle with appropriate equipment and licensed personnel | 22 | | to intercept with the licensed ambulance at the sending | 23 | | facility before departure. The pilot program shall not be | 24 | | implemented before Department approval. To participate in | 25 | | the pilot program, an agency must: | 26 | | (A) Submit a waiver request to the Department with |
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| 1 | | intercept vehicle vehicle identification numbers, | 2 | | calls signs, equipment detail, and a robust quality | 3 | | assurance plan that shall list, at minimum, detailed | 4 | | reasons each intercept had to be completed, barriers | 5 | | to initial dispatch of advanced life support services, | 6 | | and how this benefited the patient. | 7 | | (B) Report to the Department quarterly additional | 8 | | data deemed meaningful by the providing agency along | 9 | | with the data required under subparagraph (A) of this | 10 | | paragraph (12). | 11 | | (C) Obtain a signed letter of approval from the | 12 | | EMS Medical Director allowing for participation in the | 13 | | pilot program. | 14 | | (D) Update EMS System plans and protocols from the | 15 | | pilot program. | 16 | | (E) Update policies and procedures from the | 17 | | agencies participating in the pilot program.
| 18 | | (Source: P.A. 102-623, eff. 8-27-21.)
| 19 | | Section 99. Effective date. This Act takes effect upon | 20 | | becoming law. |
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